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Impact of CMS’s Section 1135 Waiver on Hospital Operations and Reimbursement During the Coronavirus Pandemic


The declaration of a national emergency, combined with the Secretary of HHS’s declaration of a public health emergency, authorized the Secretary to waive certain Medicare, Medicaid and Children’s Health Insurance Program (CHIP) requirements and conditions of participation under Section 1135 of the Social Security Act. CMS announced this past Friday that it has used this authority to activate blanket waivers of several Medicare and Medicaid requirements to give healthcare providers more flexibility in responding to the pandemic. HHS further announced on Tuesday that it is relaxing requirements related to telehealth coverage. 

This roundtable will explore the particulars, as well as the implications, of the Section 1135 waivers that CMS has announced. The affected areas include, among others:

  • Skilled nursing facilities (SNFs) and the requirements to qualify for a SNF stay following hospitalization that is reimbursed by Medicare;
  • Critical Access Hospital bed capacity;
  • Housing of acute care patients in distinct part units;
  • Care for inpatient rehabilitation and psychiatric unit patients;
  • DME replacement;
  • Long Term Acute Hospitals and minimum lengths of stay;
  • Provider services performed out of state;
  • Provider enrollment;
  • Modification of procedures for Medicare appeals;
  • Waivers of sanctions and penalties under the HIPAA privacy regulations;
  • Waivers of sanctions under EMTALA.

We will also discuss telehealth questions and the implications of the the Government’s various announcements on telehealth coverage and regulatory waivers. See the King & Spalding healthcare team’s alert about the Secretary’s 1135 waiver here. One goal of the roundtable will be to discuss further potential for waiver action as well as the possibility for providers to request individual Section 1135 waivers in areas where no blanket waiver is yet available. We also invite participants to submit questions in advance relating to CMS’s Section 1135 waiver so that the presenters can address those comments in the March 19 program. Please submit questions to coronavirus@kslaw.com with the subject line “Section 1135 Roundtable.” 

Thursday, March 19
1:00 P.M. – 2:00 P.M. ET

CLE

King & Spalding is an accredited provider of CLE credit in California, Georgia, Illinois, New York and Texas. We can issue reciprocal credit for attorneys licensed in Connecticut, Florida, and New Jersey. We will apply for credit in Colorado, North Carolina and Virginia (subject to MCLE Board approval). For jurisdictions not listed, attendees are provided with a Universal Certificate of Attendance. New York licensed attorneys: Transitional/Appropriate for newly-admitted and experienced attorneys. Financial aid is available for qualifying lawyers. For CLE-related questions, please contact Gisel Arias, garias@kslaw.com. King & Spalding, 1180 Peachtree Street NE, Atlanta, GA 30309. CA Provider #10947.

If you have questions concerning this roundtable webinar, email lifesciences-healthcare@kslaw.com.

Event Details

Date: March 19, 2020

Time: 1:00 pm (ET)