CMS Issues Additional Guidance for Nursing Homes, Hospitals on Coronavirus
- March 06, 2020
The Centers for Medicare & Medicaid Services (CMS) is focusing hospital and nursing home facility inspections on infection control and other serious health and safety threats effective immediately, the agency announced March 4. CMS said the shift would allow inspectors to concentrate on addressing the spread of novel coronavirus.
At the same time, CMS also issued additional guidance to hospitals and nursing homes for addressing cases of COVID-19.
"Today's actions, taken together, represent a call to action across the health care system," said CMS Administrator Seema Verma. "All health care providers must immediately review their procedures to ensure compliance with CMS' infection control requirements, as well as the guidelines from the Centers for Disease Control and Prevention (CDC)."
In a memorandum to state survey agency directors, CMS said it was temporarily suspending non-emergency inspections of health care facilities and limiting survey activity to immediate jeopardy complaints and allegations of abuse and neglect; complaints alleging infection control concerns; and facilities with a history of infection control deficiencies.
Surveys also will continue for statutorily required recertification, re-visits necessary to resolve current enforcement actions, and initial certifications.
The memo includes protocols for the inspection process where COVID-19 is identified or suspected.
Two other memos provide further guidance for infection control and prevention of coronavirus in nursing homes and hospitals.
Nursing homes have been pressing for more information on handling the coronavirus after a number of cases emerged at a Seattle-area nursing facility.
The memo advises that residents with mild symptoms may not require a transfer to a hospital, assuming the nursing home can follow CDC-recommended infection prevention and control practices.
Nursing homes also can accept a patient with COVID-19 so long as it can follow CDC guidance for transmission-based precautions.
The third memo notes that patients with known or suspected COVID-19 may not require hospitalization and can remain at home if they can follow monitoring requests. When discharging a COVID-19 patient to home, a hospital should consider the patient's ability to adhere to isolation recommendations and the potential of transmission to family members with compromised immune systems.
Congress Clears Funding Package
Meanwhile, Congress this week passed an emergency spending package that devotes $8.3 billion in funding for efforts to respond to the coronavirus. The House cleared the measure (H.R. 6074) in a 415-2 vote, with the Senate following suit by a 96-1 margin. President Trump signed the funding package into law on March 6.
The legislation includes $3 billion for developing treatments and a coronavirus vaccine; $300 million to ensure Americans have access to the vaccine regardless of their ability to pay; and $2.2 billion for prevention, preparedness, and response, including nearly a billion dollars to ease the financial strain on state, local, tribal, and territorial hospitals and health systems.
The measure also allows the Department of Health and Human Services to waive certain Medicare telehealth restrictions to allow providers to furnish telehealth services to beneficiaries regardless of whether they live in a rural community. The provision is expected to cost $500 million.
The measure also provides $7 billion in low-interest loans for small business affected by the epidemic.
New Codes
The number of confirmed cases across the United States continues to grow. However, wide spread testing for the virus remains limited as the federal government continues to work to distribute test kits nationally.
To encourage testing and help track new cases, CMS announced March 5 a second Healthcare Common Procedure Coding System (HCPCS) code that laboratories can use to bill for certain COVID-19 diagnostic tests. Last month CMS developed the first HCPCS code (U0001) for CDC testing laboratories to test for COVID-19. The second HCPCS billing code (U0002) allows labs to bill for non-CDC laboratory tests for the virus.
The move follows the Food and Drug Administration's new, streamlined policy unveiled last week for certain labs to develop their own validated COVID-19 diagnostics, CMS said. The second HCPCS code is for tests developed by these additional labs when submitting claims to Medicare and health insurers, which the agency hopes will encourage additional testing and improve tracking. Medicare claims processing will accept the new codes starting April 1 for dates of services on or after February 3.
CMS also released three fact sheets on diagnostic laboratory tests, immunizations and vaccines, telemedicine, drugs, and cost-sharing policies.