The Centers for Medicare and Medicaid Services (CMS) has released a fact sheet addressing the end of the COVID-19 Public Health Emergency (PHE) and the impact it will have on waivers, flexibilities, and healthcare services. While some changes that were made will remain in place, others will expire. Continue reading to learn about the impact ending the PHE may have on healthcare.
The agency has issued a fact sheet addressing flexibilities authorized during the COVID-19 federal public health emergency (PHE).
CMS has issued a fact sheet, CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency, which addresses the following areas:
COVID-19 vaccines, testing, and treatments
- Telehealth services
- Waiver flexibility
- Hospital-at-home care
- Provider scope and oversight flexibility
- Medicaid continuous enrollment
In the fact sheet, CMS noted the PHE’s widespread impact on “many aspects of health care delivery,” including those that allowed for more streamlined and flexible services. CMS notes: “While some of these changes will be permanent or extended due to Congressional action, some waivers and flexibilities will expire, as they were intended to respond to the rapidly evolving pandemic, not to permanently replace standing rules.”
Mandatory coverage of COVID-19 services will vary by payer after the PHE expires.
Traditional Medicare beneficiaries will continue to have coverage for vaccines, testing and COVID-19-related treatment. Exceptions include tests that are not ordered by healthcare providers (over the counter) and possible cost-sharing for Medicare Advantage (MA) members.
Among private payers, most must continue to offer no-cost vaccines delivered in network. Mandatory coverage of COVID-19 PCR and antigen tests will expire, will continue at the insurer’s discretion, and may involve some cost to members. Treatment coverage and associated cost-sharing and deductibles will not change unless the carrier does so.
Continued access to and reimbursement of telehealth services will vary by payer after the end of the PHE.
Via the Consolidated Appropriations Act of 2023, original Medicare will retain the following benefits through December 31, 2024:
- General access to telehealth, regardless of where they live and not dependent upon residence in a rural area.
- Access to home-based telehealth services versus those delivered in a healthcare facility.
- Audio-only telehealth services (e.g., telephone) if other resources are not available (e.g., video, smartphone, computer).
CMS implemented the Acute Hospital Care at Home initiative to allow hospitals to provide expanded at-home care during the pandemic. That initiative will stay in place through the end of 2024 as approved by the Consolidated Appropriations Act of 2023. This will allow new patients to participate and maintain continuing for those already receiving at-home care as a part of the program.
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Original article posted on healthleadersmedia.com