The number of confirmed COVID-19 cases in the US stands at 235,747 and the virus has caused 5,624 deaths in country, according to a Live Science report at the time of this writing, As the COVID-19 crisis evolves, the Centers for Medicare & Medicaid Services (CMS) is taking several steps to aggressively respond to the situation. Our medical billing company reported on the actions CMS took to expand telemedicine and to ease Medicare claims submission and processing. CMS has announced several temporary regulatory changes to support the healthcare industry during the COVID-19 public emergency.

“Front-line healthcare providers need to be able to focus on patient care in the most flexible and innovative ways possible. This unprecedented temporary relaxation in regulation will help the healthcare system deal with patient surges by giving it tools and support to create nontraditional care sites and staff them quickly,” said Seema Verma, CMS administrator.

Here are the core points of the broad flexibilities CMS has granted to hospitals, physicians and healthcare organizations:

  • Expansion of Hospital Capacity: The requirement that hospitals should deliver care within their own premises has been waived. The catchword is “Hospitals without Walls”, meaning that hospitals are now allowed to leverage other venues to handle the influx of COVID19 patients. This flexibility will allow hospitals to:
    • Transfer patients needing less intensive care (without COVID-19) to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories
    • Reserve inpatient beds for COVID-19 patients
    • Use available community resources to manage the expected patient surge, without relying on the Federal Emergency Management Agency
    • Bill for the services provided outside of their four walls

CMS has also waived the limit on the number of beds physician-owned hospitals can have.

  • Expanded Role for Ambulatory Surgical Centers: The new flexibilities allow ASCs to:
    • Contract with local health care systems to provide hospital services or enroll and bill as hospitals during the emergency
    • Perform hospital services such as cancer procedures, trauma surgeries, and other essential surgeries
    • Receive reimbursement at the hospital rate

Commenting on ASCs’ new role in fighting the COVID-19 crisis, Michelle George, MSN, RN, president of the California Ambulatory Surgery Association said, “We have valuable resources to lend to this crisis – whether it is staff, space, equipment, supplies or other capabilities. ASCs are coordinating with the public health teams on local and regional levels to identify how their facilities can be utilized most effectively on a case-by-case basis” (www.beckersasc.com).

  • Ambulance Transport to Additional Locations: The changes allow ambulances to transport to a broader range of sites when other transportation is not medically appropriate. These locations include physicians’ offices, urgent care facilities, community mental health centers, federally qualified health centers, ambulatory surgery centers and any sites furnishing dialysis services when an ESRD facility is not available.
  • Expansion of healthcare workforce: Hospitals have the flexibility to boost their workforce in various ways.
    • A “blanket waiver” allows hospitals to provide benefits to medical staff, such as multiple daily meals, laundry service for personal clothing, or child care services while the staff is at the hospital providing patient care.
    • Teaching hospitals can use residents to provide health care services under the guidance of a teaching physician, who may be available through audio/video technology.
    • CMS has made it easier for providers to register in Medicare, so that physician assistants, nurse practitioners and other healthcare professionals can provide certain services that previously required a physician’s order.

The efforts to boost staff also come with administrative flexibilities, for e.g., hospitals can use more verbal over written orders to keep doctors focused on patient care. Hospitals will not be required to have written policies on processes and visitation of patients who are in COVID-19 isolation. Hospitals will also have more time to provide patients a copy of their medical record.

  • COVID-19 Testing expanded: The new CMS guidelines have expanded COVID-19 testing facilities:
    • Healthcare systems, hospitals, and communities can set up exclusive testing and screening sites in order to identify COVID-19 positive patients in a safe environment.
    • Special centers and dialysis facilities can be set up to treat COVID-19 patients.
    • Hospitals, laboratories and other entities can perform tests for COVID-19 on people at home. Medicare will pay for lab companies to collect samples in people’s homes and nursing homes.
    • Hospital emergency departments can test and screen patients for COVID-19 at drive-through and off-campus test sites.

The American Medical Association has released guidelines on CPT reporting for COVID-19 testing and medical billing companies can help providers report their services using these codes.

  • Expansion of Telehealth Services: CMS has eased many restrictions on telehealth services during the COVID-19 emergency:
    • CMS will pay for more than 80 supplementary services when provided via telehealth, including ED visits and initial nursing facility and discharge visits.
    • Physicians can assess Medicare beneficiaries using any type of telephone, including audio-only phone, as well as interactive apps with audio and video capabilities.
    • Home health and hospice providers can provide more services using telehealth if it is part of the patient’s care plan and does not replace needed in-person visits.

All of the agency’s measures are aimed at providing the American healthcare system with maximum flexibility to deal with patient surges during the COVID-19 emergency. Medical billing service providers will also lend their support to help front line healthcare providers stay in practice they focus on patient care.