CMS Interim-Final COVID-19 Rule: Deep Dive Into Blanket Waivers and Flexibilities

After receiving feedback from the ACC and other leading medical associations and groups, the Centers for Medicare and Medicaid Services (CMS) issued an interim-final rule this week formalizing many temporary waivers and flexibilities to streamline response to the COVID-19 pandemic. The rule also expands the list of eligible Medicare telehealth services and alters MIPS requirements and extensions. Learn about the telehealth updates here, and coverage and quality policy updates here.

As part of the interim-final rule, CMS issued the following updates to blanket waivers and implemented a variety of additional burden relief changes for the COVID-19 public health emergency (PHE):

Blanket Waivers and Burden Relief

  • Blanket waivers of sanctions under the Physician Self-Referral Law (also known as the "Stark Law").
  • Provider enrollment relief that would allow temporary billing privileges for providers. The agency is waiving certain screening requirements and providing hotlines for each MAC for providers with questions/assistance and to provide expedited enrollment.
  • Suspension of in process and future Medicare Fee-For-Service (FFS) medical reviews including pre-payment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program, and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC) for the duration of the PHE. 
  • Temporarily waive requirements that out-of-state practitioners be licensed in the state where they are providing services when they are licensed in another state under certain conditions. *This is not a waiver of Telehealth across state lines; that must still be navigated state-by-state.

These temporary program changes and waivers are explained in greater specificity in either the interim-final rule, supplementary fact sheets, or both. See "Related Content" to learn more. ACC staff continue to work with the House of Medicine to monitor regulatory updates and provide feedback to CMS.

Keywords: Coronavirus, ACC Advocacy, Medicare, Centers for Medicare and Medicaid Services, U.S., COVID-19, Medicaid, Physician Self-Referral

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