Perspective: Regulatory Waivers Improve Patient Care and Should be Kept

Given the recent upsurge in COVID-19 cases around the country, we can’t say how much longer the official public health emergency will last. But we do know that many regulatory waivers put into place by the Centers for Medicare & Medicaid Services at the start of the pandemic have worked very well and deserve to live on past the current crisis.

The waivers afford essential flexibility for hospitals, allowing them to provide care in safe, efficient and innovative ways, which have been well received by both patients and providers.

In a July 29 letter to CMS, we urged the agency to recognize the important role waivers have played in battling COVID-19 and to not return to the old way of doing things, but instead permanently remove certain regulatory barriers standing in the way of better patient care post-pandemic.

Our detailed recommendations span several areas. Highlights include:

Telehealth – CMS should permanently expand the range of conditions that can be treated via telehealth; allow the use of everyday communications technologies such as FaceTime or Skype; and ensure appropriate reimbursement for telehealth provided services.   In addition, we urge including hospital-based clinics and ambulatory sites as acceptable originating locations for telehealth consults. We understand CMS needs to work with Congress to address statutory changes that will increase access to telehealth services for Medicare patients, and encourage the agency to do so.

Hospital-at-Home Programs – Waivers allowing approved providers to offer safe hospital-level care to eligible patients in their homes has enhanced patient safety and increased access to care. It’s clear that interest in this program among patients, hospitals and health system will increase if the flexibilities are made permanent.

Workforce – Our staff members are our greatest health care asset and we support eliminating any unnecessary burdens to help prevent burnout. Specifically, we’ve urged the agency to scrap specific practice limitations on nurse practitioners that are more restrictive under CMS rules than under state licensure; and remove certain licensure requirements to allow out-of-state providers to perform telehealth services.

Care Delivery in Rural Areas – We’re asking CMS to continue to support increased bed capacity during an emergency in the future, such as allowing rural health clinics to increase their bed capacity without affecting their payments so that these providers can maintain designations and other operational flexibilities. In addition, permanently allowing rural health clinics and federally qualified health centers to continue to serve as distant sites for telehealth services would remove regulatory barriers standing in the way of better patient care post-pandemic.

These actions — among others we are requesting — will help hospitals and health systems continue to put the health and safety of patients first by getting rid of barriers that impact efficiency and unlocking new opportunities to better focus on the health, well-being and wishes of patients.

We have argued for years that the regulatory burden faced by hospitals is substantial and unsustainable. Keeping this flexibility in place makes sense, supports better patient care, and helps point the entire field in the right direction for the future.