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CMS Urges Healthcare Providers to Prepare for Post-PHE Regulatory and Operating Environment

Source: American Association for Homecare


In May, HHS reaffirmed the Agency’s commitment to providing at least 60 days’ advance notice before ending the ongoing COVID-19 Public Health Emergency (PHE).  Given that there are now just 51 days remaining until the current PHE is set to expire (Oct. 15), it is highly likely that the PHE will be renewed for another 90-day term and will continue until at least mid-January of 2023.

Last week, CMS released an overview titled Creating a Roadmap for the End of the COVID-19 Public Health Emergency to help healthcare providers prepare for the post-PHE environment.  In addition, CMS made a point to share the roadmap and other related resources in an email to Congressional healthcare staffers, noting that the Agency “encourages health care providers to prepare for the eventual end of these flexibilities as soon as possible and to begin moving forward to reestablishing previous health and safety standards for and billing practices.”

The actual end-date for the PHE remains unknown; the direction of COVID-19 case numbers and hospitalization rates going into the Fall will no doubt be a major consideration in making a final decision.  However, CMS’ efforts to develop guidance for providers and to share them with Capitol Hill suggest that policymakers are setting the stage to end the PHE as early as next year, and HME providers should prepare for the post-PHE regulatory and operational environment.

One of the major transition concerns for suppliers is the potential impact of expiring waivers of clinical indications for certain products and services, including home-based oxygen and continuous glucose monitors.  AAHomecare has engaged CMS on the need for continued coverage for individuals who qualified for these products during the pandemic and will continue work with policymakers to minimize disruption for patients when the PHE comes to a close. 

CMS’ new guidance includes this summary of waivers and flexibilities for DME.  In addition to the range of policy changes affecting our industry during the PHE, the summary notes that while the 50/50 blended rates for rural suppliers will remain in effect post-PHE thanks to the December 2021 DME Rule, the Agency reminds us that the 75/25 blended rates for  non-rural, non-CBAs are only in effect for the duration of the PHE (see DMEPOS Payment Increases, p. 2).

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