General Interest

CMS Approves CA’s 1135 Waiver

CMS approved California’s 1135 Waiver request on March 23rd, which provides for new flexibility in federal requirements across several programs. The CMS response letter can be found here. Highlights of the waiver that impact aging services are below:

  • Current “blanket waivers” (waivers that are granted for the entire country) include:
    • The 3-day prior hospitalization for Medicare coverage,
    • 42 CFR 483.20 relief to SNFs on the timeframe requirements for MDS assessments and transmission
    • HHAs: Provides relief to Home Health Agencies on the timeframes related to OASIS Transmission. Allows Medicare Administrative Contractors to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs) during emergencies.
    • Provider Locations: Temporarily waive requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. This applies to Medicare and Medicaid.
    • Provider Enrollment: New waivers for applications, background checks, out-of-state providers, etc.
  • Temporarily suspend Medicaid fee-for-service prior authorization requirements
  • Extend pre-existing authorizations for which a beneficiary has received prior authorization through the end of the public health emergency
  • Modifies timelines for state fair hearings
  • Streamlines to provider enrollment
  • Allows provision of services in alternative settings
  • Provides that the waivers are operable through the duration of the public health emergency

Read the full CMS press release here.