CMS makes sweeping regulatory changes to scope of practice, telemedicine

To help address the novel coronavirus (COVID-19) patient surge in the United States, the Centers for Medicare and Medicaid Services (CMS) announced earlier this week several temporary regulatory waivers and new rules to equip the healthcare system, including relaxed scope of practice and telemedicine requirements.

The waivers and flexibilities will allow hospitals to use other practitioners, such as physician assistants and nurse practitioners, to the fullest extent possible, in accordance with a state’s emergency preparedness or pandemic plan. These clinicians can perform services such as order tests and medications that may have previously required a physician’s order where this is permitted under state law. In addition, CMS is waiving the requirements that a certified registered nurse anesthetist (CRNA) is under the supervision of a physician.

Another highlight within the new guidelines is flexibilities to promote use of telehealth. Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. Providers also can evaluate beneficiaries who have audio phones only.

Providers can bill for telehealth visits at the same rate as in-person visits. Telehealth visits include emergency department visits, initial nursing facility and discharge visits, home visits, and therapy services, which must be provided by a clinician that can provide telehealth. New and established patients now may stay at home and have a telehealth visit with their provider.

CMS is allowing telehealth to fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice, and home health. Clinicians can provide remote patient monitoring services to patients with acute and chronic conditions and for patients with only one disease. In addition, CMS is allowing physicians to supervise their clinical staff using virtual technologies when appropriate, instead of requiring in-person presence.

Other waivers and flexibilities CMS is granting include increasing hospital capacity and putting patients over paperwork. Click here read more on the waivers and flexibilities for healthcare providers.

The changes apply immediately across the U.S. healthcare system for the duration of the Trump Administration’s emergency declaration.

Editor’s note: Click here for more information and ongoing COVID-19 updates for integrative healthcare professionals.