Updated: June 11, 2020
On March 13, 2020, the President of the United States issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency. This action allows the Secretary of US Department of Health and Human Services (HHS) to waive certain federal requirements, “to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs.”
The Centers for Medicare and Medicaid Services (CMS) immediately issued a number of, “blanket waivers,” modifications to regulatory requirements that apply to providers nationwide. This included temporarily waiving requirements for out-of-state providers, expediting processes for Medicare provider enrollment, and more.
Read the list of initial CMS blanket waivers, and supporting billing instructions.
Furthermore, states were encouraged to apply for individualized 1135 waivers that address state-specific health needs for combatting the COVID-19 outbreak. Many of the waiver provisions granted to states are similar. In particular, State Medicaid Agencies (SMAs) are being granted much greater authority to create temporary provisional enrollment processes for providers who are enrolled in another SMA or in Medicare. Many of the state waivers also decrease, or in some cases, suspend, prior authorization processes for fee-for-service Medicaid claims. In some cases, waivers allow for reimbursement of care in unlicensed facilities provided that the facility in question meets minimum standards set by the state.
Since March, states have been approved for multiple waivers. Please see the updating list of approved waivers on Medicaid’s Federal Disaster Resource page.