AHA asks CMS to keep some 1135 waivers to help hospitals regain footing

by A.J. Plunkett (aplunkett@decisionhealth.com)

The American Hospital Association (AHA) is pushing for CMS to continue some COVID-19-related 1135 waivers after the official close of the pandemic.

In a letter to CMS Administrator Chiquita Brooks-LaSure, AHA asked that flexibilities such as the use of telehealth, hospital-at-home programs, and the easing of certain licensure requirements for out-of-state providers and nurse practitioners be continued.

AHA also urged that the  hospital Conditions of Participation (CoP) be permanently changed to reconsider “the use of verbal orders and certain requirements associated with discharge planning to better equip providers to assist patients. Doing so would remove unnecessary administrative burden and advance CMS’ 'Patients Over Paperwork' goals.”

In addition, the AHA asked CMS to:

• “Permanently scale back current regulations and reconsider the importance of the specific information that is most useful to patients when being discharged to post-acute care facilities, including nursing homes
• Continue to grant relief on timeframes related to pre- and post-admission patient assessment and evaluation criteria to ensure patients are treated in a timely manner and allow hospitals to better manage an influx of non-COVID-19 patients returning for care
• Continue to allow pathologists and other laboratory personnel to perform certain diagnostic tests and review remotely through a secure network to ensure continued patient access to the best possible care, and
• Continue to maintain flexibility in supervision requirements of diagnostic services by continuing to allow the virtual presence of a physician through audio or video real-time communications technology when the use of the technology is indicated to reduce exposure risk for the beneficiary or provider."

The hospital advocacy group also asked CMS to keep changes that allowed expanded care delivery in rural areas. And it asked that the agency consider easing up on hospital oversight much as it has in the heart of the pandemic.

The AHA noted that “it will take time to reestablish the capability for some types of ‘normal operations.’ For example, as CMS has already indicated in several of its fiscal year proposed rules, it may be appropriate to suspend or reassess the use of some of CMS’ quality measures. Similarly, it may be necessary to delay or rethink the scope of compliance surveys to ensure hospitals and other organizations have a chance to undo structures and practices implemented during the outbreak.”