CMS Clarifies Time Frame for Phase-Out of Face-to-Face Telehealth Flexibilities
CMS Clarifies Time Frame for Phase-Out of Face-to-Face Telehealth Flexibilities
Courtesy of the National Association for Home Care & Hospice (NAHC)
On August 18, 2022, the Centers for Medicare & Medicaid Services (CMS) issued extensive materials providing guidance related to the planned phase-out of various waivers, regulations, enforcement discretion, and sub-regulatory guidance that were utilized to ensure access to care and give health care providers the flexibilities needed to respond to COVID-19 Public Health Emergency (PHE). According to the documents, most of these waivers and broad flexibilities will terminate at the eventual end of the PHE, as they were intended to address the acute and extraordinary circumstances of a rapidly evolving pandemic and not replace existing requirements.
As part of the documents, CMS indicated that the flexibilities currently allowing home health agencies and hospices to utilize telehealth for completion of their respective face-to-face encounter requirements would terminate with the end of the PHE. Following are excerpts from the Fact Sheets issued by CMS relative to the telehealth flexibilities:
Home Health: “The required face-to-face encounter for home health can be conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time interaction between the physician/allowed practitioner and the patient) when the patient is at home. The face-to-face encounter can be conducted via telehealth irrespective of the COVID-19 PHE; however, the waiver only extends the “originating site” to the patient’s home during the duration of the COVID-19 PHE.”
Hospice: “Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (i.e., two-way audio-video telecommunications technology that allows for real-time interaction between the hospice physician/hospice nurse practitioner and the patient). This waiver will expire at the end of the PHE.”
However, under the Consolidated Appropriations Act of 2022 (CAA 2022) Congress enacted provisions that extend the geographic and originating site requirement waivers (Section 301) and the waiver allowing the use of telehealth to perform the hospice face-to-face encounter (Section 306) for 151 days following the end of the PHE.
The National Association for Home Care & Hospice (NAHC) wrote to CMS officials requesting that they revise the guidance to reflect these legislative changes.
In response to NAHC’s request, CMS officials have acknowledged the changes made by the CAA 2022 and have indicated that they are in the process of correcting the fact sheets to reflect that the home health and hospice face-to-face telehealth waivers will remain in effect through the 151st day following the end of the PHE. Home health and hospices should expect to see revisions made to the fact sheets in the near future.
On a related matter, legislation (Advancing Telehealth Beyond COVID-19 Act of 2021, H.R.4040) recently passed the House of Representatives that would extend the originating site and geographic location waivers, as well as the hospice face-to-face telehealth waiver, through the end of 2024. The legislation is awaiting action in the Senate. Home health and hospice stakeholders are asked to contact their Senators to urge their support for the passage of H.R.4040.
Following are links to pertinent materials that were issued by CMS on August 18 related to the phase-out of various PHE flexibilities: