CMS Removes Unnecessary Administrative and Regulatory Requirements for PAs, Other Health Professionals

Waiver Temporarily Eliminates Requirement for Medicare Patients in Hospital to be Under Care of Physician

April 1, 2020

By Michael Powe, Vice President of Reimbursement & Professional Advocacy

The Centers for Medicare and Medicaid Services (CMS) initiated another round of regulatory relief on March 30 aimed at increasing the ability of PAs, other health professionals and hospitals to deliver needed care to patients during the COVID-19 crisis. These temporary waivers are designed to remove unnecessary administrative and regulatory requirements and provide maximum flexibility to increase access to care for patients.

The regulations will immediately allow for:

• Waiving a long-standing provision which requires that Medicare patients in the hospital be under the care of a physician. This allows hospitals to use other practitioners, such as PAs, to the fullest extent possible.
• The use of telephone communication (as opposed to the previous audio-visual requirement) for evaluation and management services;
• Waiving certain requirements to allow hospitals to hire PAs, physicians and other health professionals to increase workforce capacity and deal with potential patient surges;
• Health professionals to temporarily enroll in Medicare including those who previously officially opted out of Medicare for the required two-year period;
• Temporarily permit non-hospital buildings to be used for patient care and quarantine sites, if approved by the state.

CMS is authorized to waive regulatory requirements for federal programs including Medicare, and for Medicare beneficiaries. However, CMS can’t alter or override existing state laws, hospital policies, such as, bylaws or privileging requirements, or regulations in state Medicaid programs.

PAs will need to check their individual state laws and workplace policies to determine how they can best utilize the CMS flexibility. AAPA is encouraging Governors to provide maximum flexibility for PAs to practice to the full extent of their education and experience by waiving physician supervision requirements during this crisis.

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