Pandemic Regulatory Changes Require Healthcare Providers to Remain Compliant-Vigilant

The pandemic has changed our lives in many ways and, while the COVID-19 vaccine will help reduce the number of new cases in the U.S. and usher in a return to some sense of normalcy, the healthcare regulatory landscape has been forever altered. Healthcare providers must continue to remain vigilant in complying with ever-changing regulations as we move toward a post-pandemic environment. It’s essential for organizations to be aware of these changes, how temporary or permanent they may be, and the impact they have on their operations, including in home healthcare

Operational Procedures Impacted by CMS & State Regulatory Changes

The pandemic, for example, helped accelerate the acceptance and widespread use of telemedicine and as a result the easing of restrictions of its utilization by the Centers for Medicare & Medicaid Services (CMS). The CMS issued a blanket waiver expanding the types of health care professionals that can furnish distant-site telehealth services to include all those that are eligible to bill Medicare for their professional services. 

The CMS now also allows home health agencies to perform Medicare-covered initial assessments and determine patients’ homebound status remotely or by record review. This enables patients to be cared for in the best environment for them while supporting infection control and reducing the impact on acute care and long-term care facilities. 

Additionally, the CMS temporarily waived the rules preventing skilled rehabilitation professionals from performing only the initial and comprehensive assessments when therapy services are ordered. This temporary order allows rehabilitation professionals to perform initial and comprehensive services as part of the plan for care (as long as it’s permitted under state law), regardless of whether or not the service establishes eligibility for the patient to receive home care.

Amid the pandemic, there were many other temporary blanket waivers issued by the CMS along with suspended deadlines regarding reporting, documentation, reimbursement and staff training regulations that impact home healthcare agencies, hospices and other healthcare providers. In fact, thus far there have been 244 Medicare regulatory changes in the wake of the pandemic. In addition, states also have updated their laws and regulations with regard to COVID-19 that affect all healthcare providers. 

Update Operational Policies

To ensure compliance, healthcare providers should document the areas of operation that have changed as a result of the pandemic to determine which procedures are impacted. During the height of the pandemic, agility was necessary to best meet patients’ needs. Now it’s time to take stock of the changes and ensure the effectiveness of a compliance program. Once a healthcare provider documents which of the regulations impact its operation, it’s important to assess how permanent these changes will likely be (although it can sometimes be difficult to predict). For instance, the Medicare waiver of telemedicine requirements ushered in calls for permanent changes. This holistic view of business operations, compliance and documentation is an excellent risk management tool for any organization. 

Written policies should be updated to reflect regulatory changes including creating an emergency policy that outlines the procedures for responding to and managing regulatory waivers and emergency declarations in the future. Keep management apprised of all changes with an open line of communication to assist with compliance and mitigation of risk. 

Manchester Specialty Programs provides agents and brokers with the ability to offer a totally integrated business insurance solution around the specific needs of Home Care, Allied Health and Human/Social Services organizations fundamental to communities.  We strive to have a deeper understanding of the health care entities that we serve, which translates into more expert underwriting of accounts.  For more information about our products, please contact us at 855.972.9399.

Sources: National Law Review, CMS