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CMS Updates Guidance on COVID-19 Waivers for Physicians, Hospitals & Other Providers

CMS Updates Guidance on COVID-19 Waivers for Physicians, Hospitals & Other Providers

February 24, 2023

The Centers for Medicare & Medicaid Services (CMS) announced it has updated guidance for health care providers regarding the COVID-19 public health emergency (PHE), which is set to expire May 11, 2023.  The agency posted a series of Fact Sheets with detailed information on payment policies and other waivers provided during the COVID-19 PHE, and how these policies will change after the end of the PHE.  The Fact Sheets generally address only Medicare and Medicaid waivers, and include clarifications on telehealth, Stark Law waivers permitting physician-owned hospital expansion, and other policies.

Telehealth:  For physicians, CMS provides information on telehealth waivers, among other flexibilities, including but not limited to the following new information:

  • CMS clarifies that, after the PHE ends, the Consolidated Appropriations Act, 2023 extends availability of the telehealth services that can be furnished using audio-only technology through December 31, 2024; and extends certain other telehealth flexibilities through that date, including the ability for a “broader range of practitioners, such as physical therapists, occupational therapists, and speech language pathologists” to use telehealth to provide specified Medicare services. 
  • After the end of the PHE, CMS will resume its prior process of considering changes to the Medicare Telehealth Services List “exclusively through notice and comment rulemaking.”
  • CMS indicates that “frequency restrictions” for certain services, such as critical care consults, furnished via Medicare telehealth will be in force after the end of the PHE.

Stark Law & Physician-Owned Hospitals:  In addition, CMS provides information on the status of waivers of the physician self-referral law “Stark Law.”  On March 30, 2020, CMS issued blanket waivers of “certain provisions of the Stark Law,” including permitting “physician-owned hospitals” to “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.”  The agency states that “When the COVID-19 PHE ends, the waivers will terminate and physicians and entities must immediately comply with all provisions of the Stark Law.”  Additional information on Stark Law waivers can be found at:

CMS posted Fact Sheets for the following provider and supplier categories (links provided below):

Physicians and Other Clinicians (PDF)
Hospitals and CAHs (including Swing Beds, DPUs), ASCs and CMHCs (PDF)
Teaching Hospitals, Teaching Physicians and Medical Residents  (PDF)
Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities)  (PDF)
Home Health Agencies   (PDF)
Hospice (PDF)
Inpatient Rehabilitation Facilities  (PDF)
Long Term Care Hospitals & Extended Neoplastic Disease Care Hospitals (PDF)
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)  (PDF)
Laboratories (PDF)
Medicare Shared Savings Program (PDF)
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (PDF)
Medicare Advantage and Part D Plans (PDF)
Ambulances (PDF)
End Stage Renal Disease (ESRD) Facilities (PDF)
Participants in the Medicare Diabetes Prevention Program (PDF)
Intermediate Care Facility for Individuals with Intellectual Disabilities (PDF)

CMS plans to host “stakeholder calls and office hours” to provide more information “in the coming weeks.”  Additional information can be found at the CMS Current Emergencies Website, and the CMS COVID-19 Waivers Website.

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