The U.S. Department of Health & Human Services (HHS) has extended the COVID-19 public health emergency (PHE) for another 90 days. 

A continued federally declared emergency allows flexibilities instituted by the U.S. Centers for Medicare & Medicaid Services (CMS) to remain intact, such as 1135 waivers of certain hospice rules. These flexibilities permitted the use of telehealth to fulfill requirements typically done in person, such as recertifications by physicians. 

“The COVID-19 public health emergency remains in effect,” an HHS spokesperson recently told Hospice News in an email. “As HHS committed to earlier, we will provide a 60-day notice to states before any possible termination or expiration.”

In addition to telehealth, the PHE allowed for the temporary removal of the requirement that a registered nurse or other skilled professional make an annual, onsite supervisory visit for each aide, as well as an annual assessment of the skills and competence of all individuals furnishing hospice care, and in-service training and education programs.

CMS also temporarily waived the requirement for volunteers to provide a minimum of 5% of hospice patient care hours.

But the telehealth waivers are top of mind for most hospice providers. Instituted as a temporary measure to limit in-person contact during the pandemic, telehealth services have become a health care staple during the past two years. Both patients and providers have come to rely on its increased availability. 

HHS has indicated that the telehealth flexibilities would remain in place for at least five months after the PHE expires. Nevertheless, providers and industry organizations have been pushing the federal government to make them permanent.

“We’re working really hard to make sure that some of those regulatory waivers and also waivers that were codified in legislation survive past the public health emergency,” National Hospice and Palliative Care Organization President and CEO Edo Banach said at the Hospice News Palliative Care Conference in Chicago. “We can address some of the concerns that folks in government have in more efficient ways, and there are a number of technological innovations that should remain past the end of the public health emergency because they just happen to make sense.”

Renewal of the PHE arrives during a new surge of COVID variants, the scope of which has been difficult to measure.

Cases, deaths, and hospitalizations have trended upward during June and July, according to the U.S. Centers for Disease Control & Prevention. But current data do not tell the whole story.

Because federal funds for testing have dried up and with home test kits widely available, the true number of infections is unknown. University of Washington researchers estimated in early June that only 14% of cases are being reported.

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