HHS Renews Public Health Emergency, Regulatory Flexibilities

HHS has renewed the COVID-19 public health emergency, extending key regulatory flexibilities such as Medicare telehealth reimbursement and higher rates for COVID-19 hospitalizations through April.

The 90-day extension of the public health emergency, effective January 21, 2021, will help hospitals and health systems battle the ongoing COVID-19 pandemic in their communities, HHS Secretary Alex Azar said on Twitter on Jan. 7.

“Our work to combat the virus will continue, as will our work to ensure a peaceful and orderly transition,” tweeted Azar, whose tenure as leader of HHS will come to a close when President-elect Joe Biden takes office later this month.

Biden has nominated Xavier Becerra, California’s Attorney General and one of the chief architects behind the Affordable Care Act’s defense in the current Supreme Court case, to be the next HHS Secretary, pending Congressional approval.

This is the fourth time HHS has renewed the COVID-19 public health emergency, with the last being in October.

The public health emergency, first enacted on Jan. 31, 2020, implemented a number of blanket waivers and regulatory flexibilities for healthcare providers to deliver fast, flexible care to infected patients while maintaining access to care for those without the novel coronavirus.

Increased telehealth coverage for Medicare beneficiaries was a key flexibility HHS has offered providers through the public health emergency. The department has added over 200 telehealth codes that are reimbursable during the public health emergency, including emergency department visits, initial inpatient and nursing facility visits, and discharge day management services.

HHS has also allowed more types of providers to bill Medicare for telehealth services given during the public health emergency and granted waivers enabling reimbursement for audio-only telehealth services.

Through the public health emergency, HHS has also paid providers 20 percent more for caring for hospitalized COVID-19 patients and waived major rules, including the long-term care hospital (LTCH) site-neutral payment policy, the LTCH “50% Rule,” and the inpatient rehabilitation facility “3-Hour Rule” for all providers.

The department has also granted providers more flexibility with where they provide care to patients and waived certain reporting requirements for the duration of the emergency.

The waivers and regulatory flexibilities have been critical to provider response efforts to COVID-19, especially since the number of new cases, hospitalizations, and deaths continue to increase across the country.

But healthcare providers are also calling on HHS to make certain flexibilities and waivers part of the permanent regulatory landscape in healthcare. For instance, providers have urged the department to keep telehealth payment parity even after COVID-19 cases go down and can be managed by providers.

“Payment parity is an important policy because it affects their financial stability; in fact, before COVID-19, finances were a significant barrier to their using telehealth at all,” the University of Kansas Medical Center recently said in a Dec. report. “Some practices would not have started using telehealth were it not for COVID-19. The nature of the disease itself (the need for less physical contact and more social distancing) certainly drove some of the increase in telehealth offering and use, but the reimbursement and other policy changes likely also played a part.”

States have started to pass legislation making telehealth payment parity or payment at all permanent, but providers are calling for HHS to set the example and make telehealth a key part of Medicare coverage.

For now, blanket waivers and other regulatory flexibilities will last until April when the HHS Secretary will have to reassess the state of COVID-19 in the country.

For a comprehensive list of waivers and flexibilities, click here.