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The Public Health Emergency Is Extended: What This Means For You!

On Friday, October 2, 2020,  Alex M. Azar II, Secretary of Health and Human Services, renewed the Public Health Emergency (PHE) that went into effect on January 27, 2020 nationwide. This extension will be effective October 23, 2020. Click here to see the official renewal.

What does this mean for you?

On April 29, 2020, the Centers for Medicare & Medicaid Services (CMS) updated its guidance regarding several emergency waivers related to Medicare and Medicaid policy and regulatory revisions, which were originally issued on March 30, 2020, in response to the COVID-19 crisis.

Several temporary changes apply retroactively to March 1, 2020, across the entire U.S. healthcare system and will remain in effect for the duration of the emergency declaration, which is now extended for 90 days.

They include:

  • Replacement of Lost or Damaged DME. Where DME is lost or damaged, DME Medicare Administrative Contractors (MACs) now have the flexibility to waive certain replacement requirements typically required by Medicare. Specifically, CMS indicated that the requirements for a face-to-face encounter, new physician order, and new medical necessity documentation, which typically are required to support payment for a replacement item, are waived for the duration of the COVID-19 national emergency. CMS cautioned that DME suppliers should still include a narrative description on the claim explaining why the equipment must be replaced, and should properly document the loss or damage. CMS made this documentation waiver retroactive to include dates of service on or after March 1, 2020.
  • DME Payment Increases. As required by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, CMS will continue to adjust the fee schedule amounts for items and services furnished in rural and non-contiguous, non-competitive bidding areas based on a 50/50 blend of adjusted and unadjusted rates for the remainder of the COVID-19 public health emergency. Specific to DME suppliers, as required by the CARES Act, CMS will provide higher payments for certain DME items and services furnished in non-rural, non-competitive bidding areas within the contiguous United States with dates of service on or after March 6, 2020, through the remainder of the COVID-19 public health emergency.
  • Signature Requirements. Retroactive to March 1, 2020, CMS is waiving patient signature and proof-of-delivery requirements for DME when signatures cannot be obtained because of the COVID-19 emergency. When this occurs, DME suppliers should document in the medical record the appropriate date of delivery and indicate that the signature could not be obtained due to COVID-19. Separately, DME items may be provided via a physician’s verbal order, although a signature (which may be electronic) is still required prior to submitting claims for payment.

Please contact any of the VGM Government team members for additional information on these waivers by calling, 1.800.642.6065, or emailing Emily Harken. VGM will continue to monitor COVID-19-related developments and provide updates.