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CMS eases hospital regulations amid COVID-19 pandemic

by John R. Fischer, Senior Reporter | April 01, 2020
CMS is allowing hospitals and health systems to care for patients at outside facilities to create more capacity for coronavirus patients.
The Centers for Medicare and Medicaid Services is lightening up on a number of hospital regulations in the midst of the Coronavirus pandemic, including where hospitals deliver services.

The federal healthcare agency has implemented CMS Hospitals Without Walls, a temporary policy that enables hospitals to care for patients at outside facilities such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels and dormitories. The aim is to increase capacity for treating patients with COVID-19, especially those in need of ventilators and intensive care.

“For example, a healthcare system can use a hotel to take care of patients needing less intensive care while using its inpatient beds for COVID-19 patients,” said CMS in a statement.

Under the policy, hospitals will continue to receive payments under Medicare, even for patients treated outside its physical location. Ambulatory surgery centers can contract with local healthcare systems to provide hospital services, or enroll and bill as hospitals throughout the course of the pandemic, provided they are consistent with their state’s Emergency Preparedness or Pandemic Plan. Doctor-owned hospitals can also increase their number of beds without incurring sanctions.

Outside facilities will be permitted to perform services typically provided by hospitals, including cancer procedures, trauma surgeries and other essential surgeries, and ambulances can transport patients to a wider range of locations when other forms of transport are not medically appropriate. These include community mental health centers, federally qualified health centers, physician’s offices, urgent care facilities, ambulatory surgery centers, and any locations furnishing dialysis services when an ESRD facility is not available.

Medicare will pay lab technicians to travel and collect specimens for COVID-19 testing from beneficiaries to limit risk of exposure to beneficiaries and others. “Under certain circumstances, hospitals and other entities will also temporarily be able to perform tests for COVID-19 on people at home and in other community-based settings,” said the agency.

CMS has also issued guidelines permitting healthcare systems, hospitals and communities to set up sites exclusively dedicated to testing and screening for COVID-19, as well as on circumstances in which emergency departments can test and screen COVID-19 patients at drive-through and off-campus test sites. Instructions for establishing special purpose facilities for the care of COVID-19 patients at dialysis sites are also available.

“Patients receiving dialysis are our most vulnerable Americans, susceptible to complications from the virus, since they are immunocompromised and need regular treatments, often within a healthcare facility,” said CMS.

Other regulatory changes include ease in provider enrollment for Medicare; a blanket waiver to allow hospitals to provide benefits and support to their medical staffs; the temporary elimination of paperwork requirements such as written policies and visitation of patients in COVID-19 isolation; and the expansion of access to telehealth services for Medicare beneficiaries.

More than 3,500 deaths have resulted from the pandemic out of a total of 180,789 cases in the U.S., which has the highest number of cases in the world, according to Worldometer.

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