On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 748 which is the third COVID-related bill to pass Congress in recent weeks. As noted on the Center for Medicare Advocacy’s COVID-19 webpage highlighting such legislation, Medicare-related provisions of this bill include:
- Significant expansion of telehealth services that can substitute for certain visits that usually require in-person visits with health care providers, such as remote patient monitoring for home health services, hospice recertification, and nephrologist visits for those using home dialysis;
- Allowing physician assistants, nurse practitioners, and other professionals to order home health services for beneficiaries;
- Waiving the Inpatient Rehabilitation Facility (IRF) 3-hour rule, which requires that a beneficiary be expected to participate in at least 3 hours of intensive rehabilitation at least 5 days per week to be admitted to an IRF;
- Allowing Up to 3-Month Fills and Refills of Covered Medicare Part D Drugs – requiring that Medicare Part D plans provide up to a 90-day supply of a prescription medication if requested by a beneficiary during the COVID-19 emergency period.
While several of the provisions of the three prior COVID-19 bills provide much-needed assistance to older adults and individuals with disabilities, advocates are pushing for a fourth COVID-19 bill that will fill in further gaps for these populations – see, e.g., websites for the Leadership Council of Aging Organizations (LCAO) and the Consortium for Citizens with Disabilities (CCD).
On March 30, 2020, as summarized on the Center’s webpage highlighting COVID-19-related materials issued by the Centers for Medicare & Medicaid Services (CMS), the agency issued a Press Release, Fact Sheet and Interim Final Rule (CMS-1744-IFC) announcing several provider waivers affecting Medicare. These policy changes include:
- Expanding the destinations to which ambulance services can be covered by Medicare;
- Allowing coverage for home testing for COVID-19;
- Further expanding telehealth services to fulfill requirements for visits that usually must be in person (e.g., inpatient rehabilitation hospitals, home health and hospice);
- Emphasized that someone can be “homebound” in order to qualify for home health coverage if a physician determines that it is contraindicated for the Medicare beneficiary to leave home – or due to suspected or confirmed COVID-19. (The homebound requirement was not waived)