Nurse practitioners will be allowed to conduct certain medical exams for Medicare patients at nursing homes for the first time under a new policy announced by the Centers for Medicare & Medicaid Services.  The greater flexibility is part of a campaign to broaden clinical capacities upstream and downstream during the COVID-19 pandemic. The goal is to free up hospitals’ and physicians’ capacities in particular.

“It’s all hands on deck during this crisis. All frontline medical professionals need to be able to work at the highest level they were trained for,” CMS Administrator Seema Verma said.

The new temporary policy will allow providers to practice at the top of their license across state lines. Nurse practitioners, for example, may be able to test skilled nursing patients for conditions that may or may not be coronavirus-related. And physicians can make treatment decisions at out-of-state rural hospitals.

Changes disclosed are in addition to other waivers announced March 30, including relaxation of nurse aide requirements. They apply immediately and address supervision, licensure and certification, and other limitations in various healthcare settings.

CMS has been throwing money at for-profit nursing homes for months now:

  • CMS has freed providers entirely from having to submit staffing data through the Payroll-Based Journal system for the first quarter of the year (1/1/20 – 3/31/20). There has been no word as to how long the submission waiver will be in effect. Providers should continue to collect their staffing data, however, since that requirement has not been waived.
  • CMS has granted speech-language pathologists, physical therapists and occupational therapists permission to evaluate and treat Medicare Part A patients in skilled nursing facilities using audiovisual devices such as smartphones and tablets. The services would not be considered telemedicine and would be billed the same as in-person services when performed in the same building as the patient.
  • CMS quickly approves $51B in advance payments: CMS announced that it had approved more than 21,000 of 32,000 requests — totaling more than $51 billion — for accelerated or advance Medicare payments. The totals include requests by nursing homes and other frontline Medicare providers over just a one-week period.
  • Lutheran Services in America President and CEO Charlotte Haberaecker told members of Congress in a letter that large nonprofit health and human services organizations need more than $102 billion in relief.


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