HHS Extends Public Health Emergency, COVID-19 Payment Flexibility

HHS recently extended the national public health emergency declared for the COVID-19 pandemic, thereby extending COVID-19 payment and regulatory flexibilities granted during the period.

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The declaration signed on Thursday renewed the public health emergency first declared at end of January just days before it was slated to expire on July 25, 2020. Without the new declaration, statutory and regulatory flexibilities, like the 20 percent add-on Medicare payment, would cease.

The new declaration will extend the national public health emergency for another 90 days, according to the Public Health Service Act.

“The Administration will continue its whole-of-America response to ensure Americans can get the care they need throughout the pandemic,” HHS Secretary Alex Azar said in a tweet on July 23.

HHS has released a wide range of waivers and regulatory flexibilities during the public health emergency to support healthcare providers during the pandemic. Among the flexibilities are Medicare payment and billing changes that aim to close the funding shortfall experienced by many organizations as a result of COVID-19.

For example, Medicare will pay a 20 percent add-on payment for inpatient hospital COVID-19 patients for the duration of the public health emergency. Medicare also released waivers for COVID-19 patients during the emergency period, including the long-term care hospital (LTCH) site-neutral payment policy, the LTCH “50% Rule,” and the inpatient rehabilitation facility “3-Hour Rule.”

Additionally, HHS has implemented key telehealth payment and coverage flexibilities during the public health emergency, including expanded coverage of telehealth services delivered to Medicare beneficiaries in a wider range of locations.

The department also allowed for higher reimbursement rates for the newly allowed telehealth services.

Earlier this month, about two-thirds of primary care clinicians responding to a survey said they are not prepared for a loss or reduction in telehealth reimbursement rates. Additionally, less than 10 percent said their practice could survive the pullback in payment.

HHS is contemplating making some of the waivers and flexibilities granted during the public health emergency permanent. Significant adoption of telehealth services during the pandemic, for example, has led CMS to consider lasting changes to Medicare coverage of telehealth and higher reimbursement for the services.

With the newly extended public health emergency, however, providers have at least another couple of months to leverage the waivers and flexibilities to support their pandemic response efforts.

“This action will allow us to continue our efforts to ensure that hospitals and health systems are using every tool available to respond to COVID-19,” Rick Pollack, president and CEO of the American Hospital Association (AHA), said in a statement.

The AHA previously called on HHS Secretary Azar to extend the public health emergency in a June 19th letter expounding the benefits of waivers and flexibilities during the pandemic. The Association also recently advocated for the permanent implementation of certain waivers and flexibilities, including expanded telehealth coverage and payment, elimination of specific practice limitations on nurse practitioners, site-neutral payment exceptions, and the scaling back of Medicare Conditions of Participation.

“The declaration of a public health emergency has given hospitals and health systems and our caregivers the ability to respond in an innovative, timely and decisive manner to the virus,” Pollack stated. “It has been an invaluable tool in the battle against COVID-19 by providing the necessary resources to care for patients and communities, such as expanded use of telemedicine and the ability to provide care in alternative care sites.”