CMS Policies and Waivers that Provide Regulatory Flexibility to Physicians

March 31, 2020 11:11 AM | Sally Winkelman (Administrator)

Jeffrey Davis, ACEP Director of Regulator Affairs, shared the following details regarding the announcement of CMS policies including big wins for emergency medicine: 

  • EMTALA: CMS issued the long-awaited revised guidance on EMTALA that will allow medical screening exams to be delivered via telehealth. This has been a major ACEP priority, and we repeatedly asked CMS to issue this revised EMTALA guidance. There are other temporary changes to EMTALA, and Dr. Todd Taylor will send a separate email explaining these. 
  • Telehealth: CMS added the ED E/M codes (CPT codes 99281 to 99285) and the critical care codes (CPT codes 99291 and 99292) to the list of approved Medicare telehealth services for the duration of the COVID-19 national emergency. CMS had previously expanded the ability to perform telehealth services but had not allowed emergency physicians to use the ED E/M codes-which most accurately reflect the intensity and value of emergency services. ACEP had identified this issue as a top regulatory priority, and through ACEP's advocacy, CMS has now recognized that ED E/M codes are indeed the most appropriate codes to use when delivering emergency telehealth services.  
  • Expanding the Healthcare Workforce: CMS is allowing hospitals to increase their workforce capacity by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community as well as those licensed from other states without violating Medicare rules. ACEP had urged CMS to relax state licensure requirements. 
  • CMS Hospital Without Walls: CMS is allowing hospitals to provide services in locations beyond their existing walls to expand care capacity and to develop sites dedicated to COVID-19 treatment. Under CMS's temporary new rules, hospitals will be able to transfer patients to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories, while still receiving hospital payments under Medicare. Ambulances will also be able to transport patients to a wider range of locations when other transportation is not medically appropriate. These destinations include community mental health centers, federally qualified health centers (FQHCs), physician's offices, urgent care facilities, or ambulatory surgery centers.  
  • Waiver of Physician Self-Referral Law: CMS issued blanket waivers of sanctions under the physician self-referral law.  

These are only some of the many policies announced. ACEP is scheduling a webinar with CMS for Friday, April 3rd to discuss EMTALA. More details to follow.