National and State advocacy organizations have appealed to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to extend flexibilities that have been vital to state systems during the COVID-19 pandemic. Our national organizations, ANCOR and ACCSES, signed this letter dated October 23, 2020. It is an Appendix K waiver that has been invaluable to maintaining the capacity of states and providers in continuing to support individuals in need of long-term supports and services throughout this pandemic.

CMS originally developed a timeline for Appendix K expiration of one year from the initial start date in recognition of the fact that it may take a year to reestablish the pre-public health emergency. However, given that the COVID-19 pandemic has continued for several months, the advocates have suggested that the one-year timeframe should actually begin when the public health emergency has ended.

The second very important issue for many states and providers of service is the continued availability of retainer payments. These payments are crucial to keeping provider networks in place during a period of time when they are unable to provide services due to the pandemic. The three 30-day periods of retainer payments were crucial to keeping providers in business; however, we are now entering a new phase of the pandemic. It is still not safe for typical services to resume. Without retainer payments, the stability of the provider network is at risk. The request to CMS is to extend to states the ability to provide retainer payments beyond the three 30-day periods.