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Earlier today, President Donald Trump declared a national emergency under the National Emergencies Act in response to spread of the novel coronavirus (COVID-19). Doing so invokes section 1135 of the Social Security Act, allowing the Secretary of Health and Human Services (HHS) to exercise the authority to temporarily waive or modify certain requirements of the Medicare, Medicaid, and State Children’s Health Insurance programs (CHIP) and of the Health Insurance Portability and Accountability Act Privacy Rule (HIPAA) throughout the duration of the public health emergency declared in response to the COVID-19 outbreak. The “1135 waiver” is intended to provide regulatory and programmatic flexibility to ensure that providers have access to the resources they need in order to continue providing timely and necessary care during this crisis.
Late this evening, CMS released a fact sheet listing the blanket waivers that are now available as a result of the declaration. These include waiving the Medicare “3-day rule” that requires a patient spend 3 inpatient days in a hospital before becoming eligible for a skilled nursing facility (SNF) stay, waiving licensure rules to allow Medicare and Medicaid providers to deliver care across state lines, and waiving rules to allow hospitals to take care of acute care patients in more spaces on their property, among others. It is expected that HHS will issue additional waivers in the near future, especially those related to telehealth flexibilities.
Taking this critical step is an important action that will help the healthcare system more swiftly direct its resources and expertise where they are needed most and most quickly. Many of the waivers and modifications will be especially important for those facing serious illness, given their heightened risk of infection and poor outcomes.
- Read the president’s remarks on his declaration HERE.
- See the list of CMS 1135 waivers HERE
- For more background on 1135 waivers, please click HERE.
- If you have specific questions about the 1135 waivers CMS has issued, you can email firstname.lastname@example.org
C-TAC will be sharing updates from CMS regarding Section 1135 waivers and guidance related to COVID-19 as they become available. For more information about C-TAC’s legislative and regulatory efforts, please contact Policy & Advocacy Manager Davis Baird at DBaird@theCTAC.org.