At both the state and federal level, much of the coronavirus policy response has focused on deregulatory efforts to assist the effort of frontline health care workers. Lawmakers and state leaders around the country have relaxed regulations on things like certificate of need laws, medical licensure laws, and scope of practice laws.

Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced significant regulatory changes that will provide massive flexibility to the health care system as they face unprecedented challenges in caring for patients during this time. A CMS article details the changes in the following four areas which I summarize below: 

  • Increase in Hospital Capacity – Typically, under CMS rules, a hospital must provide services in its facility. However, under the new rule change, hospitals may now transfer patients to alternate locations such as ambulatory surgery centers, rehabilitation hospitals, hotels, and dormitories and still bill Medicare as if the service was provided in a hospital. The new rule will also allow ambulatory surgery centers to contract with local health care systems to provide care for patients and bill CMS as a hospital. CMS hopes these sites will help to care for patients who need care other than that related to the coronavirus. Also, CMS gives additional guidance for how hospitals and emergency departments can set up testing sites on- and off-campus. Specifically, in Medicare, lab technicians could travel to a patient’s home to collect a test.
  • Expanding the Health Care Workforce – to expand the health care workforce, CMS is making the following changes: 
    • Making it easier for hospitals to provide benefits to medical staff, such as multiple meals a day, laundry service, or child care services. 
    • Making it easier for providers to enroll in Medicare 
    • Allowing medical residents to provide services under the direction of a teaching physician 
    • Permitting a more extensive use of verbal, instead of written, orders by hospital doctors 
    • Waiving requirements for nurses to conduct visits to home health and hospice care
  • Reducing Paperwork – CMS is temporarily suspending paperwork requirements to give physicians more time with patients. In addition, CMS will stop requesting certain oversight documents from providers and reduce audits in Medicare Advantage and other Medicare plans.
  • Further Promoting Telehealth in Medicare – CMS is now paying for an additional 80 services that can be provided via telehealth. This includes increasing the number of services that will be paid for by Medicare and increasing the number of facilities that can provide services and bill Medicare. It also eliminates many of the regulations that require patients to have an established relationship with a doctor before seeking telemedicine services. 

CMS is building on its current deregulatory mission to help the frontline health care workers as well as increase the options patients have to seek care while following social distancing guidelines.