1135 Waiver May Modify Medicaid Rules

You’ve undoubtedly seen reports that the COVID-19 crisis is threatening to overwhelm the nation’s healthcare system. Hospitals and other healthcare providers have been positioning themselves to receive an influx of COVID-19 patients, which has created a ripple effect throughout the healthcare system.

One of the most significant ripples involves Medicaid. On March 31, 2020, TennCare received approval from the Centers for Medicare and Medicaid Services (CMS) for certain waivers requested as part of Tennessee’s 1135 Emergency Waiver application. The 1135 Waiver is a provision in federal law that makes it possible for Medicaid rules to be modified or relaxed during times of national emergency.

CMS has announced an array of temporary regulatory waivers that will apply broadly across all states. Included among these broad waivers is the 30-day suspension of all pre-admission screening and resident review (PASRR) requirements. Read about the current requirements here.

Importantly, the 30-day PASRR suspension is a one-time waiver which cannot be extended or renewed. Tennessee’s waiver authority provides that “the effective date of the 30-day suspension of PASRR reviews will be determined by the state, but will take place during the declared emergency period.”

TennCare will notify nursing facilities and hospitals when the 30-day period will commence.

For now, nursing facilities are being asked to continue to comply with all federally required PASRR provisions. This includes a Level 1 screening for all residents newly admitted to a facility.

As with everything involving Medicaid and TennCare, there are exceptions and nuances. We’ll be watching this situation closely and will share updates as we receive them. In the meantime, please call the office if you have questions.

 

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