Breaking: CMS Announcements
Just this afternoon, the Centers for Medicare and Medicaid Services held a national call for providers with important announcements. See the full details of the call in the
CMS press release here.
Summary:
- The Centers for Medicare & Medicaid Services (CMS) announced sweeping regulatory changes for nursing homes and other providers dealing with COVID-19 outbreaks.
- Nursing homes will have to test staff and offer testing to residents, while labs and nursing facilities using point-of-care testing must report diagnostic test results.
- The new rules also require hospitals to provide COVID-19 cases and related data to the U.S. Department of Health and Human Services (HHS).
New Testing Requirements for Nursing Homes:
- CMS is again acting to safeguard nursing home residents from the ongoing threat of COVID-19 by revising its infection-control regulations for long-term care facilities to require nursing homes to test their staff for COVID-19.
- CMS recommendations for the frequency of staff testing will be based on the degree of community spread, to be announced shortly through guidance, that indicate the facility may be at increased risk for COVID-19 transmission.
- Nursing homes will have to provide tests to residents during all outbreaks, or when residents show any symptoms of COVID-19.
- State and federal surveyors will hold centers accountable. Facilities that do not comply with the new requirements will be cited for non-compliance and may face enforcement sanctions based on the severity of the noncompliance, such as civil money penalties in excess of $400 per day, or over $8,000 for an instance of noncompliance.
- CMS will help offset the cost of testing through new funding from the Provider Relief Fund, authorized under the CARES Act.
Hospitals Must Report Data:
- The emergency regulations will also require hospitals and critical access hospitals to report daily important data critical to support the fight against COVID-19.
New Reporting Requirements for Labs:
- CMS’ new rule implements a CARES Act requirement that laboratories report COVID-19 test results daily to the HHS Secretary. All laboratories conducting COVID-19 testing and reporting patient-specific results – including hospital labs, nursing homes, and other facilities conducting testing for COVID-19 – will be required to comply.
- If a laboratory does not report the required information, CMS will impose a civil monetary penalty in the amount of $1,000 a day for the first day, and $500 for each subsequent day. Labs will have a one-time, three-week grace period to begin reporting required test data. This requirement complements existing HHS guidance requiring laboratories to report test results and additional information, such as demographic data.
Physician and Pharmacist Orders for Tests:
- CMS is also revising its previous policy that covered repeated COVID-19 testing for Medicare beneficiaries without practitioner orders during the PHE.
- To help ensure that beneficiaries have broad access to testing, CMS is also paying for tests when ordered by a pharmacist or other healthcare professional authorized under applicable state law to order diagnostic laboratory tests.
- Earlier this week, CMS released guidance for state Medicaid agencies on new flexibilities CMS has made available under emergency authorities to increase reimbursement for nursing facilities that implement specific infection control practices, such as designating a quarantine or isolation wing for COVID-19 patients.
