Building on previously announced waivers and emergency rulemaking, Centers for Medicare and Medicaid Services (CMS) announced additional waivers on March 30, 2020, to provide hospitals, health systems, and many other providers with “maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic.” In contrast to the prior Section 1135 waiver process announced earlier in March, the blanket waivers announced on March 31 by CMS do not require advanced request or notification. The new blanket orders are in effect retroactive to March 1, 2020, and will remain in effect until the end of the national emergency declaration.

The newly announced waivers are designed to allow the nation’s health care delivery systems to effectively manage and absorb the potential surge of COVID-19 patients. To that end, a prominent part of the waivers allows the delivery of hospital services at new locations beyond the existing hospital buildings in order for COVID-19 patients to receive needed acute care at existing facilities. This CMS announced concept of “hospitals without walls” removes existing limits to permit transfer and/or treatment of hospital patients in non-hospitals settings such as Ambulatory Surgery Centers (ASC), rehab hospitals, hotels, and dormitories while still remaining Medicare-eligible for hospital reimbursement.

The span of these blanket waivers is significant and impacts virtually all Medicare provider types and a vast variety of service areas (e.g., further telehealth services, lab specimen collection, workforce expansion, and provider/medical staff benefits and support etc.).  These CMS waivers provide hospitals and other health care providers the opportunity to pursue initiatives that will improve revenues that have decreased significantly from the cancelation of many in-person encounters, including elective surgeries and procedures.