On April 23, 2020, the Centers for Medicare and Medicaid Services (CMS) issued updated guidance for hospitals to resume the provision of elective surgeries and other updates on Covid-19 related measures and activities.
The new recommendations are specifically targeted to communities that are in Phase 1 of the Guidelines for Opening Up America Again with low incidence or relatively low and stable incidence of COVID-19 cases as described in the Trump Administration’s Guidelines for Opening Up America Again. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials, and to review the availability of personal protective equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.
Prior to entering Phase 1, states or regions need to pass gating criteria regarding symptoms, cases, and hospitals. The CMS recommendations are not meant to be implemented by every state, county, or city at this time and Governors and local leaders ultimately need to make decisions on whether they are appropriate for their communities.
Healthcare facilities and providers that are in areas still seeing a higher number of COVID-19 cases are encouraged to continue following the recommendations made by CMS last month. These were issued to expand capacity to care for patients with COVID-19, to reduce the risks of transmission and exposure to patients, and to conserve adequate supplies, especially PPE and manpower, during the public health emergency.
According to CMS, the healthcare facilities in some areas may have been stretched to their limits of capacity, and surge areas have been needed to augment care. However, many parts of the country have a low, or relatively low and stable incidence of COVID-19, and it is important to allow flexibility to provide non-COVID-19 healthcare. Both sets of recommendations issued by CMS are based on ensuring doctors are making the ultimate decision about patient care. Providers and patients are still highly encouraged to continue to utilize virtual care for services that can be managed via remote appointments to continue limiting the risk of exposure and spread of this virus.
The new recommendations can be found here: https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf
The Guidelines for Opening Up America Again can be found here: https://www.whitehouse.gov/openingamerica/#criteria
These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.
To read previous ISASS guidance on CMS and COVID-19 related practice updates see COVID-19 practice update click link here: https://www.isass.org/cms-announces-financial-relief-package-for-medicare-providers/
To read previous ISASS guidance on Telemedicine updates click link here: https://www.isass.org/covid-19series2-2/