CMS will likely implement a "glide path" when removing temporary waivers put into effect during the COVID-19 pandemic, rather than a hard stop, according to a principal deputy administrator at the agency.
"Exactly how that glide path plays out is still to be determined … in conjunction with the White House and the administration," said Kim Brandt, principal deputy administrator for policy and operations at CMS, during a webinar hosted by the Healthcare Information and Management Systems Society on Monday.
CMS to date has released more than 130 waivers related to Medicare and more than 150 waivers related to Medicaid, according to Brandt.
That's included expanding reimbursement for telemedicine and allowing licensed Medicare providers to render services outside of their state. CMS also released temporary new rules that give hospitals more flexibility to transfer patients to outside facilities, such as ambulatory surgery centers, converted hotels and dormitories, while still receiving hospital payments under Medicare.
But as providers prepare for the new normal after the coronavirus outbreak subsides, many are left wondering which of the flexibilities will remain in place after the pandemic—and how the remainder will be rolled back.
CMS is studying administrative, claims and encounter data to better understand how Medicare and Medicaid beneficiaries have been accessing care and taking advantage of temporary flexibilities during the pandemic, Brandt said. As an example, she shared that telehealth visits have increased by 1,300% in the past year.
That analysis will help to inform which waivers and flexibilities to keep in place.
CMS will release information on which flexibilities it intends to make permanent "as we make those decisions," Brandt said.
"For everything else, I expect it would be a glide path," she said.
Brandt highlighted telemedicine flexibilities as a "prime example" of what could remain in place.
"People have embraced (telehealth)," she said. "So those will stay."
But for extending some telemedicine flexibilities, Congress might have to act, too.
Jim Parker, senior adviser to the HHS secretary for health reform, last week stressed that while HHS is reviewing possible steps to reduce regulatory barriers for telemedicine, there are statutory barriers that require intervention by Congress. HHS for example was able to waive originating site requirements for Medicare beneficiaries after being given that authority by Congress.
Still, Parker said the department's vision is to "ensure a soft landing for telehealth, instead of a hard stop." "Consumer expectations are likely changed moving forward," he said last week.
