Waiver Tracker
Coronavirus (COVID-19)

Trained healthcare professionals are standing by to answer questions about coronavirus. The call is free. NJ residents should call the 24-Hour Public Hotline, called "The NJ Poison Control and Coronavirus Hotline," at 1-800-962-1253.

The NJ Poison Control Center and 211 have partnered with the State to provide information to the public on COVID-19:

Call: 2-1-1 | Text: NJCOVID to 898-211 | Visit: https://covid19.nj.gov/ for additional information

In a highly regulated field like healthcare, temporary waivers of certain regulations allow healthcare facilities to adjust and respond more quickly during a public health emergency. This Waiver Tracker provides status updates on federal and state waivers sought by NJHA.

Main COVID-19 Page Hospital Visitation Codes COVID BigShot Site Coronavirus Briefings Key for locked members only page.

Updated on July 22, 2021

N.J. Department of Health

Hospitals (General and Specialty), Nursing Homes, Assisted Living/CPCH, Home Health, Hospice

WaiverApplies ToStatus
On July 21, 2021, the NJ DOH issued a blanket waiver for the requirement at N.J.A.C. 8:43G-2.5 that a licensed general hospital only provide services within the hospital’s licensed space and to permit hospitals to apply for entry into CMS’ Acute Care Hospital at Home Program and provide the services permitted under the program by CMS, if approved.

To institute the Hospital at Home Program, CMS issued an individual waiver requirement for standards at 42 CFR 482.23(b) and (b) 1 that required nursing services to be provided in a hospital 24 hours a day, 7 days a week with a registered nurse immediately available for the care of any patient. The Hospital at Home program identified 60 acute care conditions that can be treated at home with proper monitoring and treatment protocols.

NJ hospitals that have been granted a waiver by CMS to participate in the Hospital at Home Program must — prior to providing any services under the program – send to the NJDOH (Eugene.brenycz@doh.nj.gov):
  • A copy of the hospital’s CMS waiver approval
  • The date the hospital will begin providing acute care hospital at home program services
  • The name, phone number and email address of the hospital’s contact for NJDOH to contact about the program.


After the conclusion of the CMS waiver, hospitals will be required to resume compliance with the temporarily waived NJDOH standards noted above.
Hospitals Reinstated

01/11/2021
Allow RMTs and CHHAs to function in CNA Role Nursing Homes EXPIRED

01/11/2021
CNA Reciprocity

SNF & Assisted Living Reinstated

1/11/2022
Pre-employment Requirements The Department of Health will not require prior Department approval of temporary waivers for the following requirements from licensed facilities:

  • Exceeding licensed bed capacity
  • Bed additions requiring prior CN approval
  • Physical space requirements
  • Staff qualifications requirements
  • Facilities will have to provide a written report to DOH detailing which, if any, actions were implemented, the duration and any adverse outcomes that result
All licensed health care providers licensed under N.J.A.C. 8:36, 39, 43G and 43H Covered under DOH memo

Reinstated

1/11/2022
Credentialing Standards N.J.A.C. 8:43G-16.1(b)-(e) permits acute care hospitals to substitute the credentialing standards of their accrediting body instead of the DOH requirements Hospitals, as per N.J.A.C. 8:43G-16.1(b)-(e) Reinstated

1/11/2022
Certification – Assisted Living Administrators — Expiration dates between March 1 and May31, 2020 are extended 90 days. CALA will be able to complete CEUs up to the new expiration date of their certification Assisted Living, as per N.J.A.C. 8:36 Expired 8/31/2020
Certification – Nursing Assistants — all expiration dates between March 1 and May 31, 2020 are extended 90 days Nursing homes, Assisted Living, Hospitals, as per N.J.A.C. 8:39-43 Reinstated

1/11/2022
Certification – Medication Aides — all expiration dates between March 1 and May 31, 2020 are extended 90 days. CMAs will be permitted to complete CEUs up to the new expiration date of their certification Assisted Living, as per N.J.A.C. 8:36-9.2 Reinstated

1/11/2022
Providing services outside certificate of need or designated area Home Health and Hospice, as per N.J.A.C. 8:42 and 8:42C Reinstated

1/11/2022
WAIVER/MODIFICATION OF N.J.A.C. 8:39-43.2 - REQUIREMENTS FOR NURSE AIDE CERTIFICATION, adopted by THE COMMISSIONER OF THE DEPARTMENT OF HEALTH

Updated: Extends expiration of certifications for CNAs through August 31. The above-referenced rule is hereby waived/modified subject to the following additional terms and conditions:

  1. During the period of Public Health Emergency declared by Governor Philip D. Murphy in Executive Order No. 103 issued on March 9, 2020, and extended by Executive Order No.119 issued on April 7, 2020, and so long as the Public Health Emergency exists pursuant to a Governor’s Executive Order, the following individuals, although not certified, may be employed as nurse aides: Individuals who complete and pass the 8-hour Temporary Nurse Aide Training Program sponsored by the American Health Care Association and the National Center for Assisted Living program and have demonstrated competency using the program’s skills competency checklist.


All individuals seeking to work as a nurse aide pursuant to this waiver/modification must comply with the requirements for a criminal background check pursuant to N.J.A.C. 8:43I, and the time delineated in N.J.S.A. 26:2H-84(d) (60 days for the Division of State Police in the Department of Law and Public Safety background check and an additional 60 days for the federal authorities’ background check) will be extended for a period of 90 days.

Long-term care facilities, assisted living facilities, assisted living programs and comprehensive personal care homes may temporarily employ individuals who qualify under N.J.A.C. 8:39-43.2(c)(1) and (2). Facilities that hire one or more nurse aides under the modified requirements created by this waiver/modification must:

  1. retain records detailing which, if any, of the above actions were implemented, including a list of the names, Social Security numbers and birth dates of the individuals temporarily hired pursuant to this waiver/modification, the training records and completed competency checklists, the duration of the implementation, and must document and immediately report to the Department any incidents involving the abuse,neglect or misappropriation of property of a resident of the facility, which are attributable to the nurse aides hired under this waiver/modification
  2. within one week of the hiring of one or more nurse aides, provide the Department with the names, Social Security numbers and birth dates of the individuals temporarily hired pursuant to this waiver/modification by sending the information to: Garlina Finn, Education Program Development Specialist Certification Program New Jersey Department of Health P.O. Box 358 Trenton, New Jersey 08625-0358


  1. When the Public Health Emergency is lifted, facilities will be required to return to operation in accordance with all licensure standards. Nurse aides employed pursuant to this waiver/modification will no longer be eligible to work as nurse aides and will have to fulfill the regulatory requirements to become a certified nurse aide.
https://www.state.nj.us/health/legal/covid19/4-15-2020_NurseAideCompetency.pdf
Nursing homes, as per N.J.A.C. 8:39-43 Reinstated

1/11/2022
Foreign nurses, graduate nurses, student nurses are able to work as CNAs under certain circumstances Nursing homes, hospitals, assisted living Reinstated

1/11/2022
Uncertified aides are permitted to work up to 7 months Nursing homes, hospitals, assisted living Reinstated

1/11/2022
CNAs with expired certifications within the last 3 years are permitted to continue working Nursing homes, hospitals, assisted living, as per N.J.A.C. 8:39-43 Reinstated

1/11/2022
Waiver/modification of NJAC 8:36-9.1 Qualifications of Personal Care Assistants Assisted living Reinstated

1/11/2022
Waiver/modification of NJAC 8:36-9.2© Extends by six months the timeframe for a candidate to take the CMA exam if their original date was march 1 through May 31, 2020 Assisted living, as per N.J.A.C. 8:36 Reinstated

1/11/2022
Emergency Medical Services Waivers for EMTs, Paramedics, BLS, ALS

Paramedics; Hospitals Reinstated

1/11/2022
Notwithstanding (c) above, criminal background clearance notifications issued to a CNA or CNA candidate between November 1, 2019 and March 31, 2020 are valid for a period of 270 days from the date of issuance of the notice of qualification. If full certification is not obtained by the 270th day following the issuance of the notice of qualification, the notice shall expire, and a new criminal history report must be obtained. Hospitals, nursing homes, assisted living Reinstated

1/11/2022
Paid Dining Assistants

On April 22, 2020, CMS issued a waiver from the requirements of 42 C.F.R. 483.160 for the duration of the federal emergency declared for the COVID-19 pandemic. Under this waiver, a State agency may recognize a one-hour temporary feeding assistant training program that incorporates the topics covered by the 8-hour training course as a substitute for the 8-hour training course required under the rule. The waiver also requires a long term care facility to conduct a competency assessment of the temporary feeding assistant trained under the one-hour program before allowing the feeding assistant to provide dining and feeding assistance to a resident and continues to prohibit a facility from using feeding assistants for complex residents with swallowing difficulties. Pursuant to the CMS waiver, the Department has reviewed and is recognizing a one-hour online training course developed by the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAl) for temporary feeding assistants. This free one-hour online training course is found at: https://educate.ahcancal.org/products/temporary-feeding-assistant
Nursing Homes Reinstated

1/11/2022
Blanket Waiver for Home Health Agency Licensing Standards at N.J.A.C. 8:42 and Hospice Agency Licensing Standards at N.J.A.C. 8:42C that are More Stringent than Waivers and Guidance Issued by the Centers for Medicare & Medicaid Services during the Public Health Emergency

4-23-2020 Blanket Waiver for Home Hospice Programs
4-24-2020 Blanket Waiver for Home Health Agency Licensing Standards
Home Health and Hospice Agencies, as per N.J.A.C. 8:42 and 42C Reinstated

1/11/2022
Hospital Nursing Ratios waived on units prescribed by regulation- N.J.A.C. 8:43G-17.1 Hospitals, as per N.J.A.C. 8:43G-11, 11A, 17.1 and 20 Reinstated

1/11/2022
Discharge planning requirements waiver – N.J.A.C. 8:39-5.4 and N.J.A.C. 8:43G-11 Hospitals, Nursing Homes Reinstated

1/11/2022
Mandatory nurse staffing hours – N.J.A.C. 8:39-25.2 Nursing Homes Reinstated

1/11/2022
Dialysis Staffing Waiver
In the event CMS issues new superseding guidance, the new guidance shall be followed.
Dialysis Providers Reinstated

1/11/2022
Waiver of APN/Anesthesia and Certified Registered Nurse Anesthetists requirements at N.J.A.C. 8:43A Hospitals, ASCs Reinstated

1/11/2022
Permits a telemedicine or telehealth examination to substitute for any on-site examination or in-office visit of a resident by an outside healthcare provider that is required under the rules for long-term care facilities, assisted living facilities, assisted living programs, comprehensive personal care homes, dementia care homes and residential health care facilities. Nursing Home, Assisted Living Dementia Care Homes, RHCFs Reinstated

1/11/2022
Hospitals Reinstated

2021
Authorization for Members of Healthcare Provider Community to Conduct COVID-19 Vaccination Administration

Permission for Paramedics to Administer COVID-19 Vaccine
Paramedics Reinstated

1/11/2022

Volume Utilization Requirements for Invasive Cardiac Diagnostic Facilities, Cardiac Surgical Centers, Physicians Practicing at centers



SUBCHAPTER 1. CARDIAC DIAGNOSTIC FACILITIES
8:33E-1.4 Utilization criteria for invasive cardiac diagnostic facilities
(a)-(c) (No change.)
(d) Notwithstanding (a), (b), or (c) above, the minimum volume utilization requirements for invasive cardiac diagnostic facilities and physicians practicing at these facilities are suspended during the COVID-19 Public Health Emergency, as follows:

  1. The minimum volume utilization requirements for invasive cardiac diagnostic facilities are waived if at least one quarter of the facility's reporting cycle occurred during the Public Health Emergency originally declared in Executive Order No. 103 (2020); and
  2. The minimum volume utilization requirements for physicians are waived for any calendar year in which the Public Health Emergency originally declared in Executive Order No. 103 (2020) was in effect for 90 days or more.


SUBCHAPTER 2. REGIONAL CARDIAC SURGERY CENTERS
(a)-(e) (No change.)
(f) Notwithstanding (a) through (e) above, the minimum volume utilization requirements for cardiac surgical centers and physicians practicing at the centers are suspended during the COVID-19 Public Health Emergency, as follows:
  1. The minimum volume utilization requirements for cardiac surgical centers are waived if at least one quarter of the cardiac surgical center's reporting cycle occurred during the Public Health Emergency originally declared in Executive Order No. 103 (2020); and
  2. The minimum volume utilization requirements for physicians are waived for any calendar year in which the Public Health Emergency originally declared in Executive Order No. 103 (2020) was in effect for 90 days or more.
Hospitals Reinstated

1/11/2022

GO TO TOP

NJ Department of Human Services — Waivers & Policy Guidance Related to Medicaid

WaiverApplies ToStatus
COVID-19 Policy Guidance: Suspension of Face-to-Face Assessments and Suspension of PASRR Level I and Level II Requirements

Preadmission Screening and Resident Review (PASRR) Level I and Level II requirements for NF and SCNF admissions will be temporarily waived. Face-to-face assessment, reassessment, transfer requests, and I Choose Home/Money Follows the Person activities will be replaced with telephonic processes for the most critical functions to the greatest extent possible. The following processes are in place to facilitate placement in long term care facilities to ensure that these services are available to the individuals who are in need as well as facilitate Medicaid payment for those individuals who are determined financially eligible for NJ Medicaid programs.
SNFs, Assisted Living, SCNFs, Hospitals, Psychiatric Hospitals Rescinded:
11/15/2021
Guidance on Telehealth for Behavioral Health Providers Behavioral Health Providers Reinstated

1/11/2022
Guidance on Telehealth for Partial Hospitalization and Partial Care Providers Partial Hospitalization and Partial Care Reinstated

1/11/2022

GO TO TOP

NJ Department of Banking & Insurance

WaiverApplies ToStatus
COVID-19 and Health Insurance FAQ Providers; Insurers Remains Available

1/11/2022
Telehealth FAQ Providers; Insurers Remains available

1/11/2022
Coverage of COVID-19 Testing

https://www.state.nj.us/dobi/bulletins/blt20_24.pdf

https://www.state.nj.us/dobi/bulletins/blt20_03.pdf

The Department of Banking and Insurance (“Department”) is expanding the requirements in Bulletin 20-03 to require carriers to cover, without cost-sharing, without prior authorization or other medical management requirements, any SARS-COV-2 molecular test authorized pursuant to the DOH standing order. This requirement includes such testing, regardless of site as authorized by the DOH Standing Order, including tests administered at any in or out-of-network community-based, county testing, or private testing site, (including, but not limited to, in and out-of-network hospitals, provider offices, urgent care centers, and pharmacies), and includes items and services furnished to an individual during such visits that result in an order for or administration of a SARS-COV-2 molecular test. Carriers must treat any such test authorized pursuant to the DOH standing order as medically appropriate for the individual. Carriers must not impose cost-sharing for SARSCOV-2 molecular tests provided by in-network or out-of-network laboratories.
Providers; Insurers Reinstated

1/11/2022
USE OF TELEMEDICINE AND TELEHEALTH DURING THE COVID-19 PANDEMIC – PERSONAL INJURY PROTECTION COVERAGE Auto Insurers providing medical expense benefits under PIP; Providers Remains available

1/11/2022
USE OF TELEMEDICINE AND TELEHEALTH TO RESPOND TO THE COVID-19 PANDEMIC HEALTH INSURANCE COMPANIES, HEALTH MAINTENANCE ORGANIZATIONS, HEALTH SERVICE CORPORATIONS AND ANY OTHER ENTITY ISSUING HEALTH BENEFITS PLANS IN THIS STATE Remains available

1/11/2022

GO TO TOP

Centers for Medicare & Medicaid Services — Hospitals

WaiverApplies ToStatus
Emergency Medical Treatment & Labor Act (EMTALA). CMS is waiving the enforcement of section 1867(a) of the Act. This will allow hospitals, psychiatric hospitals, and critical access hospitals (CAHs) to screen patients at a location offsite from the hospital’s campus to prevent the spread of COVID-19, so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan. Hospitals; Psychiatric Hospitals APPROVED

Updated 11/29/2021
Verbal Orders. CMS is waiving some requirements to provide additional flexibility related to verbal orders where read-back verification is required, but authentication may occur later than 48 hours. Specifically, the following requirements are waived:

  • §482.23(c)(3)(i) -If verbal orders are used for the use of drugs and biologicals (except immunizations), they are to be used infrequently.
  • §482.24(c)(2) -All orders, including verbal orders, must be dated, timed, and authenticated promptly by the ordering practitioner or by another practitioner who is responsible for the care of the patient.
  • §482.24(c)(3) -Hospitals may use pre-printed and electronic standing orders, order sets, and protocols for patient orders. This would include all subparts at §482.24(c)(3).
  • §485.635(d)(3) -Although the regulation requires that medication administration be based on a written, signed order, this does not preclude the CAH from using verbal orders. A practitioner responsible for the care of the patient must authenticate the order in writing as soon as possible after the fact.
Hospitals APPROVED

Updated 11/29/2021
Signature Requirements: CMS is not enforcing signature and proof of delivery requirements for Part B drugs and Durable Medical Equipment when a signature cannot be obtained because of the inability to collect signatures. Suppliers should document in the medical record the appropriate date of delivery and that a signature was not able to be obtained because of COVID-19. Hospitals APPROVED

Updated 11/29/2021
Reporting Requirements. CMS is waiving the requirements which require that hospitals report patients in an intensive care unit whose death is caused by their disease, but who required soft wrist restraints to prevent pulling tubes/IVs, no later than the close of business on the next business day. Any death where the restraint may have contributed must still be reported within standard time limits (i.e., close of business on the next business day following knowledge of the patient’s death). Hospitals APPROVED

Updated 11/29/2021
Patient Rights. CMS is waiving requirements under 42 CFR §482.13 only for hospitals that are considered to be impacted by a widespread outbreak of COVID-19. Hospitals that are located in a state which has widespread confirmed cases (i.e., 51 or more confirmed cases*) as updated on the CDC website, CDC States Reporting Cases of COVID-19, at ttps://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html, would not be required to meet the following requirements:

  • §482.13(d)(2) -With respect to timeframes in providing a copy of a medical record.
  • §482.13(h) -Related to patient visitation, including the requirement to have written policies and procedures on visitation of patients who are in COVID-19 isolation and quarantine processes.
  • §482.13(e)(1)(ii) -Regarding seclusion.
Hospitals APPROVED

Updated 11/29/2021
Telehealth

Hospital Outpatient Services Accompanying Professional Services Furnished Via Telehealth:

When a physician or non-physician practitioner who typically furnishes professional services in the hospital outpatient department furnishes telehealth services during theCOVID-19 PHE, they bill with a hospital outpatient place of service since that is likely where the services would have been furnished if not for the COVID-19 PHE. The physician or practitioner is paid for the service under the PFS at the facility rate, which does not include payment for resources such as clinical staff, supplies, or office overhead since those things are usually supplied by the hospital outpatient department. During the COVID-19 PHE, if the beneficiary’s home or temporary expansion site is considered to be a provider-based department of the hospital, and the beneficiary is registered as an outpatient of the hospital for purposes of receiving telehealth services billed by the physician or practitioner, the hospital may bill under the PFS for the originating site facility fee associated with the telehealth service.

CMS is waiving the provisions related to telemedicine at 42 CFR §482.12(a) (8)– (9)for hospitals, making it easier for telemedicine services to be furnished to the hospital’s patients through an agreement with an off-site hospital.
Hospitals APPROVED

Updated 11/29/2021
Hospitals Able to Provide Care in Temporary Expansion Sites: Hospitals can provide hospital services in other healthcare facilities and sites that would not otherwise be considered to be part of a healthcare facility; or can set up temporary expansion sites to help address the urgent need to increase capacity to care for patients. For the duration of the COVID-19 PHE, CMS is allowing hospitals to screen patients at offsite locations, and furnish inpatient and outpatient services at temporary expansion sites. Hospitals APPROVED

Updated 11/29/2021
Ambulatory Surgical Centers Temporary Enrollment as Hospitals. ASCs that wish to enroll to receive temporary billing privileges as a hospital should call the COVID-19 Provider Enrollment Hotline to reach the contractor that serves their jurisdiction, and then will complete and sign an attestation form specific to the COVID-19 PHE. See https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf for additional information. ASCs APPROVED

Updated 11/29/2021
Sterile Compounding. CMS is waiving requirements at 42CFR §482.25(b)(1) and §485.635(a)(3) in order to allow used face masks to be removed and retained in the compounding area to be re-donned and reused during the same work shift in the compounding area only. CMS will not review the use and storage of face masks under these requirements. Hospitals APPROVED

Updated 11/29/2021
Detailed Information Sharing for Discharge Planning for Hospitals and CAHs. CMS is waiving the requirement 42 CFR §482.43(a)(8), §482.61(e), and §485.642(a)(8) to provide detailed information regarding discharge planning, described below:

  • The hospital, psychiatric hospital, and CAH must assist patients, their families, or the patient’s representative in selecting a post-acute care provider by using and sharing data that includes, but is not limited to, home health agency (HHA), skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), and long-term care hospital (LTCH) quality measures and resource use measures. The hospital must ensure that the post-acute care data on quality measures and resource use measures is relevant and applicable to the patient’s goals of care and treatment preferences.
  • CMS is maintaining the discharge planning requirements that ensure a patient is discharged to an appropriate setting with the necessary medical information and goals of care as described in 42 CFR §482.43(a)(1)-(7) and (b).
Hospitals APPROVED

Updated 11/29/2021
Limiting Detailed Discharge Planning for Hospitals. CMS is waiving all the requirements and subparts at 42 CFR §482.43(c) related to post-acute care services as follows:

  • §482.43(c)(1): Include in the discharge plan a list of HHAs, SNFs, IRFs, or LTCHs that are available to the patient.
  • §482.43(c)(2): Inform the patient or the patient’s representative of their freedom to choose among participating Medicare providers and suppliers of post-discharge services.
  • §482.43(c)(3): Identify in the discharge plan any HHA or SNF to which the patient is referred in which the hospital has a disclosable financial interest, as specified by the Secretary, and any HHA or SNF that has a disclosable financial interest in a hospital under Medicare.
Hospitals APPROVED

Updated 11/29/2021
Physical Environment. CMS is waiving certain physical environment requirements at 42 CFR §482.41 and 42 CFR §485.623 to allow for increased flexibilities for surge capacity and patient quarantine at hospitals, psychiatric hospitals, and critical access hospitals (CAH). CMS will permit facility and non-facility space that is not normally used for patient care to be utilized for patient care or quarantine, provided the location is approved by the state and is consistent with the state’s emergency preparedness or pandemic plan. States are still subject to obligations under the integration mandate of the Americans with Disabilities Act, to avoid subjecting persons with disabilities to unjustified institutionalization or segregation. Hospitals APPROVED

Updated 11/29/2021
Specific Life Safety Code (LSC) for Hospitals: CMS is modifying these requirements as follows:

Alcohol-based Hand-Rub (ABHR) Dispensers: We are waiving the prescriptive requirements for the placement of alcohol-based hand rub (ABHR) dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs contain ethyl alcohol, which is considered a flammable liquid, and there are restrictions on the storage and location of the containers. This includes restricting access by certain patient/resident population to prevent accidental ingestion. Due to the increased fire risk for bulk containers (over five gallons) those will still need to be stored in a protected hazardous materials area. Refer to: 2012 LSC, sections 18/19.3.2.6. In addition, facilities should continue to protect ABHR dispensers against inappropriate use as required by 42 CFR §482.41(b)(7) for hospitals and §485.623(c)(5) for CAHs.

Fire Drills: Due to the inadvisability of quarterly fire drills that move and mass staff together, we will instead permit a documented orientation training program related to the current fire plan, which considers current facility conditions. The training will instruct employees, including existing, new or temporary employees, on their current duties, life safety procedures and the fire protection devices in their assigned area. Refer to: 2012 LSC, sections 18/19.7.1.6.

Temporary Construction: CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients. Refer to: 2012 LSC, sections18/19.3.3.2.
Hospitals APPROVED

Updated 11/29/2021
Hospital Outpatient: Use of Provider-Based Departments as Temporary Expansion Sites: CMS is waiving certain requirements at 42 CFR §482.41 and §485.623 and the provider-based department requirements at 42 CFR §413.65 to allow hospitals to expand capacity by create new or relocating existing provider-based departments. CMS has made several changes to support hospitals so they can more effectively respond to the COVID-19 PHE. Hospitals APPROVED

Updated 11/29/2021
Hospital-Only Remote Outpatient Therapy and Education Services: Hospitals may provide behavioral health and education services furnished by hospital-employed counselors or other professionals that cannot bill Medicare directly for their professional services. This includes partial hospitalization services. These services may be furnished to a beneficiary in their home when the beneficiary is registered as an outpatient of the hospital and the hospital considers the beneficiary’s home to be a provider-based department of the hospital. Hospitals APPROVED

Updated 11/29/2021
Expanded Ability for Hospitals to Offer Long-term Care Services (“Swing-Beds”) for Patients Who do not Require Acute Care but do Meet the Skilled Nursing Facility (SNF) Level of Care Criteria as Set Forth at 42 CFR 409.31. CMS is waiving the requirements at 42 CFR 482.58, to allow hospitals to establish SNF swing beds payable under the SNF prospective payment system (PPS) to provide additional options for hospitals with patients who no longer require acute care but are unable to find placement in a SNF. Hospitals APPROVED

Updated 11/29/2021
Housing Acute Care Patients in Excluded Distinct Part Units: CMS is waiving requirements to allow acute care hospitals to house acute care inpatients in excluded distinct part units, where the distinct part unit’s beds are appropriate for acute care inpatients. The Inpatient Prospective Payment System (IPPS) hospital should bill for the care and annotate the patient’s medical record to indicate the patient is an acute care inpatient being housed in the excluded unit because of capacity issues related to the disaster or emergency. Hospitals APPROVED

Updated 11/29/2021
Care for Excluded Inpatient Psychiatric Unit Patients in the Acute Care Unit of a Hospital: CMS is waiving requirements to allow acute care hospitals with excluded distinct part inpatient psychiatric units that, as a result of a disaster or emergency, need to relocate inpatients from the excluded distinct part psychiatric unit to an acute care bed and unit. This waiver may be utilized where the hospital’s acute care beds are appropriate for psychiatric patients and the staff and environment are conducive to safe care. For psychiatric patients, this includes assessment of the acute care bed and unit location to ensure those patients at risk of harm to self and others are safely cared for. Hospitals APPROVED

Updated 11/29/2021
Care for Excluded Inpatient Rehabilitation Unit Patients in the Acute Care Unit of a Hospital: CMS is waiving requirements to allow acute care hospitals with excluded distinct part inpatient Rehabilitation units that, as a result of a disaster or emergency, need to relocate inpatients from the excluded distinct part rehabilitation unit to an acute care bed and unit. This waiver may be utilized where the hospital’s acute care beds are appropriate for providing care to rehabilitation patients and such patients continue to receive intensive rehabilitation services. Hospitals APPROVED

Updated 11/29/2021
Flexibility for Inpatient Rehabilitation Facilities Regarding the “60 Percent Rule". CMS is allowing IRFs to exclude patients from the freestanding hospital’s or excluded distinct part unit’s inpatient population for purposes of calculating the applicable thresholds associated with the requirements to receive payment as an IRF if an IRF admits a patient solely to respond to the emergency and the patient’s medical record properly identifies the patient as such. Inpatient Rehabilitation Hospitals APPROVED

Updated 11/29/2021
Inpatient Rehabilitation Facility – Intensity of Therapy Requirement (“3-Hour Rule”). The Secretary has waived 42 CFR§412.622(a)(3)(ii) which provides that payment generally requires that patients of an inpatient rehabilitation facility receive at least 15 hours of therapy per week. This waiver clarifies information provided in “Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency” (CMS-1744-IFC). (85 Federal Register19252, 19287, April 6, 2020). The information in that rulemaking (CMS-1744-IFC) about Inpatient Rehabilitation Facilities was contemplated prior to the passage of the CARES Act. Inpatient Rehabilitation Hospitals APPROVED

Updated 11/29/2021
Long Term Care Hospitals -Site Neutral Payment Rate Provisions. The Secretary has waived section 1886(m)(6) of the Social Security Act relating to certain site neutral payment rate provisions for long-term care hospitals (LTCHs).

  • Section 3711(b)(1) of the CARES Act waives the payment adjustment under section 1886(m)(6)(C)(ii) of the Act for LTCHs that do not have a discharge payment percentage (DPP) for the period that is at least 50 percent during the COVID-19 public health emergency period. Under this provision, for the purposes of calculating an LTCH’s DPP, all admissions during the COVID-19 public health emergency period will be counted in the numerator of the calculation, that is, LTCH cases that were admitted during the COVID-19 public health emergency period will be counted as discharges paid the LTCH PPS standard Federal payment rate.
  • Section 3711(b)(2) of the CARES Act provides a waiver of the application of the site neutral payment rate under section 1886(m)(6)(A)(i) of the Act for those LTCH admissions that are in response to the public health emergency and occur during the COVID-19 public health emergency period. Under this provision, all LTCH cases admitted during the COVID-19 public health emergency period will be paid the relatively higher LTCH PPS standard Federal rate. A new LTCH PPS Pricer software package will be released in April 2020 to include this temporary payment policy effective for claims with an admission date occurring on or after January 27, 2020 and continuing through the duration of the COVID-19 public health emergency period. Claims received on or after April 21, 2020, will be processed in accordance with this waiver. Claims received April 20, 2020, and earlier will be reprocessed.
Long Term Care Hospitals APPROVED

Updated 11/29/2021
Supporting Care for Patients in Long-Term Care Acute Hospitals (LTCHs). CMS has determined it is appropriate to issue a blanket waiver to long-term care hospitals (LTCHs) where an LTCH admits or discharges patients in order to meet the demands of the emergency from the 25-day average length of stay requirement at § 412.23(e)(2), which allows these hospitals to participate in the LTCH PPS. Hospitals should add the “DR” condition code to applicable claims. Long Term Care Hospitals; Acute Care Hospitals APPROVED

Updated 11/29/2021
Medicare Graduate Medical Education (GME) Affiliation Agreement

CMS is waiving the July 1 submission deadline under 42 CFR 413.79(f)(1) for new Medicare GME affiliation agreements and the June 30 deadline under the May 12, 1998 Health Care Financing Administration Final Rule (63 FR 26318, 26339, 26341) for amendments of existing Medicare GME affiliation agreements. CMS is allowing hospitals to submit new and/or amended Medicare GME affiliation agreements as applicable to CMS and the MACs by January 1, 2021. As under existing procedures, hospitals should email new and/or amended agreements to CMS at Medicare_GME_Affiliation_Agreement@cms.hhs.gov, and indicate in the subject line whether the affiliation agreement is a new one or an amended one.
Hospitals APPROVED

Updated 11/29/2021
Postponement of Application Deadline to the Medicare Geographic Classification Review Board

CMS is postponing the September 1 deadline until 15 days after the public display date of the FY 2021 IPPS/LTCH final rule by the Office of the Federal Register.
Hospitals EXPIRED
Medical Staff. CMS is waiving requirements under 42 CFR §482.22(a)(1)-(4) to allow for physicians whose privileges will expire to continue practicing at the hospital and for new physicians to be able to practice before full medical staff/governing body review and approval CMS is waiving §482.22(a) (1)-(4) regarding details of the credentialing and privileging process. Hospitals APPROVED

Updated 11/29/2021
Physician Services. CMS is waiving requirements under 42 CFR §482.12(c)(1)–(2)and§482.12(c)(4), which requires that Medicare patients be under the care of a physician. This waiver may be implemented so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan. This allows hospitals to use other practitioners to the fullest extent possible. Hospitals APPROVED

Updated 11/29/2021
Anesthesia Services. CMS is waiving requirements under 42 CFR §482.52(a)(5), §485.639(c) (2), and §416.42 (b)(2) that a certified registered nurse anesthetist (CRNA) is under the supervision of a physician CRNA supervision will be at the discretion of the hospital and state law. Hospitals; ASCs APPROVED

Updated 11/29/2021
Nursing Services. CMS is waiving the requirements at 42 CFR §482.23(b)(4), which requires the nursing staff to develop and keep current a nursing care plan for each patient, and§482.23(b)(7), which requires the hospital to have policies and procedures in place establishing which outpatient departments are not required to have a registered nurse present. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. Hospitals APPROVED

Updated 11/29/2021
Respiratory Care Services. CMS is waiving the requirements at 42 CFR §482.57(b)(1) that require hospitals to designate in writing the personnel qualified to perform specific respiratory care procedures and the amount of supervision required for personnel to carry out specific procedures. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. Hospitals APPROVED

Updated 11/29/2021
Medical Records. CMS is waiving requirements under 42 CFR §482.24(a) through (c), which cover the subjects of the organization and staffing of the medical records department, requirements for the form and content of the medical record, and record retention requirements, and these flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. CMS is waiving §482.24(c)(4)(viii) related to medical records to allow flexibility in completion of medical records within 30 days following discharge from a hospital. Hospitals APPROVED

Updated 11/29/2021
Flexibility in Patient Self Determination Act Requirements (Advance Directives). CMS is waiving the requirements which require hospitals to provide information about their advance directive policies to patients. Hospitals APPROVED

Updated 11/29/2021
Utilization Review. CMS is waiving the entire utilization review condition of participation Utilization Review (UR) at §482.30, which requires that a hospital must have a UR plan with a UR committee that provides for a review of services furnished to Medicare and Medicaid beneficiaries to evaluate the medical necessity of the admission, duration of stay, and services provided. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. Hospitals APPROVED

Updated 11/29/2021
Written Policies and Procedures for Appraisal of Emergencies at Off Campus Hospital Departments. CMS is waiving 42 CFR §482.12(f)(3), emergency services, with respect to surge facilities only, such that written policies and procedures for staff to use when evaluating emergencies are not required for surge facilities. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. Surge Hospitals APPROVED

Updated 11/29/2021
Emergency Preparedness Policies and Procedures. CMS is waiving 42 CFR §482.15(b) and §485.625(b), which requires the hospital to develop and implement emergency preparedness policies and procedures, and §482.15(c)(1)–(5) and §485.625(c)(1)–(5) which requires that the emergency preparedness communication plans for hospitals to contain specified elements with respect to the surge site. The requirement under the communication plan requires hospitals to have specific contact information for staff, entities providing services under arrangement, patients’ physicians, other hospitals and volunteers. This would not be an expectation for the surge site. Surge Hospitals APPROVED

Updated 11/29/2021
Quality Assessment and Performance Improvement Program. CMS is waiving 42CFR§482.21(a)–(d) and (f), and §485.641(a), (b), and (d), which provide details on the scope of the program, the incorporation, and setting priorities for the program’s performance improvement activities, and integrated Quality Assurance & Performance Improvement programs. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. We expect any improvements to the plan to focus on the Public Health Emergency (PHE). While this waiver decreases burden associated with the development of a QAPI program, the requirement to maintain an effective, ongoing, hospital-wide, data-driven quality assessment and performance improvement program will remain. Hospitals APPROVED

Updated 11/29/2021
Food and Dietetic Services. CMS is waiving the requirement at paragraph 42 CFR §482.28(b) (3), which requires providers to have a current therapeutic diet manual approved by the dietitian and medical staff readily available to all medical, nursing, and food service personnel. These flexibilities may be implemented so long as they are not inconsistent with a state’s emergency preparedness or pandemic plan. Surge Hospitals APPROVED

Updated 11/29/2021
Hospital Value-Based Purchasing (VBP) Program’s Extraordinary Circumstances Exceptions (ECE) policy: CMS has the ability to grant exceptions to hospitals located in entire regions or locales without an ECE request form where we determine that the extraordinary circumstance has affected the entire region or locale. CMS is granting an exception for certain HVBP reporting requirements in light of the COVID PHE as specified in the March 27, 2020 guidance memo:

https://www.cms.gov/files/document/guidance-memo-exceptions-and-extensionsquality-reporting-and-value-based-purchasing-programs.pdf
Hospitals APPROVED

Updated 11/29/2021
Application of Teaching Physician Regulations: Under current rules, Medicare payment is made for services furnished by a teaching physician involving residents only if the physician is physically present for the key portion of the service or procedure or the entire procedure, where applicable. During the COVID-19 PHE, teaching physicians may use audio/video real time communications technology to interact with the resident through virtual means, which would meet the requirement that they be present for the key portion of the service, including when the teaching physician involves the resident in furnishing Medicare Telehealth services. Teaching physicians involving residents in providing care at primary care centers can provide the necessary direction, management and review for the resident’s services using audio/video real time communications technology. Residents furnishing services at primary care centers may furnish an expanded set of services to beneficiaries, including levels 4-5 of an office/outpatient evaluation and management (E/M) visit, telephone E/M, care management, and communication technology-based services. These flexibilities do not apply in the case of surgical, high risk, interventional, or other complex procedures, services performed through an endoscope, and anesthesia services. This allows teaching hospitals to maximize their workforce to safely take care of patients. Teaching Hospitals APPROVED

Updated 11/29/2021
Resident Moonlighting: Under current rules, Medicare considers the services of residents that are not related to their approved graduate medical education programs and performed in the outpatient department or the emergency department of a hospital as separately billable physicians’ services. During the COVID-19 PHE, Medicare also considers the services of residents that are not related to their approved GME programs and furnished to inpatients of a hospital in which they have their training program as separately billable physicians’ services Teaching Hospitals APPROVED

Updated 11/29/2021
Counting of Resident Time at Alternate Locations: Existing regulations have specific rules on when a hospital may count a resident for purposes of Medicare direct graduate medical education (DGME) payments or indirect medical education (IME) payments. Normally, if the resident is performing activities with the scope of his/her approved program in his/her own home, or a patient’s home, the hospital may not count the resident. During the PHE, a hospital that is paying the resident’s salary and fringe benefits for the time that the resident is at home or in a patient’s home, but performing duties within the scope of the approved residency program and meets appropriate physician supervision requirements can claim that resident for IME and DGME purposes. This allows medical residents to perform their duties in alternate locations, including their own home or a patient’s home, so long as such activities meet appropriate physician supervision requirements. Teaching Hospitals APPROVED

Updated 11/29/2021
Graduate Medical Education (GME) Residents Training in Other Hospitals: During the COVID-19 PHE, a teaching hospital that sends residents to other hospitals will be able to continue to claim those residents in the teaching hospital’s IME and DGME FTE resident counts, if certain requirements are met. Those requirements include that 1) the teaching hospital sends the resident to the other hospital in response to the COVID-19 pandemic; 2) the time spent by the resident training at the other hospital is in lieu of time that would have been spent training at the sending hospital; and 3) the time that the resident spent training immediately prior to and/or subsequent to the time frame that the COVID-19 PHE was in effect was included in the FTE count for the sending hospital. Moreover, the presence of residents in non-teaching hospitals will not trigger establishment of IME and/or DGME FTE resident caps at those non-teaching hospitals. Specifically, for DGME, the presence of residents in non-teaching hospitals will not trigger establishment of PRAs at those non-teaching hospitals. Teaching Hospitals APPROVED

Updated 11/29/2021
IME Payments Held Harmless for Temporary Increase in Beds: During the COVID-19 PHE, CMS will hold teaching hospitals harmless from a reduction in IME payments due to beds temporarily added during the COVID-19 PHE by not considering such beds when determining IME payment. Teaching Hospitals APPROVED

Updated 11/29/2021
Inpatient Psychiatric Facilities (IPFs) Teaching Status Adjustment Payments: To ensure that teaching IPFs can alleviate bed capacity issues by taking patients from the inpatient acute care hospitals without being penalized by lower teaching status adjustments, we are freezing the IPFs’ teaching status adjustment payments at their values prior to the PHE. For the duration of the COVID-19 PHE, a teaching IPF’s teaching status adjustment payments will be the same as they were on the day before the COVID-19 PHE was declared. Inpatient Psychiatric Hospitals APPROVED

Updated 11/29/2021
“Stark Law” Waivers: The physician self-referral law (also known as the “Stark Law”) prohibits a physician from making referrals for certain healthcare services payable by Medicare if the physician (or an immediate family member) has a financial relationship with the entity performing the service. There are statutory and regulatory exceptions, but in short, a physician cannot refer a patient to any entity with which he or she has a financial relationship. On March 30, 2020, CMS issued blanket waivers of certain provisions of the Stark Law regulations. These blanket waivers apply to financial relationships and referrals that are related to the COVID-19 emergency. The remuneration and referrals described in the blanket waivers must be solely related to COVID-19 Purposes, as defined in the blanket waiver document. Under the waivers, CMS will permit certain referrals and the submission of related claims that would otherwise violate the Stark Law. These flexibilities include:

  • Hospitals and other health care providers can pay above or below fair market value for the personal services of a physician (or an immediate family member of a physician), and parties may pay below fair market value to rent equipment or purchase items or services. For example, a physician practice may be willing to rent or sell needed equipment to a hospital at a price that is below what the practice could charge another party. Or, a hospital may provide space on hospital grounds at no charge to a physician who is willing to treat patients who seek care at the hospital but are not appropriate for emergency department or inpatient care.
  • Health care providers can support each other financially to ensure continuity of health care operations. For example, a physician owner of a hospital may make a personal loan to the hospital without charging interest at a fair market rate so that the hospital can make payroll or pay its vendors. o Hospitals can provide benefits to their medical staffs, such as multiple daily meals, laundry service to launder soiled personal clothing, or child care services while the physicians are at the hospital and engaging in activities that benefit the hospital and its patients
  • Health care providers may offer certain items and services that are solely related to COVID-19 Purposes (as defined in the waivers), even when the provision of the items or services would exceed the annual non-monetary compensation cap. For example, a home health agency may provide continuing medical education to physicians in the community on the latest care protocols for homebound patients with COVID-19, or a hospital may provide isolation shelter or meals to the family of a physician who was exposed to the novel coronavirus while working in the hospital’s emergency department
  • Physician-owned hospitals can temporarily increase the number of their licensed beds, operating rooms, and procedure rooms, even though such expansion would otherwise be prohibited under the Stark Law. For example, a physician-owned hospital may temporarily convert observation beds to inpatient beds to accommodate patient surge during the COVID-19 pandemic in the United States. o Some of the restrictions regarding when a group practice can furnish medically necessary designated health services (DHS) in a patient’s home are loosened. For example, any physician in the group may order medically necessary DHS that is furnished to a patient by one of the group’s technicians or nurses in the patient’s home contemporaneously with a physician service that is furnished via telehealth by the physician who ordered the DHS. o Group practices can furnish medically necessary MRIs, CT scans or clinical laboratory services from locations like mobile vans in parking lots that the group practice rents on a part-time basis
Hospitals; Physicians APPROVED

Updated 11/29/2021
Comprehensive Care for Joint Replacement (CJR) Model

Extension of Comprehensive Care for Joint Replacement (CJR) Model Year 5: In the IFC issued October 28, 2020, CMS extended Performance Year (PY) 5 of the Comprehensive Care for Joint Replacement (CJR) model an additional 6 months, so PY 5 now ends September 30, 2021. To accommodate the extension of PY 5, CMS will perform a 12-month reconciliation period and a 9- month reconciliation period in PY 5. Further the adjustment to the extreme and uncontrollable circumstances policy for COVID-19, previously established in Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency IFC, will now expire on March 31, 2021 or the end of the PHE, whichever occurs first. After that, the extreme and uncontrollable circumstances policy for COVID-19 will be episode-based, where, beginning after the PHE or on April 1, 2020 (whichever occurs first) and through the end of the PHE, actual episode payments are capped at the quality adjusted target price for an episode with actual episode payments that include a claim with a COVID-19 diagnosis code. Lastly, to ensure that the model continues to include the same inpatient Lower Extremity Joint Replacement (LEJR) procedures, despite the adoption of new MS-DRGs 521 and 522 to describe those procedures, CMS made a technical change, retroactive to October 1, 2020, to include these new DRGs in the model. Questions about the CJR model can be submitted via email at CJRSupport@cms.hhs.gov.
CJR Hospitals EXPIRED
Enhanced Medicare Payments for New COVID-19 Treatments: Hospital Inpatient Stays: In order to mitigate potential financial disincentives for hospitals to provide new COVID-19 treatments hospital during the COVID-19 PHE, the Medicare program will provide an enhanced payment for eligible inpatient cases that involve use of certain new products authorized or approved to treat COVID-19. The enhanced payment will be equal to the lesser of: (1) 65 percent of the operating outlier threshold for the claim; or (2) 65 percent of the cost of a COVID-19 stay beyond the operating Medicare payment (including the 20 percent add-on payment under section 3710 of the CARES Act) for eligible cases. Hospitals APPROVED

Updated 11/29/2021
Price Transparency for COVID-19 Testing: In an Interim Final Rule with Comment Period (IFC) issued October, 28, 2020, CMS implemented the CARES Act requirement that providers of a diagnostic test for COVID-19 to make public the cash price for such tests on their websites. Providers without websites will be required to provide price information in writing within two business days upon request and on a sign posted prominently at the location where the provider performs the COVID-19 diagnostic test, if such location is accessible to the public. Noncompliance may result in civil monetary penalties up to $300 per day. Hospitals APPROVED

Updated 11/29/2021
Coverage for Monoclonal Antibody Therapies

During the COVID-19 public health emergency (PHE), Medicare will cover and pay for these infusions the same way it covers and pays for COVID-19 vaccines (when furnished consistent with the EUA). This will allow a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract for this, to administer these treatments in accordance with each product’s EUA and in accordance with any state scope of practice and licensure requirements. Please refer to Section BB of the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document for more information about coverage for COVID-19 Monoclonal Antibody Therapies.
Hospitals APPROVED

Updated 11/29/2021

GO TO TOP

Centers for Medicare & Medicaid Services — Skilled Nursing Facilities, Nursing Homes

WaiverApplies ToStatus
Physical Environment: Provided that the State has approved the location as one that sufficiently addresses safety and comfort for patients and staff, CMS is waiving requirements under 42 CFR §483.90 to allow for a non-SNF/NF building to be temporarily certified as and available for use by a SNF in the event there are needs for isolation processes for COVID-19 positive residents which may not be feasible in the existing SNF structure to ensure care and services during treatment for COVID-19 is available while protecting other vulnerable adults. CMS will waive certain conditions of participation and certification requirements for opening a SNF/NF if the state determines there is a need to quickly stand up a temporary COVID-19 isolation and treatment location. To assist with isolation needs, CMS is also temporarily allowing for rooms in a long-term care facility not normally used as a resident’s room, to be used to accommodate beds and residents for resident care in emergencies and situations needed to help with surge capacity. Rooms that may be used for this purpose include activity rooms, meeting/conference rooms, dining rooms, or other rooms, as long as residents can be kept safe, comfortable, and other applicable requirements for participation are met. This can be done so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan, or as directed by the local or state health department. SNFs; Temporary SNFS APPROVED

Updated 11/29/2021
3-Day Prior Hospitalization: Using the waiver authority under Section 1812(f) of the Social Security Act, CMS is temporarily waiving the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay. This waiver provides temporary emergency coverage of SNF services without a qualifying hospital stay. SNFs APPROVED

Updated 11/29/2021
Renewed SNF Coverage without 60-day wellness period
For certain beneficiaries who exhausted their SNF benefits, the waiver authorizes renewed SNF coverage without first having to start and complete a 60-day “wellness period” (that is, the 60-day period of non-inpatient status that is normally required in order to end the current benefit period and renew SNF benefits). This waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the 60-day “wellness period” that would have occurred under normal circumstances. By contrast, if the patient has a continued skilled care need (such as a feeding tube) that is unrelated to the COVID-19 emergency, then the beneficiary cannot renew his or her SNF benefits under the Section 1812(f) waiver, as it is this continued skilled care in the SNF rather than the emergency that is preventing the beneficiary from beginning the 60-day “wellness period.”
SNFs APPROVED

Updated 11/29/2021
Waive Pre-Admission Screening and Annual Resident Review (PASRR): CMS is allowing states and nursing homes to suspend these assessments for new residents for 30 days. After 30 days, new patients admitted to nursing homes with a mental illness (MI) or intellectual disability (ID) should receive the assessment as soon as resources become available. SNFs APPROVED

Updated 11/29/2021

Note: NJ reinstated PASRR requirements as of Nov. 2021
Resident Groups: CMS is waiving the requirements at §483.10(f)(5) to allow for residents to have the right to participate in-person in resident groups. This waiver would only permit the facility to restrict having in-person meetings during the national emergency given the recommendations of social distancing and limiting gatherings of more than ten people. Refraining from in-person gatherings will help prevent the spread of COVID-19. SNFs APPROVED

Updated 11/29/2021
Quality Assurance and Performance Improvement (QAPI). CMS is modifying certain requirements in 42 CFR §483.75, which requires long-term care facilities to develop, implement, evaluate, and maintain an effective, comprehensive, data-driven QAPI program. Specifically, CMS is modifying §483.75(b)–(d) and (e)(3) to the extent necessary to narrow the scope of the QAPI program to focus on adverse events and infection control. SNFs APPROVED

Updated 11/29/2021
Nurse Aide In-Service Training: CMS is modifying the nurse aide training requirements at §483.95(g)(1) for SNFs and NFs, which requires the nursing assistant to receive at least 12 hours of inservice training annually. In accordance with section 1135(b)(5) of the Act, we are postponing the deadline for completing this requirement throughout the COVID-19 PHE until the end of the first full quarter after the declaration of the PHE concludes. SNFs APPROVED

Updated 11/29/2021
Detailed Information Sharing for Discharge Planning. CMS is waiving the discharge planning requirement in §483.21(c)(1)(viii), which requires LTC facilities to assist residents and their representatives in selecting a post-acute care provider using data, such as standardized patient assessment data, quality measures and resource use. This temporary waiver is to provide facilities the ability to expedite discharge and movement of residents among care settings. CMS is maintaining all other discharge planning requirements, such as but not limited to, ensuring that the discharge needs of each resident are identified and result in the development of a discharge plan for each resident; and involving the interdisciplinary team, as defined at 42 CFR §483.21(b)(2)(ii), in the ongoing process of developing the discharge plan address the resident's goals of care and treatment preferences. SNFs APPROVED

Updated 11/29/2021
Clinical Records. Pursuant to section 1135(b)(5) of the Act, CMS is modifying the requirement at 42 CFR §483.10(g)(2)(ii) which requires long-term care (LTC) facilities to provide a resident a copy of their records within two working days (when requested by the resident). Specifically, CMS is modifying the timeframe requirements to allow LTC facilities ten working days to provide a resident’s record rather than two working days. SNFs APPROVED

Updated 11/29/2021
Transfers of COVID-19 Patients: A long term care (LTC) facility can temporarily transfer its COVID-19 positive resident(s) to another facility, such as a COVID-19 isolation and treatment location, with the provision of services “under arrangements.” The transferring LTC facility need not issue a formal discharge in this situation, as it is still considered the provider and should bill Medicare normally for each day of care. The transferring LTC facility is then responsible for reimbursing the other provider that accepted its resident(s) during the emergency period. This is consistent with recent CDC guidance, and helps residents with COVID-19 by placing them into facilities that are prepared to care for them. It also helps residents without COVID-19 by placing them in facilities without other COVID19 residents, thus helping to protect them from being infected. If the LTC facility does not intend to provide services under arrangement, the COVID-19 isolation and treatment facility is the responsible entity for Medicare billing purposes. The SNF should follow the procedures described in 40.3.4 of the Medicare Claims Processing Manual (https://www.cms.gov/Regulations-andGuidance/Guidance/Manuals/Downloads/clm104c06.pdf) to submit a discharge bill to Medicare. The COVID-19 isolation and treatment facility should then bill Medicare appropriately for the type of care it is providing for the beneficiary. If the COVID-19 isolation and treatment facility is not yet an enrolled provider, the facility should enroll through the provider enrollment hotline for the Medicare Administrative Contractor that services their geographic area to establish temporary Medicare billing privileges. SNFs APPROVED

Updated 11/29/2021
Inspection, Testing & Maintenance (ITM) under the Physical Environment Conditions of Participation: CMS is waiving certain physical environment requirements §483.90, §483.90(a)(1)(i) and (b) for SNFs/NFs to reduce disruption of patient care and potential exposure/transmission of COVID-19. The physical environment regulations require that facilities and equipment be maintained to ensure an acceptable level of safety and quality. CMS will permit facilities to adjust scheduled inspection, testing and maintenance (ITM) frequencies and activities for facility and medical equipment.

The following LSC and HCFC ITM are considered critical are not included in this waiver:
  • Sprinkler system monthly electric motor-driven and weekly diesel engine-driven fire pump testing.
  • Portable fire extinguisher monthly inspection.
  • Elevators with firefighters’ emergency operations monthly testing.
  • Emergency generator 30 continuous minute monthly testing and associated transfer switch monthly testing.
  • Means of egress daily inspection in areas that have undergone construction, repair, alterations or additions to ensure its ability to be used instantly in case of emergency.
SNFs APPROVED

Updated 11/29/2021
Waiver of §483.90(a)(7) that requires SNFs to have an outside window or outside door in every sleeping room. CMS will permit a waiver of these outside window and outside door requirements to permit these providers to utilize facility and non-facility space that is not normally used for patient care to be utilized for temporary patient care or quarantine. SNFs APPROVED

Updated 11/29/2021
Specific Life Safety Code (LSC) for Multiple Providers. CMS is waiving and modifying particular waivers under §483.90(a) for SNF/NFs. Specifically, CMS is modifying these requirements as follows:

  • Alcohol-based Hand-Rub (ABHR) Dispensers: We are waiving the prescriptive requirements for the placement of alcohol based hand rub (ABHR) dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs contain ethyl alcohol, which is considered a flammable liquid, and there are restrictions on the storage and location of the containers. This includes restricting access by certain patient/resident population to prevent accidental ingestion. Due to the increased fire risk for bulk containers (over five gallons) those will still need to be stored in a protected hazardous materials area. Refer to: 2012 LSC, sections 18/19.3.2.6. In addition, facilities should continue to protect ABHR dispensers against inappropriate use as required by 42 CFR §483.470(j)(5)(ii) for ICF/IIDs and §483.90(a)(4) for SNF/NFs.
  • Fire Drills: Due to the inadvisability of quarterly fire drills that move and mass staff together, we will instead permit a documented orientation training program related to the current fire plan, which considers current facility conditions. The training will instruct employees, including existing, new or temporary employees, on their current 10 duties, life safety procedures and the fire protection devices in their assigned area. Refer to: 2012 LSC, sections 18/19.7.1.6.
  • Temporary Construction: CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients. Refer to: 2012 LSC, sections 18/19.3.3.2.
SNFs APPROVED

Updated 11/29/2021
Physician Delegation of Tasks in SNFs: 42 CFR 483.30(e)(4). CMS is waiving the requirement in § 483.30(e)(4) that prevents a physician from delegating a task when the regulations specify that the physician must perform it personally. This waiver gives physicians the ability to delegate any tasks to a physician assistant, nurse practitioner, or clinical nurse specialist who meets the applicable definition in 42 CFR 491.2 or, in the case of a clinical nurse specialist, is licensed as such by the State and is acting within the scope of practice laws as defined by State law. We are temporarily modifying this regulation to specify that any task delegated under this waiver must continue to be under the supervision of the physician. This waiver does not include the provision of § 483.30(e)(4) that prohibits a physician from delegating a task when the delegation is prohibited under State law or by the facility’s own policy. SNFs APPROVED

Updated 11/29/2021
Physician Visits: 42 CFR 483.30(c)(3). CMS is waiving the requirement at § 483.30(c)(3) that all required physician visits (not already exempted in § 483.30(c)(4) and (f)) must be made by the physician personally. We are modifying this provision to permit physicians to delegate any required physician visit to a nurse practitioner (NPs), physician assistant, or clinical nurse specialist who is not an employee of the facility, who is working in collaboration with a physician, and who is licensed by the State and performing within the state’s scope of practice laws.

CMS is not waiving the requirements for the frequency of required physician visits at § 483.30(c)(1). CMS has only modified the requirement to allow for the requirement to be met by an NP, physician assistant, or clinical nurse specialist, and via telehealth or other remote communication options, as appropriate. In addition, CMS is not waiving requirements for physician supervision in § 483.30(a)(1), and the requirement at § 483.30(d)(3) for the facility to provide or arrange for the provision of physician services 24 hours a day, in case of an emergency. It is important that the physician be available for consultation regarding a resident’s care.
SNFs APPROVED

Updated 11/29/2021
Physician visits in skilled nursing facilities/nursing facilities: CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options. SNFs APPROVED

Updated 11/29/2021
Training and Certification of Nurse Aides: CMS is waiving the requirements at 42 CFR §483.35(d), (except for 42 CFR §483.35(d)(1)(i)), which require that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under §483.35(d). To ensure the health and safety of nursing home residents, CMS is not waiving §483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing related services. CMS is not waiving §483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care. SNFs APPROVED

Updated 11/29/2021
Paid Feeding Assistants: CMS is modifying the requirements at 42 CFR §§ 483.60(h)(1)(i) and 483.160(a) regarding required training of paid feeding assistants. Specifically, CMS is modifying the minimum timeframe requirements in these sections, which require this training to be a minimum of 8 hours. CMS is modifying to allow that the training can be a minimum of 1 hour in length. CMS is not waiving any other requirements under 42 CFR §483.60(h) related to paid feeding assistants or the required training content at 42 CFR §483.160(a)(1)-(8), which contains infection control training and other elements. Additionally, CMS is also not waiving or modifying the requirements at 42 CFR §483.60(h)(2)(i), which requires that a feeding assistant must work under the supervision of a registered nurse (RN) or licensed practical nurse (LPN). SNFs APPROVED

Updated 11/29/2021
Coverage for Monoclonal Antibody Therapies

During the COVID-19 public health emergency (PHE), Medicare will cover and pay for these infusions the same way it covers and pays for COVID-19 vaccines (when furnished consistent with the EUA). This will allow a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract for this, to administer these treatments in accordance with each product’s EUA and in accordance with any state scope of practice and licensure requirements. Please refer to Section BB of the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document for more information about coverage for COVID-19 Monoclonal Antibody Therapies.

Enforcement Discretion: In order to facilitate the efficient administration of COVID-19 monoclonal antibody products to SNF residents, CMS will exercise enforcement discretion with respect to certain statutory provisions as well as any associated statutory references and implementing regulations, including as interpreted in pertinent guidance (collectively, “SNF Consolidated Billing Provisions”). Through the exercise of that discretion, CMS will allow Medicare-enrolled immunizers including, but not limited to, pharmacies working with the United States, as well as infusion centers, and home health agencies to bill directly and receive direct reimbursement from the Medicare program for administering this treatment to Medicare SNF residents.

For specific instructions on how to bill the Medicare program for monoclonal antibody treatments, please see the Monoclonal Antibody Program Instruction. View an infographic on coverage of monoclonal antibody therapies at https://www.cms.gov/ files/document/covid-infographic-coverage-monoclonal-antibody-products-treat-covid-19.pdf
SNFs APPROVED

Updated 11/29/2021

GO TO TOP

Centers for Medicare & Medicaid Services — Home Health & Hospice

WaiverApplies ToStatus
Medicare Telehealth

Home Health Agencies (HHAs) can provide more services to beneficiaries using telecommunications technology within the 30-day period of care, so long as it’s part of the patient’s plan of care and does not replace needed in-person visits as ordered on the plan of care. Telecommunications technology can include, for example: remote patient monitoring; telephone calls (audio only and TTY); and 2-way audio-video technology that allows for real-time interaction between the clinician and patient. However, only in-person visits can be reported on the home health claim.

Hospice providers can provide services to a Medicare patient receiving routine home care through telecommunications technology (e.g., remote patient monitoring; telephone calls (audio only and TTY); and 2-way audio-video technology), if it is feasible and appropriate to do so. Only in-person visits are to be recorded on the hospice claim.
HH Agencies; Hospices APPROVED

Updated 11/29/2021
Telehealth Face-to-Face Encounter Requirement

The required face-to-face encounter for home health can be conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time interaction between the physician/allowed practitioner and the patient).

Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time interaction between the hospice physician/hospice nurse practitioner and the patient).
HH Agencies; Hospices APPROVED

Updated 11/29/2021
Homebound Definition: A beneficiary is considered homebound when their physician advises them not to leave the home because of a confirmed or suspected COVID-19 3 11/4/20 diagnosis or if the patient has a condition that makes them more susceptible to contract COVID-19. As a result, if a beneficiary is homebound due to COVID-19 and needs skilled services, an HHA can provide those services under the Medicare Home Health benefit. HH Agencies APPROVED

Updated 11/29/2021
Detailed Information Sharing for Discharge Planning. CMS is waiving the requirements of 42 CFR §484.58(a) to provide detailed information regarding discharge planning, to patients and their caregivers, or the patient’s representative in selecting a post-acute care provider by using and sharing data that includes, but is not limited to, (another) home health agency (HHA), skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), and long-term care hospital (LTCH) quality measures and resource use measures. HH Agencies APPROVED

Updated 11/29/2021
Plans of Care and Certifying/Recertifying Patient Eligibility: In addition to a physician, section 3708 of the CARES Act allows a Medicare-eligible home health patient to be under the care of a nurse practitioner, clinical nurse specialist, or a physician assistant who is working in accordance with State law. These physicians/practitioners can: (1) order home health services; (2) establish and periodically review a plan of care for home health services (e.g., sign the plan of care), (3) certify and re-certify that the patient is eligible for Medicare home health services. These changes, effective March 1, 2020, provide the flexibility needed for more timely initiation of services for home health patients, while allowing providers and patients to practice social distancing. Specifically, for Medicare, these changes are effective for Medicare claims with a “claim through date” on or after March 1, 2020. HH Agencies APPROVED

Updated 11/29/2021
Clinical Records: In accordance with section 1135(b)(5) of the Act, CMS is extending the deadline for completion of the requirement at 42 CFR §484.110(e), which requires HHAs to provide a patient a copy of their medical record at no cost during the next visit or within four business days (when requested by the patient). Specifically, CMS will allow HHAs ten business days to provide a patient’s clinical record, instead of four. HH Agencies APPROVED

Updated 11/29/2021
Training and Assessment of Aides: CMS is waiving the requirement at 42 CFR §418.76(h)(2) for Hospice and 42 CFR §484.80(h)(1)(iii) for HHAs, which require a registered nurse, or in the case of an HHA a registered nurse or other appropriate skilled professional (physical therapist/occupational therapist, speech language pathologist) to make an annual onsite supervisory visit (direct observation) for each aide that provides services on behalf of the agency. In accordance with section 1135(b)(5) of the Act, CMS is postponing completion of these visits. All postponed onsite assessments must be completed by these professionals no later than 60 days after the expiration of the PHE. HH Agencies APPROVED

Updated 11/29/2021
12-hour annual in-service training requirement for home health aides: CMS is modifying the requirement at 42 C.F.R. §484.80(d) that home health agencies must assure that each home health aide receives 12 hours of in-service training in a 12-month period. In accordance with section 1135(b)(5) of the Act, CMS is postponing the deadline for completing this requirement throughout the COVID-19 PHE until the end of the first full quarter after the declaration of the PHE concludes. HH Agencies APPROVED

Updated 11/29/2021
Quality Assurance and Performance Improvement (QAPI): CMS is modifying the requirement at 42 CFR §418.58 for Hospice and §484.65 for HHAs, which requires these providers to develop, implement, evaluate, and maintain an effective, ongoing, hospice/HHA-wide, data-driven QAPI program. Specifically, CMS is modifying the requirements at §418.58(a)–(d) and §484.65(a)–(d) to narrow the scope of the QAPI program to concentrate on infection control issues, while retaining the requirement that remaining activities should continue to focus on adverse events. The requirement that HHAs and hospices maintain an effective, ongoing, agency-wide, data driven quality assessment and performance improvement program will remain. HH Agencies; Hospices APPROVED

Updated 11/29/2021
Waive Onsite Visits for HHA Aide Supervision: CMS is waiving the requirements at at 42 CFR 42 CFR 418.76(h), for Hospice and at 42 CFR §484.80(h) for HHAs, which require a nurse to conduct an onsite visit every two weeks. This would include waiving the requirements for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan, as this may not be physically possible for a period of time. This waiver is also temporarily suspending the 2-week aide supervision by a registered nurse for home health agencies requirement at §484.80(h)(1), but virtual supervision is encouraged during the period of the waiver. HH Agencies; Hospices APPROVED

Updated 11/29/2021
OASIS Reporting: CMS is providing relief to HHAs on the timeframes related to OASIS transmission through the following 1) extending the 5-day completion requirement for the comprehensive assessment to 30 days; and 2) waiving the 30-day OASIS submission requirement. Delayed submission is permitted during the PHE. CMS is now allowing 30 days for the completion of the comprehensive assessment. HHAs must submit OASIS data prior to submitting their final claim in order to receive Medicare payment. HH Agencies APPROVED

Updated 11/29/2021
Home Health Quality Reporting Program: HHAs are exempted from the Home Health Quality Reporting Program reporting requirements. The time period covered by this exemption is October 1, 2019 through June 30, 2020. HHAs that do not submit data for those quarters will not have their annual market basket percentage increase reduced by two percentage points. CMS is also delaying the compliance dates for collecting and reporting the Transfer of Health Information quality measures and certain standardized patient assessment data elements (SPADEs) adopted for the HH Quality Reporting Program. HHAs will be required to begin collecting the Transfer of Health Information 5 11/4/20 quality measures and certain SPADEs on January 1st of the year that is at least one calendar year after the end of the public health emergency. HH Agencies APPROVED

Updated 11/29/2021
Allow Occupational Therapists (OTs), Physical Therapists (PTs), and Speech Language Pathologists (SLPs) to Perform Initial and Comprehensive Assessment for all Patients: CMS is waiving the requirements in 42 CFR § 484.55(a)(2) and § 484.55(b)(3) that rehabilitation skilled professionals may only perform the initial and comprehensive assessment when only therapy services are ordered. This temporary blanket modification allows any rehabilitation professional (OT, PT, or SLP) to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether or not the service establishes eligibility for the patient to be receiving home care. The existing regulations at § 484.55(a) and (b)(2) would continue to apply; rehabilitation skilled professionals would not be permitted to perform assessments in nursing only cases. We would continue to expect HHAs to match the appropriate discipline that performs the assessment to the needs of the patient to the greatest extent possible. Therapists must act within their state scope of practice laws when performing initial and comprehensive assessments, and access a registered nurse or other professional to complete sections of the assessment that are beyond their scope of practice. HH Agencies APPROVED

Updated 11/29/2021
Requests for Anticipated Payments (RAPs): MACs can extend the auto-cancellation date of RAPs during emergencies. RAPs are a pre-payment for home health services. HH Agencies APPROVED

Updated 11/29/2021
Ordering Medicaid Home Health Services and Equipment: Medicaid home health regulations now allow non-physician practitioners to order medical equipment, supplies and appliances, home health nursing and aide services, and physical therapy, occupational therapy or speech pathology and audiology services, in accordance with state scope of practice laws. HH Agencies APPROVED

Updated 11/29/2021
Certification for Payment of Medicare Home Health Services: As required under section 3708 of the CARES Act, CMS is allowing nurse practitioners, clinical nurse specialists and physician assistants to certify the need for home health services as defined under 42 CFR § 424.507(b)(1) payment requirements for covered Part A or Part B home health services. HH Agencies APPROVED

Updated 11/29/2021
Annual Training. CMS is modifying the requirement at 42 CFR §418.100(g)(3), which requires hospices to annually assess the skills and competence of all individuals furnishing care and provide in-service training and education programs where required. Pursuant to section 1135(b)(5) of the Act, we are postponing the deadline for completing this requirement throughout the COVID-19 PHE until the end of the first full quarter after the declaration of the PHE concludes. This does not alter the minimum personnel requirements at 42 CFR §418.114. Selected hospice staff must complete training and have their competency evaluated in accordance with unwaived provisions of 42 CFR Part 418. Hospices APPROVED

Updated 11/29/2021
Waive requirement for hospices to use volunteers: CMS is waiving the requirement at 42 CFR §418.78(e) that hospices are required to use volunteers (including at least 5% of patient care hours). It is anticipated that hospice volunteer availability and use will be reduced related to COVID-19 surge and anticipated quarantine. Hospices APPROVED

Updated 11/29/2021
Comprehensive Assessments: CMS is waiving certain requirements for Hospice 42 CFR §418.54 related to update of the comprehensive assessments of patients. This waiver applies the timeframes for updates to the comprehensive assessment (§418.54(d)). Hospices must continue to complete the required assessments and updates, however, the timeframes for updating the assessment may be extended from 15 to 21 days. Hospices APPROVED

Updated 11/29/2021
Waive Non-Core Services: CMS is waiving the requirement for hospices to provide certain non-core hospice services during the national emergency, including the requirements at 42 CFR §418.72 for physical therapy, occupational therapy, and speech-language pathology. Hospices APPROVED

Updated 11/29/2021
Specific Life Safety Code (LSC) for Hospice: CMS is waiving and modifying particular waivers under 42 CFR §418.110(d) for inpatient hospice. Specifically, CMS is modifying these requirements as follows:

  • Alcohol-based Hand-Rub (ABHR) Dispensers: We are waiving the prescriptive requirements for the placement of alcohol based hand rub (ABHR) dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs contain ethyl alcohol, which is considered a flammable liquid, and there are restrictions on the storage and location of the containers. This includes restricting access by certain patient/resident population to prevent accidental ingestion. Due to the increased fire risk for bulk containers (over five gallons) those will still need to be stored in a protected hazardous materials area.
  • Fire Drills: Due to the inadvisability of quarterly fire drills that move and mass staff together, we will instead permit a documented orientation training program related to the current fire plan, which considers current facility conditions. The training will instruct employees, including existing, new or temporary employees, on their current duties, life safety procedures and the fire protection devices in their assigned area. Refer to: 2012 LSC, sections 18/19.7.1.6.
  • Temporary Construction: CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients. Refer to: 2012 LSC, sections 18/19.3.3.2.
Inpatient Hospices APPROVED

Updated 11/29/2021
Coverage for Monoclonal Antibody Therapies

During the COVID-19 public health emergency (PHE), Medicare will cover and pay for these infusions the same way it covers and pays for COVID-19 vaccines (when furnished consistent with the EUA). This will allow a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract for this, to administer these treatments in accordance with each product’s EUA and in accordance with any state scope of practice and licensure requirements. Please refer to Section BB of the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document for more information about coverage for COVID-19 Monoclonal Antibody Therapies.

Provider Enrollment: Health care providers administering the COVID-19 monoclonal antibody infusions will follow the same Medicare enrollment process as those administering the COVID-19 vaccines. Review information about provider enrollment.

For specific instructions on how to bill the Medicare program for monoclonal antibody treatments, please see the Monoclonal Antibody Program Instruction. View an infographic on coverage of monoclonal antibody therapies at https://www.cms.gov/ files/document/covid-infographic-coverage-monoclonal-antibody-products-treat-covid-19.pdf.
Home Health APPROVED

Updated 11/29/2021

GO TO TOP

U.S. Department of Labor, Occupational Health & Safety Administration

Division of Consumer Affairs

WaiverApplies ToStatus

Vaccinators

COVID Immunization Administration by Additional Health Care Practitioners

COVID Immunization Administration by Certified Medical Assistants

COVID Immunization Administration by Health Care Practitioners-in-Training
Health Care Practitioners-in-Training, Certified Medical Assistants, Additional Health Care Practitioners Reinstated

1/11/2022
Emergency Graduate Licensure

https://www.njconsumeraffairs.gov/COVID19/Documents/DCA-AO-2020-05_DCA-W-2020-09.pdf

https://www.njconsumeraffairs.gov/COVID19/Documents/DCA-AO-2020-12_DCA-W-2020-11.pdf
Graduate Nurses, PAs, Pharmacists, RTs

Mental Health Practitioners

Reinstated

1/11/2022
Suspension of Certain Restrictions on the Scope of Practice for Advanced Practice Nurses (APNs) and Physician Assistants (PAs) APNs/PAs Reinstated

1/11/2022
In Home Plan of Care Evaluations by Nursing Supervisors Health Care Service Firms Reinstated

1/11/2022
The state Division of Consumers Affairs has extended the temporary licensure of out-of-state healthcare practitioners through June 30, 2021, as long as the state’s public health emergency remains in place. Under the Temporary Emergency Reciprocity Licensure Program, temporary licenses had been set to expire Feb, 28, 2021. Along with the extensions, any new licenses granted will be valid through June 30.

The extension will be automatically applied for those healthcare personnel who currently hold a temporary reciprocity license, so workers don’t have to take any additional action. However, DCA advises any healthcare personnel who anticipate a continuing need to provide healthcare services in New Jersey after June 30 should applyimmediately for a plenary N.J. license because of significant processing times. Additional information is available on the DCA website.



Reciprocity of Licensure for licensed, certified health care professionals from other states
All licensees under DCA Reinstated

1/11/2022
Telehealth – waiver of parameters that are barriers to telehealth Reinstated

1/11/2022
Temporary reactivation of expired licenses within 5 years All licensees under DCA Reinstated

1/11/2022
Prescription Management Program Enrollment Physicians Reinstated

1/11/2022
Pharmacists Collecting COVID-19 Specimens Pharmacists Reinstated

1/11/2022
Elective Surgeries Office Practices Reinstated

1/11/2022
Temporary Certification of Alcohol and Drug Counselor Interns Office Practices Reinstated

1/11/2022
Waiver of On-Site Supervision – AUDIOLOGISTS AND SPEECH-LANGUAGE PATHOLOGISTS, OCCUPATIONAL THERAPISTS, AND PHYSICAL THERAPISTS Audiologists, SLP, OT, PT Reinstated

1/11/2022
Allow healthcare practitioners to utilize telemedicine encounters to meet CDS prescribing requirements. Prescribers Reinstated

1/11/2022
Allow pharmacy interns and pharmacy externs to administer influenza vaccines to patients over age 7 and under age 18 (with prescription requirements for children between ages 7 and 9), and administer all authorized vaccines, including for influenza, to eligible patients who are 18 and older. Pharmacy Interns and Externs Reinstated

1/11/2022
Temporary waiver for 16 professional boards of rules requiring continuing education to be completed in person. 16 licensee types Reinstated

1/11/2022
Pharmacists may now dispense up to a 30-day supply of Schedule II CDS upon the oral order of a prescriber. In addition, consistent with waivers issued by the United States Drug Enforcement Administration, follow up paper prescriptions may be submitted within 15 days, and may be submitted via facsimile. This waiver does NOT apply to "initial" opioid prescriptions for pain; it is only applicable for patients being treated for "chronic" pain. Pharmacists Reinstated

1/11/2022
Telehealth Guidance Manual Reinstated

1/11/2022

GO TO TOP