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PUBLIC POLICY UPDATES

Trump Administration Implements New Reporting and Testing Requirements


Posted on: 8/26/2020

On August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) announced another sweeping round of regulatory changes impacting providers across the continuum of care.

Nursing Home Testing Requirements

CMS now requires that nursing homes will offer tests to residents when there is an outbreak or residents show symptoms. This is part of CMS’ continued efforts to help nursing homes to control the spread of the virus. The interim final rule will also require nursing homes participating in Medicaid and Medicare to test their staff for COVID-19.

Facilities that do not comply with the new requirements will be cited for non-compliance and may face enforcement sanctions based on the severity of the noncompliance, such as civil money penalties in excess of $400 per day, or over $8,000 for an instance of noncompliance.

Hospital Reporting

Additional regulations will also require hospitals and critical access hospitals to report daily important data critical to support the fight against COVID-19, including, but not limited to elements such as the number of confirmed or suspected COVID-19 positive patients, ICU beds occupied, and availability of essential supplies and equipment such as ventilators and PPE. While most hospitals were voluntarily reporting this information, the new rules make reporting a requirement of participation in the Medicare and Medicaid programs. CMS states the reporting is needed to support broader surveillance of COVID-19.

Hospitals will face possible termination of Medicare and Medicaid payment if unable to meet reporting requirements. The required reporting rule has received swift pushback from the American Hospital Association among others.

Lab Reporting

CMS’ new rule implements a CARES Act requirement that laboratories report COVID-19 test results daily to the HHS Secretary. All laboratories conducting COVID-19 testing and reporting patient-specific results – including hospital labs, nursing homes, and other facilities conducting testing for COVID-19 – will be required to comply. If a laboratory does not report the required information, CMS will impose a civil monetary penalty in the amount of $1,000 a day for the first day, and $500 for each subsequent day. Labs will have a one-time, three-week grace period to begin reporting the required test data.

Physician and Pharmacist orders for tests

CMS is also revising its previous policy that covered repeated COVID-19 testing for Medicare beneficiaries without practitioner orders during the PHE. The revised policy specifies that each beneficiary may receive one COVID-19 test without the order of a physician or other health practitioner, but Medicare will require such an order for all further COVID-19 tests.

Read the press release >>>

View the new rule >>>

The Centers for Medicare and Medicaid Services, the ACMA Public Policy Committee and our advocacy firm Lobbyit contributed to this information.

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