AGG Hospice CMS Quarterly Report

CMS Announces Hospice Flexibilities to Fight COVID-19

CMS has announced a series of temporary regulatory waivers and new rules to provide hospice providers with
flexibility to respond to the COVID-19 pandemic. The goals of these actions are to expand the healthcare system
workforce; ensure adequate capacity in hospitals and health systems; increase access to telehealth in Medicare;
expand in-place testing; and put patients before paperwork. These exibilities include the following:
Medicare Telehealth and Telecommunications Technology.

Hospice providers can provide services to a Medicare patient through telecommunications technology (e.g.,
remote patient monitoring; telephone calls (audio only and TTY); and two-way audio-video technology), if it is
feasible and appropriate to do so. Only in-person visits are to be recorded on the hospice claim.

Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefits can now be
conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time
interaction between the hospice physician/hospice nurse practitioner and the patient).
Workforce

Training and Assessment of Aides – CMS postponed the annual onsite hospice aide supervisory visit until 60 days
from the end of the public health emergency (PHE).

Annual Training – CMS postponed the annual assessment of hospice aide skills and competence until the end of
the first full quarter following the lifting of the PHE. This waiver does not alter minimum personnel requirements.

Quality Assurance and Performance Improvement (QAPI) – During the PHE, CMS is allowing hospices to narrow
their QAPI focus to infection control issues, along with a focus on any adverse events.

Volunteer Requirement – In anticipation that volunteer availability and use will be reduced due to the COVID-19
pandemic, CMS waived the requirement that hospices use volunteers.

Onsite visits for Hospice Aide Supervision – CMS waived the requirement that a nurse to conduct an onsite visit
every two weeks to evaluate if aides are providing care consistent with the care plan.
Patients Over Paperwork

Comprehensive Assessments – CMS extended the time to complete required patient assessments and updates
from 15 to 21 days.

Waive Non-Core Services – CMS waived the requirement for hospices to provide certain non-core hospice services
during the national emergency (e.g., physical therapy, occupational therapy, and speech/language pathology).

Accelerated/Advance Payments – As of April 26, 2020, CMS is reevaluating all pending and new applications for
the Accelerated Payment Program and has suspended the Advance Payment Program, in light of direct payments
made available through the Department of Health & Human Services’ (HHS) Provider Relief Fund. For providers
and suppliers who have received accelerated or advance payments related to the COVID-19 Public Health
Emergency, CMS will not pursue recovery of these payments until 120 days after the date of payment issuance

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**This report is is provided to MHPCA through a partnership with Arnall, Golden & Gregory, LLP (Jason Bring-Partner)**

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