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COVID-19: New CMS Waivers; Increased Medicare Payments

The Centers for Medicare & Medicaid Services (CMS) announced new waivers for Inpatient Prospective Payment System (IPPS) hospitals, long-term care hospitals (LTCHs), and inpatient rehabilitation facilities under the Coronavirus Aid, Relief, and Economic Security Act.

For IPPS hospitals, the weighting factor of the assigned Medicare diagnosis-related group for patients diagnosed with COVID-19 will be increased 20 percent. ICD-10 clinical modification codes for COVID-19 patients include:

Additionally, Health and Human Services (HHS) Secretary Alex Azar is waiving the site-neutral payment rate for LTCH admissions in response to the COVID-19 emergency. All LTCH cases admitted from Jan. 27 through the end of the PHE will receive the standard federal rate.

Increased Medicare Payment for High-Production Lab Tests

Medicare will nearly double payment for COVID-19 diagnostic tests that use high-throughput technology, including the:

  • Roche cobas 6800 System;
  • Roche cobas 8800 System;
  • Abbott m2000 System;
  • Hologic Panther Fusion System;
  • GeneXpert Infinity System; and
  • NeuMoDx 288 Molecular.

From April 14 through the duration of the PHE, Medicare will pay labs for these tests at $100 to help provide nursing home communities with quicker results.

New NHSN COVID-19 Module

To facilitate daily reporting of COVID-19 cases, hospital capacity, and supply status, the Centers for Disease Control and Prevention’s (CDC)’s National Healthcare Safety Network (NHSN) launched a new COVID-19 module.

The module comprises three pathways:

  • Patient Impact and Hospital Capacity Pathway;
  • Healthcare Worker Staffing Pathway; and
  • Healthcare Supply Pathway.

The module will enable data sharing with state and local health departments for hospitals in their jurisdictions, as well as with HHS’ COVID-19 tracking system. NHSN has shared recorded webinars and training slides to aid facilities in data collection.

Additionally, CMS announced new regulatory requirements for nursing homes to inform residents, their families, and their representatives of COVID-19 cases in their facilities. In rulemaking that will follow, CMS will require facilities to report this data in a standardized format and frequency through the NHSN.

FDA Relaxes Compounding Rules for Sedatives

The Food and Drug Administration (FDA) on April 16 issued guidance temporarily allowing compounding of select sedatives amid COVID-19–related shortages.

For the duration of the PHE, outsourcing facilities that have registered with FDA under section 503B of the Federal Food, Drug, and Cosmetic Act may produce their own versions of these premixed drugs:

  • cisatracurium besylate;
  • dexmedetomidine hydrochloride;
  • etomidate;
  • fentanyl citrate;
  • furosemide;
  • hydromorphone hydrochloride;
  • ketamine hydrochloride;
  • lorazepam;
  • midazolam hydrochloride;
  • norepinephrine bitartrate;
  • rocuronium bromide;
  • vancomycin hydrochloride; and
  • vecuronium bromide.

For questions, contact FDA’s human drug compounding team at compounding@fda.hhs.gov.

HRSA Waives National Practitioner Data Bank Query Fees

To expedite credentialing, hiring, privileging, and licensing for health care providers amid the COVID-19 pandemic, the Health Resources and Services Administration (HRSA) announced April 15 it temporarily will waive query fees for health care entities to search the National Practitioner Data Bank (NPDB).

The waiver is retroactive from March 1 through May 31, 2020. The NPDB will issue query credits to reimburse for searches conducted between March 1 and April 15.

The NPDB will hold a conference call April 23, from 1 to 2 pm ET, to respond to presubmitted and live questions.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the outbreak.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a senior communications associate for America's Essential Hospitals.

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