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COVID-19: Vulnerable Populations
Q & A: Federal waivers for home health agencies and hospices

What federal waivers are available for home health agencies and hospices?

Federal legislative and regulatory action has included several important provisions affecting home health agencies and hospices. As the crisis continues and additional areas emerge, additional waivers may be forthcoming. 

March 27 Blanket Waivers: In response to a request from CHA, the Centers for Medicare & Medicaid Services (CMS) issued several 1135 Medicare blanket waivers in addition to those previously issued.

  • Home Health OASIS transmission: Clarifies relief on timeframes related to OASIS transmission.

    • Extends the five-day completion requirement for the comprehensive assessment
    • Waives the 30-day OASIS submission requirement
  • Remote Home Health Assessment: CMS is allowing home health agencies to perform initial assessments and determine patients’ homebound status remotely or by record review. This will allow patients to be cared for in the best environment while supporting infection control and reducing impact on acute care and long-term care facilities.
  • Hospice Comprehensive Assessments: CMS is waiving certain requirements for hospice related to updating patients’ comprehensive assessments. Hospices must continue to complete the required assessments and updates;however, the timeframes for updating the assessment may be extended from 15 to 21 days.
  • Non-Core Hospice Services: CMS is waiving the requirement for hospices to provide certain non-core hospice services during the national emergency, including requirements for physical and occupational therapy and speech-language pathology.
  • Home Health Agency and Hospice Aide Supervision: CMS is waiving the requirements that a nurse conduct an onsite visit every two weeks and temporarily suspending the two-week aide supervision requirement by a registered nurse for home health agencies. Virtual supervision is encouraged during the period of the waiver.
  • Hospice Volunteer Requirement: CMS is waiving the requirement that hospices are required to use volunteers (including at least 5% of patient care hours).

Additional information on the waivers noted above is available here

March 13 Blanket Waivers: On March 13, President Trump declared a national emergency, which allows flexibility in requirements for health care providers. CMS announced several blanket waivers. Hospitals do not need to request an individual waiver to be relieved from compliance with these laws to the extent described in this list. Of specific interest to home health agencies are the following: 

  • OASIS Time Frames and RAPs: Provides relief to home health agencies on the timeframes related to OASIS transmission. Allows Medicare administrative contractors to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs) during emergencies.

Additional information is available here. (3/31)    

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