Use of waivers for Medicare Part A under increased scrutiny
On October 15, 2021, the Department of Health and Human Services released a declaration of renewal of the National Public Health Emergency (PHE) which will be in effect for another 90 days, starting October 18th. This declaration renews for the 7th time, those changes that have been made as a result of the initial declaration in January 2020, and subsequent renewals on April 21, 2020, July 23, 2020, October 2, 2020, January 7, 2021, April 15, 2021 and July 19, 2021.
This declaration was released by the new HHS Secretary, Xavier Becerra:
For now, the major components used from the waivers in the SNF setting, the Qualifying Hospital Stay (QHS) and Benefit Period Waiver (BPW), are still in play.
MLN Matters SE20011, the primary CMS document that has outlined all the SNF changes from the start of the PHE and is updated by CMS regularly, with the last update on September 8th, is now targeting use of the waivers with noted increased scrutiny:
Pages 12 and 13 of the document have added language for the waivers, stating:
“These emergency measures don’t waive or change any other existing requirements for SNF coverage under Part A such as the SNF level of care criteria, which remain in effect under the emergency,”
“We are monitoring for any SNF admissions under Section 1812(f) that don’t meet the SNF level of care criteria (which, as noted above, remain in effect during the emergency), and we’ll take appropriate administrative action in any instances that we find.”
As always, if you have any questions, send them in via the Just Ask Q&A tab.
In Your Corner,
Dolores Montero, PT, DPT, RAC-CT, RAC-CTA
SNF Therapy & MDS Compliance Team