Here’s a shorthand version of many aspects of the Medicare conditions of participation (CoPs) waivers that apply to CMS’s new Acute Hospital Care at Home program[1] during the COVID-19 public health emergency. They are compared to the CoPs that are still in effect. The comparison was prepared by attorney Ann McCullough of Polsinelli in Denver. Contact her at amccullough@polsinelli.com.
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What’s Waived |
What’s Not Waived |
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42 C.F.R. § 482.11 Compliance with Federal, State and Local Laws Compliance is not waived, e.g., state may require hospital license. | |
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42 C.F.R. § 482.12 Governing Body Waives distant site agreement for telemedicine, (a)(8-9); requirement that Medicare beneficiary is “under the care of” a physician, (c); and emergency policies for off-campus hospital department surge facilities, (f)(3). |
42 C.F.R. § 482.12 Governing Body Other governing body conditions of participation (CoPs) not waived, including medical staff oversight. |
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42 C.F.R. § 482.13 Patient’s Rights Certain visitation (h) and seclusion waivers (e)(1)(ii)/(g)(1)(i-ii) waived in states with “widespread confirmed cases.” |
42 C.F.R. § 482.13 Patient’s Rights Other patient rights are not waived, including notice of rights, privacy, safe setting, grievances, participation in plan of care, etc. |
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42 C.F.R. § 482.15 Emergency Preparedness Waived requirement for emergency policies. |
42 C.F.R. § 482.15 Emergency Preparedness Emergency and standby power systems are not waived. |
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42 C.F.R. § 482.22 Medical Staff Medical staff may keep practicing if privileges expire and start before governing body approval. Waiver of privileges requirements, including telemedicine. |
42 C.F.R. § 482.22 Medical Staff Most medical staff CoPs not waived, including informed consent. |
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42 C.F.R. § 482.23 Nursing Services Waived requirement for current nursing plan and requirement that verbal orders be used infrequently. |
42 C.F.R. § 482.23 Nursing Services* Did not waive requirement for 24/7 immediate availability of a registered nurse. *Focus of new CMS Acute Hospital Care at Home model |
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42 C.F.R. §§ 482.25, 482.26 and 482.27 Pharmacy, Radiology and Laboratory |
42 C.F.R. §§ 482.25, 482.26 and 482.27 Pharmacy, Radiology and Laboratory Hospital must provide pharmaceutical service, radiologic services, and laboratory services that meet patient needs. CoPs for Schedule II-IV drugs not waived. |
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42 C.F.R. § 482.28 Waived dietary manual requirement. |
42 C.F.R. § 482.28 Most food and dietetic services requirements still apply. |
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42 C.F.R. § 482.41 Physical Environment Allows facility and nonfacility space not normally used for patient care to be used for patient care or quarantine. |
42 C.F.R. § 482.41 Physical Environment Did not waive safety features, including testing sprinklers, fire extinguishers, emergency generators. Location “must be approved by the state.” |
