As the end of the public health emergency (PHE) approaches, home care providers need to wean themselves off certain waivers that are set to expire, according to regulatory experts at the National Association for Home Care & Hospice who provided guidance on this during a webinar Thursday.
Among the flexibilities that are scheduled to conclude are those related to telehealth. While Congress recently extended telehealth provisions through 2024, providers may no longer use non-HIPAA-compliant technologies for patient encounters after May 11, when the PHE is over, explained Mary Carr, VP of regulatory affairs for NAHC.
“They will not be permissible after May 11, and you need to understand this,” she said.
Covered providers should be able to continue using non-public-facing technologies, such as Skype and Zoom, she and Katie Wehri, director of home care and hospice regulatory affairs at NAHC, clarified.
Carr also suggests that home health providers track how clinicians are tracking comprehensive assessments. Waivers related to these assessments, such as offering flexibility within the 30-day time frame for the OASIS data set, will no longer be available after May 11.
As the loosening of restrictions on assessments has been in place for three years, “there could be various degrees of compliance,” Carr noted.
Providers will have grace periods with some waivers. For example, flexibilities related to 12-hour annual in-service training for home health and hospice aides will conclude at the end of this calendar year. And home health and hospice have an additional 60 days to adjust to the waiver related to annual on-site supervisory visits for aides in home health and hospice.
The fate of some waivers is still unclear. NAHC is working to make permanent the waiver that allows occupational therapy, physical therapy and speech language pathologists to conduct initial and comprehensive assessments.
The field has had an “essentially successful demonstration project” the last three years with this waiver so it will be harder for the Centers for Medicare & Medicaid Services to justify dropping it, Carr said.
NAHC also is seeking clarification from CMS on the 12-hour in-service training waiver for hospice aides, along with one related to on-site aide supervision. And the organization is looking for additional guidance from CMS as to which point all hospices must reach the 5% level of activity for hospice volunteers, according to Wehri.