CMS Releases Post-PHE Roadmap

While it is likely that HHS will extend the PHE for another 90 days after it expires on Oct. 15, the agency has released guidance on preparing for the end of the PHE, including guidelines for DMEPOS suppliers.

CMS has released a summary “roadmap” and other resources to help providers and suppliers start preparing for the regulatory environment that will come after the Covid-19 public health emergency ends.

There are three key documents involved in CMS’s guidance:

Most recently, HHS Xavier Becerra extended the PHE until an Oct. 15 expiration date, and in a May 10 letter to U.S. governors, Becerra reaffirmed HHS’s commitment to providing at least 60 days advance notice before ending the PHE. Based on that information and the fact that HHS has extended the PHE in 90-day increments, it is expected the PHE will continue into January 2023.

However, when the PHE does end, Medicare providers and suppliers will need to transition to a regulatory environment that will likely see CMS change or remove many of the regulatory waivers and regulatory waivers it put into place during the PHE, according to CMS’s overview document, Creating a Roadmap for the End of the COVID-19 Public Health Emergency.

“Many of these waivers and broad flexibilities will terminate at the eventual end of the PHE, as they were intended to address the acute and extraordinary circumstances of a rapidly evolving pandemic and not replace existing requirements,” the document’s authors note. “… In the meantime, CMS encourages health care providers to prepare for the end of these flexibilities as soon as possible and to begin moving forward to reestablishing previous health and safety standards and billing practices.”

In terms of reimbursement policy, CMS’s DMEPOS summary notes that while it made the 50/50 blended rate for rural suppliers permanent as part of its December 2021 Final Payment Rule, the 75/25 blended rates for-non-rural, non-CBA suppliers only remain in effect until the end of the PHE.

An update from the American Association for Homecare suggested that even though the end of the PHE is unknown, the release of the roadmap and guidelines that means providers should start preparing now.

“One of the major transition concerns for suppliers is the potential impact of expiring waivers of clinical indications for certain products and services, including home-based oxygen and continuous glucose monitors,” the association added in its statement. “AAHomecare has engaged CMS on the need for continued coverage for individuals who qualified for these products during the pandemic and will continue work with policymakers to minimize disruption for patients when the PHE comes to a close.”


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