CMS Changes Rules for Providers in States Hit by Harvey

Ken Terry

September 08, 2017

The Centers for Medicare & Medicaid Services (CMS) said on Thursday that it would suspend certain Medicare enrollment screening requirements for healthcare providers and suppliers that are assisting with Hurricane Harvey recovery efforts in Texas and Louisiana.

The waiver is aimed at enabling clinicians who don't participate in Medicare or who have come to the affected states from other areas of the country to help care for victims of the natural disaster.

The agency has established a hotline (1-855-247-8428) for healthcare providers in the two affected states to enroll in Medicare and receive temporary Medicare billing privileges. "The hotline is intended for noncertified Part B providers and other practitioners to initiate temporary Medicare billing privileges," according to a CMS news release.

Novitas Solutions, a Medicare administrator contractor, will temporarily enroll these providers. CMS is waiving the following enrollment requirements:

  • Payment of the application fee

  • Fingerprint-based criminal background checks

  • Site visits

  • In-state licensure requirements

Providers who are not currently enrolled in Medicare may initiate temporary billing privileges by providing a national provider identifier, a Social Security number or a business taxpayer identification number, and valid in-state or out-of-state licensure. CMS is temporarily ceasing revalidation efforts for Medicare providers located in Texas, Louisiana, and other areas affected by Harvey.

CMS has also waived its practice location reporting requirements in these areas and will not take administrative actions against providers who fail to notify them of their temporary practice locations. This temporary process will remain in effect until the disaster designation is lifted in the affected areas.

"This is an unprecedented opportunity to work with healthcare providers to put our patients and people with Medicare benefits first," said CMS Administrator Seema Verma in a news release. "While we have heard from providers in these states that are willing and able to help, we know that by temporarily relaxing these and other Medicare provider and supplier enrollment requirements, we can make the services of skilled professionals more readily available to those in need."

CMS is also working with Texas and Louisiana to facilitate healthcare providers serving patients in the affected areas. These measures include relaxing Medicaid enrollment requirements, as well as the following Medicare rule changes:

  • Delay or suspend on-site annual recertification and revisit surveys for certified providers

  • Delay or suspend certain enforcement actions

  • Allow additional time for providers to submit plans of corrections

  • Allow healthcare providers to exceed their certified bed capacity by 10% (additional increases over 10% will be processed on a case-by-case basis to ensure safety)

  • Allow clinical labs to set up temporary testing sites and perform waived testing in accordance with the manufacturer's instructions at the temporary site

CMS has also temporarily suspended several requirements to help Medicare beneficiaries who need durable medical equipment and supplies in the wake of the storm. Beneficiaries do not have to meet face to face with a doctor or get a new physician's order, and doctors don't have to provide new medical necessity documentation to replace medical equipment and supplies lost or damaged in the storm and its aftermath.

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