Guidance Documents 

CMS and other federal entities have released several guidance documents to assist states and health care stakeholders in responding to the COVID-19 emergency. 

  • CDC Launches Coronavirus Landing Page: The CDC activated a webpage to provide information to the public on coronavirus symptoms, reducing transmission, reported COVID-19 cases, and resources for health care providers.
  • CMS Medicare Provider Enrollment FAQs: CMS issued a set of FAQs to assist providers in understanding expedited enrollment processes available for Medicare.
  • Medicaid Telehealth Resource: CMS developed a short resource providing an overview of Medicaid FFS telehealth options and sample payment structures.
  • OCR Waiving HIPAA Enforcement: HHS Office of Civil Rights announced it will waive potential penalties for HIPAA violations against health care providers who act in good faith in serving patients via everyday communications technologies, such as Skype or Facetime, during the national emergency. 
  • SAMHSA 42 CFR Part 2 Guidance: SAMHSA issued guidance which allows providers to share patient SUD diagnosis information that would normally be protected under 42 CFR Part 2 in instances of a bona fide medical emergency. Usage of the medical emergency exception must be documented by providers.
  • SAMHSA OTP Guidance: SAMHSA issued guidance allowing states with and without emergency declarations to allow Opioid Treatment Programs (OTPs) to provide 28 days of take-home medication to stable patients and 15 days of medication to less stable patients whom the OTP believes can responsibly manage this amount of medication.
  • CMS Guidance on Postponing Elective Surgery: CMS issued guidance to stakeholders advising limitations on all non-essential planned surgeries and procedures, including dental procedures. The guidance provides a triaging method to assist with decisions in this area.
  • CMS Extension of Reporting Periods for VBP, Quality Programs:CMS announced in a press release that it is implementing “extreme and uncontrollable circumstances” policy exceptions with regard to quality reporting and value-based purchasing programs. Programs with April and May 2020 deadlines will be optional, and no data from January 1 through June 30, 2020 will be used in CMS calculations for those performance periods.
  • CMS Guidance to Catastrophic Coverage Plans: CMS issued an FAQ clarifying that catastrophic coverage plans must include coverage of COVID-19 diagnosis and treatment under the Essential Health Benefits. CMS will waive enforcement actions against any such plan which provides COVID-19 services before patients pay the plan’s deductible, and encourages plans and states to provide such pre-deductible coverage.
  • Updated Medicaid COVID-19 FAQs:  CMS updated its set of Medicaid FAQs on COVID-19 to include new topics, such as pharmacy, managed care, additional telehealth topics focused on FQHCs and RHCs, and 1115 waivers. Additional questions can be submitted to [email protected] or sent directly to CMS Regional or Central office staff.
  • CMS Guidance to PACE Organizations: CMS provided guidance to PACE organizations on infection control protocols, responsibility for providing COVID-19 testing, ability to limit PACE participants’ visits to the PACE center to mitigate risk of COVID-19 transmission, and ability to relax Medicare Part D “refill to soon” edits to extend supply of prescription drugs.