Public Health Emergency Extended to October 15

The COVID-19 public health emergency (PHE) has been extended through October 15. Many waivers and temporary authorities currently in place will be continued through this date. Here’s a quick overview of a few Medicare and Medicaid flexibilities which psychiatric-mental health nurses might find relevant:

Medicare

Declaration/ Flexibility Authority Description Expiration Timeline Medicare Telehealth HIPAA Flexibility for Telehealth Technology

• What it is: An HHS enforcement discretion to allow providers to use video and text-based applications without being subject to HIPAA violations.
• When it ends: End of the PHE

Audio-only Telehealth for Certain Services Waiver

• What it is: A waiver allowing the use of audio-only equipment to provide telehealth services for audio-only telephone behavioral health counseling and educational services, as well as evaluation and management services.
• When it ends: It won’t! It will become permanent at end of PHE

Practitioner Location Waiver

• What it is: Temporarily waived CMS requirements that out-of-state practitioners must be licensed in the state where they practice.
• When it ends: Can be retroactive to March 1, 2020, and reissued until the end of the PHE

Removal of Geographic Restrictions

• What it is: Eligible telehealth individuals under Medicare can use telehealth for diagnosis, treatment, or evaluation of mental health disorders without geographic restrictions.
• When it ends: It won’t! This will become permanent when the PHE ends.

Prescribing Controlled Substances via Telehealth Waiver

• What it is: Providers can prescribe controlled substances via telehealth without needing an in-person medical evaluation
• When it ends: End of the PHE, unless DEA specifies an earlier date.

Emergency Medical Treatment & Labor Act

• What it is: Allows hospitals, psychiatric hospitals, and CAHs to screen patients at offsite locations to prevent the spread of COVID-19.
• When it ends: End of the PHE

Limiting Detailed Discharge Planning for Hospitals Waivers

• What it is: CMS-waived requirements related to post-acute care services so as to expedite the discharge and movement of patients among care settings.
• When it ends: Can be retroactive to March 1, 2020, and can be reissued until the end of the PHE

Nursing Services Requirements Waiver

• For both hospitals and CAHs, removes requirements that nursing staff develop and maintain a nursing care plan for each patient
• When it ends: Can be retroactive to March 1, 2020, and reissued until the end of the PHE

Community Mental Health Clinics Waivers

• What it is: Flexibility for QAPI resources to be reworked and used in PHE-specific circumstances; allows Community Mental Health Clinics (CMHCs) to provide partial hospitalization services and waives the requirement that CMHCs provide at least 40% of services to patients that are ineligible for Medicare benefits.
• When it ends: Can be retroactive to March 1, 2020, and reissued until the end of the PHE

Combined Medicare, Medicaid, CHIP, and/or Medicare Advantage

Intermediate Care Facility for Individuals with Intellectual Disabilities Waivers

• What it is: Waives certain requirements for Medicare and Medicaid facilities for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), including flexibilities around the responsibilities designated for direct support staff and direct care staff; requirements that beneficiaries have the opportunity to participate in group activities; and some training requirements for staff.
• When it ends: Retroactive to March 1, 2020 and can be reissued until the end of the PHE.