American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Federal and State Regulatory and Legislative Issues

New CMS Rule Includes Policies to Ease Coverage and Reimbursement Requirements for Care

The Centers for Medicare & Medicaid Services (CMS) released a second interim final rule with comment period (IFC) April 30, expanding on COVID-19-related regulatory flexibilities included in the agency’s first IFC issued March 30.

The rule introduces numerous new policies to ease coverage and reimbursement requirements for care provided during the national public health emergency (PHE), including the following provisions:

  • Waive the interactive video requirement for telephone evaluation and management (E/M) services and increase the payment rates for audio-only E/M services to match the payment rates of the established patient office/outpatient E/M
  • Enable facilities to increase their bed capacity without reducing Medicare payments to those facilities
  • Permit teaching hospitals to shift residents to other hospitals to meet COVID-19-related needs without reducing Medicare payments to those hospitals
  • Allow payment for outpatient hospital services, including wound care and drug administration, that are delivered in temporary expansion locations, such as patients’ homes, converted hotels, and parking lot tents
  • Maintain reimbursement rates under the Outpatient Prospective Payment System for services furnished by hospital outpatient departments that relocate off campus during the PHE

The changes made in this rule are retroactive to March 1 and are effective through the duration of the PHE declaration, unless otherwise specified.

A fact sheet about the April 30 IFC is available on the CMS website. Contact with questions.

CARES Act Provider Relief—Missing Checks?

Were you expecting to receive a CARES Act provider relief fund payment but have yet to receive your check? The first $30 billion disbursement of the Public Health and Social Services Emergency Fund occurred between April 10 and April 17. If you believe you were eligible but did not receive this payment, tell us your story.