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CMS

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As ANCOR is analyzing the impact of the Centers for Medicare and Medicaid Services (CMS) mandate released this morning, it is clear that ICF employees are included; however, waiver services are not unless the provider employs 100 or more employees. We are trying to get a handle on how many providers this will impact. Please let Carol Ferenz know ASAP if this will impact your organization.

From the CMS Frequently Asked Questions document:

Q. Does this requirement apply to Medicaid home care services, such as Home and Community-Based Services (HCBS), since these providers receive Medicaid funding but are not regulated as certified facilities?

A. No, this regulation only applies to those Medicare and Medicaid-certified provider and supplier types that are subject to CMS health and safety regulations. CMS’s health and safety regulations do not cover providers of Home and Community-Based Services.

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CMS just released an Interim Final Rule With Comment Period (IFC-6) requiring COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities. Please join John Blum, CMS’s Principal Deputy Administrator, and Dr. Lee Fleisher, Chief Medical Officer and Director of the Center for Clinical Standards and Quality, in a discussion of this important rule.

When:   Thursday, November 4, 2021 2:00 pm–3:00 pm ET

Who should attend: Leaders and administrators of Medicare and Medicaid Certified Facilities as well as representatives of those who work in such facilities.

RSVP Here. Please RSVP by Thursday, November 4, 2021 at 12:00 pm ET. After registering, you will receive a confirmation email containing information about joining the webinar.

Questions: Please submit questions in advance, with the Subject heading “IFC-6 Stakeholder Call Question” here. On the call, we will answer as many of the questions received by noon as possible. We’ll also post a subsequent FAQ document.

Web links:

Press Release

To view a list of frequently asked questions, visit here. External FAQs are also posted to CMS Current Emergencies Page under ‘Clinical & Technical Guidance for All Health Care Providers.’

Interim Final Rule with Comment Period in Federal Register: web page and PDF forms.

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As required by the Biden-Harris Administration, the Centers for Medicare and Medicaid Services (CMS) issued an emergency regulation that requires the COVID-19 vaccination of eligible staff at heath care facilities that participate in Medicare and Medicaid programs.

The regulation will create a consistent standard within Medicare and Medicaid while giving patients assurance of the vaccination status of those delivering care. These requirements will apply to approximately 76,000 providers and cover over 17 million health care workers across the country.

Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. All eligible staff must have received the necessary shots to be fully vaccinated (either two doses of Pfizer or Moderna or one dose of Johnson & Johnson) by January 4, 2022.

The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.

CMS will ensure compliance with these requirements through established survey and enforcement processes. If a provider or supplier does not meet the requirements, it will be cited by a surveyor as being non-compliant and have an opportunity to return to compliance before additional actions occur. CMS’s goal is to bring health care providers into compliance. However, the Agency will not hesitate to use its full enforcement authority to protect the health and safety of patients.

The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.

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The Department of Health and Human Services (HHS) Secretary Xavier Becerra has again issued the renewal of the COVID-19 public health emergency (PHE) due to the continued consequences of the COVID-19 pandemic. The renewal became effective on October 18, 2021 and will extend the PHE into early 2022. This PHE status enables the Centers for Medicare and Medicaid Services (CMS) to keep all applicable waivers in place.

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Message from Centers for Medicare and Medicaid Services (CMS):

Coverage without cost-sharing available for eligible people with Medicare, Medicaid, CHIP, and Most Commercial Health Insurance Coverage.

Following the FDA’s recent action that authorized a booster dose of the Pfizer COVID-19 vaccine for certain high-risk populations and a recommendation from the CDC, CMS will continue to provide coverage for this critical protection from the virus, including booster doses, without cost sharing.

Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance, or deductible. In addition, thanks to the American Rescue Plan Act of 2021, nearly all Medicaid and CHIP beneficiaries must receive coverage of COVID-19 vaccines and their administration, without cost-sharing. COVID-19 vaccines and their administration, including boosters, will also be covered without cost-sharing for eligible consumers of most issuers of health insurance in the commercial market. People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

“The Biden-Harris Administration has made the safe and effective COVID-19 vaccines accessible and free to people across the country. CMS is ensuring that cost is not a barrier to access, including for boosters,” said CMS Administrator Chiquita Brooks-LaSure. “CMS will pay Medicare vaccine providers who administer approved COVID-19 boosters, enabling people to access these vaccines at no cost.”

CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available on the CDC COVID-19 Vaccination Program Provider Requirements and Support webpage and through the CMS COVID-19 Provider Toolkit.

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The Centers for Medicare and Medicaid Services (CMS) recently announced the creation of a new Technical Expert Panel (TEP) consisting of 8-15 individuals that will focus on the maintenance and development of vaccination-related items and measures within each post-acute care (PAC) setting (inpatient rehabilitation facilities, home health agencies, skilled nursing facilities, and long-term care hospitals). The TEP will focus on reviewing and identifying potential improvements to existing vaccination measures and the development of a COVID resident/patient-level measure for each PAC setting.

Individuals selected to be a part of the TEP will meet through webinar twice in November. The nomination form is located on the announcement page and should be sent via email by October 11, 2021.

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The Centers for Medicare and Medicaid Services (CMS) will conduct a national stakeholder call tomorrow, September 17, 2021 at 12:30 pm. The call will be led by new Administrator, Chiquita Brooks-LaSure, and her leadership team, and will focus on key updates from her first 100 days in office. The Administrator’s vision is for CMS to serve the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes. Members are encouraged to join this first national stakeholder call to learn more about how you can partner with CMS as they implement their vision.

Join the Call here:

OR

Call: 833-568-8864 (Toll Free)
Webinar ID: 161 910 6718
Passcode: 891135

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The Centers for Medicare and Medicaid Services (CMS) published a second Information Collection Request (ICR) notice in the September 8, 2021 Federal Register related to the proposed inpatient rehabilitation facility (IRF) Review Choice Demonstration. Similar to the original notice, CMS proposes that IRFs in certain states would be subjected to 100 percent pre- or post-claim review for Medicare Part A fee-for-service payments until the IRF meets the target affirmation or claim approval rate. The demonstration is set to begin in Alabama, followed by California, Texas and Pennsylvania. In conjunction with this notice, there is additional information that includes limited revisions from the initial December 2020 proposal, including expanding the language from “trained nurse reviewers” to instead include registered nurses, therapists, or physician reviewers and the elimination of some documentation requirements that were listed in the initial proposal.

Individuals are invited to submit comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency’s functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden. Comments must be submitted by October 8, 2021.

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Message from Centers for Medicare and Medicaid Services (CMS): 

New action will protect patients of the 50,000 providers and over 17 million health care workers in Medicare and Medicaid certified facilities

The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect both them and patients from the virus and its more contagious Delta variant. Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19.

“There is no higher priority for us than patient health and safety. As the Delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Nursing homes with an overall staff vaccination rate of 75% or lower experience higher rates of preventable COVID infection. In CMS’s review of available data, the agency is seeing lower staff vaccination rates among hospital and End Stage Renal Disease (ESRD) facilities. To combat this issue, CMS is using its authority to establish vaccine requirements for all providers and suppliers that participate in the Medicare and Medicaid programs. Vaccinations have proven to reduce the risk of severe illness and death from COVID-19 and are effective against the Delta variant.  CMS will continue to work closely with all Medicare and Medicaid certified facilities to ensure these new requirements are met.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” said CMS Administrator Chiquita Brooks-LaSure. “As the Delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care. Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”

CMS is developing an Interim Final Rule with Comment Period that will be issued in October. CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements. Health care workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

Please note that RCPA is working diligently with the Department of Health, Department of Human Services, and the Governor’s Office in order to obtain clarification of the above information. In this way, we will be able to fully understand the impact of this expansion. If you have any questions, please contact your RCPA Policy Director.

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