On March 13, 2020, the United States has declared a public health emergency regarding Coronavirus (COVID-19).
Below you’ll find information on 1135 Waivers for a Public Health Emergency, sourced from the US Department of Health and Human Services.
1135 WAIVERS IN A PUBLIC HEALTH EMERGENCY
The following requirements may be waived or modified:
certain conditions of participation certification requirements, program participation or similar requirements for individual health care providers or types of health care providers;
pre-approval requirements;
requirements that physicians and other health care professionals hold licenses in the State in which they provide services if they have a license from another State (and are not affirmatively barred from practice in that State or any State in the emergency area) for purposes of Medicare, Medicaid, and CHIP reimbursement only;
sanctions under the Emergency Medical Treatment and Active Labor Act (EMTALA) for redirection or reallocation of an individual to another location to receive a medical screening pursuant to an appropriate state emergency preparedness plan or a state preparedness plan for the transfer of an individual who has not been stabilized if the transfer is necessitated by the circumstances of the declared Federal public health emergency. A waiver of EMTALA sanctions is effective only if actions under the waiver do not discriminate on the basis of a patient’s source of payment or ability to pay;
sanctions under section 1877(g) (Stark) relating to limitations on physician referral under such conditions and in such circumstances as the Centers for Medicare & Medicaid determines appropriate;
deadlines and time tables for performance of required activities to allow timing of such deadlines to be modified;
limitations on payments for healthcare items and services to permit Medicare Advantage Plan enrollees to use out-of-network providers in an emergency situation. To the extent possible, the Secretary must reconcile payments so that enrollees do not pay additional charges and so that the plan pays for services included in the capitation payment;
sanctions and penalties arising from noncompliance with HIPAA privacy regulations relating to: a) obtaining a patient’s agreement to speak with family members or friends or honoring a patient’s request to opt out of the facility directory, b) distributing a notice of privacy practices, or c) the patient’s right to request privacy restrictions or confidential communications. The waiver of HIPAA requirements is effective only if actions under the waiver do not discriminate on the basis of a patient’s source of payment or ability to pay.
We are constantly updating our free resource library on our website…
View our COVID-19 Resource Collection and our Risk & Resiliency Resource List.
Upcoming updates will include lessons learned and resources regarding staffing, triggers for decision support, and continuity of operations.
Have a question? Send us an email at team@wakefieldbrunswick.com.
WORK COLLABORATIVELY. ACT DECISIVELY.
The WB Team
Disclaimer: We at Wakefield Brunswick feel strongly that in order to effect positive outcome change in this critical time, conveying information in a timely manner is critical. We will continue to follow the advice of medical experts and to disseminate actionable information as fast as possible. We further understand that this will necessitate periodic revisions and clarifications of some of our recommendations. Please remain flexible to update your protocols with these modifications if and when they become necessary.