The coronavirus health care crisis is evolving rapidly. 
Information changes often.  We want to help you keep up. 
This list provides links to some of the important new developments. 
 

Homebound eligibility 
CMS says COVID-19 patients will meet eligibility requirements for home care as long as their physician (or certain other provider types) has documented that they do not need to leave home due to a confirmed or suspected diagnosis of COVID-19. This relaxation of homebound status requirements will also apply to patients whose underlying medical conditions make the patient more susceptible to COVID-19.  As always, documentation by the physician or other provider (see below)  must show that the patient requires skilled services and why. It should fully address the risk to the patient if services are not provided. Note that the patient may be certified now for home health by providers other than a physician -- specifically, a nurse practitioner, clinical nurse specialist or physician assistant.  Click here to read the PDF from CMS.

Non-physician certification

CMS will allow the patient to be certified for home health by providers other than a physician -- specifically, a nurse practitioner, clinical nurse specialist or physician assistant. CMS has said that no audits will be conducted for episodes of care during the public health emergency for the purpose of making sure that only a physician certified the patient for home care, issued the orders and signed the plan of care. Click here to read the PDF from CMS. 

OASIS delays
CMS will not hold agencies to the 5-day completion requirement for the comprehensive assessment and will waive the 30-day submission requirement. However, agencies are still expected to complete the assessment in order to determine patient needs and develop the plan of care.  Click to read the PDF from CMS. 



Review Choice Demonstration paused

CMS has paused its Review Choice Demonstration in Illinois, Texas and Ohio, effective for all claims submitted on or after March 29, through the end of the public health emergency. These claims will not be subject to the review. The Review Demonstration will not begin in Florida and North Carolina on May 4 as previously scheduled. Click here to read provider FAQs from CMS addressing this issue. 


Telehealth for home health and hospice 

CMS will allow the face-to-face encounter between patient and physician which is required for home health eligibility to take place via telehealth during the COVID-19 crisis. Hospice may rely on telehealth for the face-to-face encounter which is required for recertification. However, CMS said agencies should not rely on telehealth instead of needed in-person visits to the homes of patients. Telehealth may be used otherwise as long as it meets needs set out in the patient's plan of care.  Click to read PDF. 
Both home health and hospice are encouraged by CMS to rely on telehealth for supervision of aides when a nurse is unavailable to perform the two-week supervisory visit. 

Are you confused about what is and is not allowed under relaxed telehealth rules during the COVID-19 crisis? The Department of Health and Human Services Office of Civil Rights has released some FAQs for guidance. Click here to read FAQs.


Quality reporting exceptions 
CMS is releasing home health and hospice providers from quality reporting requirements for the first two quarters of 2020, and making it optional for agencies to report quality data from the last quarter of 2019. 
Read the CMS memo on quality reporting data exceptions here. 


No standard surveys; infection control instead 
CMS has suspended standard surveys for home health and hospice agencies due to the COVID-19 pandemic, but will conduct targeted infection control surveys and complaint-related incident surveys involving immediate jeopardy.
Read the CMS memo on surveys here. 


TPE, RAC audits and other reviews suspended
CMS has suspended most Medicare Fee-For-Service (FFS) medical review during the emergency period due to the COVID-19 pandemic.  This includes pre-payment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program, and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC). Read the provider FAQs from CMS addressing this. 


Access previous CMS stakeholder calls 
Keeping up with the latest information from CMS can be daunting at a time when things are changing so rapidly. If you have missed any of the previous CMS calls for providers, you will be able to access transcripts and/or recordings via a new page added to the CMS website. Access the CMS list of recordings and transcripts here. 


Dealing with PPE shortages  
Agencies are reporting shortages of personal protective equipment. The CDC recommends several strategies to be used when PPE supplies are running low. Access the CDC article here.  When commercial masks are not available, handmade masks may be worn instead. Need instructions for making a simple respiratory mask? Access a National Institutes of Health article here. 

Looking for distributors? Here are some distributors where your agency may be able to find supplies.  While we want to pass along these sources to help you in your urgent quest to find PPE, please note that we have not purchased and cannot vouch for quality.
Henry Schein Medical – distributor of ear loop masks, isolation gowns, protective glasses or goggles, hand sanitizer, gloves, alcohol, etc.
Benchmark Inc – masks and miscellaneous items such as gloves, hand sanitizer
Aunt Flow – Surgical masks, FDA approved, and N95 respirator NIOSH approved
OtteGear – N95 masks
Maddy's Print Shop - Masks, gloves, hand sanitizer 
 


COVID-19 patients discharged from or to hospitals
The Home Care Alliance of Massachusetts has put together helpful recommendations for admitting patients with a diagnosis of COVID-19 to home health or hospice following a hospital discharge, and the National Association of Home Health and Hospice has made those recommendations available as a PDF on its web site.
Click here to read the PDF.


Important CMS guidance for home health and hospice
CMS issued a COVID-19 guidance document for home health and hospice providers outlining patient isolation, staff and visitor restrictions, etc. 
Access the home health guidance here.
Access the hospice guidance here. 


Note: We will be updating this list again soon, so check back frequently.  

 

 

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