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COVID-19 Interim Final Rule Released

Yesterday CMS issued another round of sweeping regulatory waivers and rule changes to deliver expanded care and provide flexibility to the healthcare system as America reopens. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services. The Interim Final Rule (IFR) includes new rules to support and expand COVID-19 testing, increase hospital capacity, and allows more diabetic patients to monitor their glucose and adjust insulin doses at home.

Specific items related to DMEPOS include:

  • Addresses the 75/25 blended rates for non-rural, non-competitive bid areas being implemented beginning March 6, 2020 based on the CARES Act legislation. 
  • Adds PTs/OTs to the list of eligible practitioners who can conduct telehealth visits. 
  • CMS will not be enforcing the clinical indications for therapeutic continuous glucose monitors in LCDs during this PHE. 
  • Provides clarification on the first IFR that was published on March 31 regarding waiving clinical indications for coverage for respiratory, home anticoagulation management and infusion pump NCDs and LCDs (including articles), stating that even though the clinical conditions for coverage are being waived, the items and services must still be “reasonable and necessary."

The VGM Government Relations and Regulatory team will continue to review the IFR over the weekend and will report more information next week.

Click here to view the full CMS press release and the IFR in its entirety.