The CMS Monday unveiled a host of new flexibilities for hospitals to combat the COVID-19 pandemic.
During a White House Rose Garden event, CMS Administrator Seema Verma unveiled the hospitals without walls program.
"Under the CMS's temporary new rules, hospitals will be able to transfer patients to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories, while still receiving hospital payments under Medicare. For example, a healthcare system can use a hotel to take care of patients needing less intensive care while using its inpatient beds for COVID-19 patients," CMS noted in a press release.
Verma also said many ambulatory surgery centers, which are delaying or canceling elective procedures, could be devoted to "hospital-like care." The agency's move will also allow physician-owned facilities to increase bed capacity without sanctions.
Ultimately, the hospitals without walls program is meant to give providers additional flexibility to triage patients and send them to the most appropriate facilities, based on acuity of care.
"This has to be in accordance with the state's pandemic plan," Verma said on a call with reporters Monday evening. "We can't have providers operating outside of an organized plan at a local level."
New York recently established a command center "to share information between hospitals about the supplies each hospital has in stock and the supplies each hospital is ordering," according to a statement from the governor's office.
States and providers could take a similar approach to triage patients and ensure that patients go to the most appropriate care setting, said Ashley Thompson, senior vice president of public policy analysis and development for the American Hospital Association.
"It's all hands on deck," she said.
The regulatory flexibility will last as long as the national public health emergency for the COVID-19 pandemic is active. Once that status is reevaluated, Verma said "we'll evaluate how we go back to the current system."
Hospitals may also take advantage of additional workforce flexibility. The CMS relaxed barriers that prevent some healthcare workers from performing at the top of their licenses. By allowing nurse anesthetists to work in surgeries, that will free up anesthesiologists to work in ICUs and monitor COVID-19 patients.
The CMS will allow hospitals to provide their workforce with additional benefits, such as daily meals, laundry service and childcare, without running afoul of anti-kickback laws.
Medicare will now pay for lab technicians to visit beneficiaries who can't travel to be tested for COVID-19. Homebound Medicare beneficiaries have been placed on a plan of care by their physician, and only those individuals will be eligible for in-home testing.
Ambulances will see additional CMS reimbursement as they will be allowed to transport patients between different facilities, such as between doctors' offices.
The agency's regulatory relief moves will also ease some paperwork burden on hospitals, including documenting physicians' time with patients. There are also increased flexibility for using telehealth and providing remote monitoring for patients.
Erica Teichert and Michael Brady contributed to this report.
