CMS Waives Hospice Requirements and Expands Telehealth in Response to COVID-19 Pandemic

Categories: In The Media and Policy.

Flexibilities that NHPCO has advocated for will support hospice providers in caring for patients and families during the COVID-19 crisis.

Last night, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced new regulatory flexibilities and rules in response to the coronavirus pandemic.  CMS granted blanket Medicare waivers for hospice providers and expanded the use of telehealth for hospice visits.  The National Hospice and Palliative Care Organization (NHPCO) sought these regulatory changes to ensure that hospice providers across the nation could continue to provide uninterrupted person-centered care to their patients and families during this national emergency.

“During the national emergency, flexibilities are needed to allow hospice providers to continue providing quality care for patients and family caregivers as the COVID-19 pandemic impacts every aspect of society,” said NHPCO President and CEO Edo Banach.

“Several of these flexibilities are things that NHPCO has been advocating for since the crisis began and we appreciate CMS understanding of this; however, there are further provisions necessary to minimize exposure to the virus, protect staff, and accurately reflect care that is provided,” Banach added.

The flexibilities provided to hospice are temporary and have a retroactive effective date of March 1, 2020.  With yesterday’s announcement of blanket waivers, states and providers no longer need to apply for these waivers individually and can begin using the flexibilities immediately. The flexibilities waive requirements for use of volunteers, comprehensive assessments, some non-core services, and waives the requirement for the nurse aide supervision during this national emergency.

In addition to the flexibilities provided by these blanket waivers, CMS also issued an Interim Final Rule providing guidance on the use of telehealth for hospice visits. CMS is allowing telehealth to fulfill face-to-face recertification requirements.

Hospice providers can also provide services to a Medicare patient receiving routine home care through virtual visits which is particularly helpful for members of the hospice interdisciplinary team visiting their patients in inpatient facilities or in cases where family caregivers are reluctant to allow the team into the home. .

Although NHPCO is encouraged by the Administration’s efforts to expand telehealth, we are concerned about the inflexibility in counting of visits on the required claim forms, reporting requirements and payment.

“I applaud CMS for promoting telehealth for hospice but am concerned about the impact on quality reporting and the financial burden on hospice providers, which unlike institutional providers do not get separate supports for technology or training” said Banach.

NHPCO has created a page with information and helpful links for providers at www.nhpco.org/coronavirus.