On March 13, 2020, the President of the United States issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency. On the same day, the Secretary of the United States Department of Health and Human Services invoked his authority to waive or modify certain requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). This waiver also ensures that health care providers that furnish such items and services in good faith may be reimbursed for those items and services.
This authority took effect at 6PM Eastern Standard Time on March 15, 2020, with a retroactive effective date of March 1, 2020. The emergency period will terminate, and section 1135 waivers will no longer be available, upon termination of the public health emergency, including any extensions.
Missouri submitted their request for flexibility or waiver of several requirements on March 20, 2020 and received approval from CMS on March 25, 2020. https://dss.mo.gov/covid-19/pdf/cms-approval-letter-for-waiver-1135.pdf
The areas of flexibility or waiver requested focused on strengthening the healthcare workforce, flexibility in some Emergency Medical Treatment and Labor Act (EMTALA) regulations, removing barriers to the delivery of health care services, removing restrictions to payment limitations to providers, and, removing restrictions to provider enrollment and revalidation efforts. Additionally, flexibility in waiving certain prior authorization requirements, waiver of timely filing requirements, flexibilities related to appeals and State Fair Hearings, waiver of public notice requirements, waiver of implementation of some performance deadlines, and flexibility with critical access and alternative setting requirements were requested.
Missouri anticipates further approvals by CMS under this and other authorities in the coming days.