CMS to streamline and automate emergency waiver requests

CMS is developing a streamlined, automated process to standardize emergency waiver requests based on lessons learned during the COVID-19 pandemic, according to a proposed information collection on Tuesday.

The agency said the new system would be based mainly on the volume of requests to ensure facilities receive a quick response. CMS will collect relevant information from healthcare providers and suppliers to decide whether to approve their waiver request. The new waiver request form was approved on an emergency basis Oct. 15.

“Prior to this request, CMS did not have a standard process or (White House budget office) approval for providers/suppliers impacted to submit 1135 waiver/flexibility requests or inquiries, as these were generally seen on a smaller scale (natural disasters) prior to the COVID-19 public health emergency,” CMS wrote.

Comments on the information collection are due in December.

Under the old system, providers and suppliers would email a summary of their request to each CMS location—previously known as CMS regional offices.

The agency also plans to create a streamlined, automated system to gather information from providers about how their operations have been affected by an emergency or disaster. CMS currently relies on State Survey Agencies to collect that information.

Under the new process, the agency would directly collect the information through a “public-facing web form.” CMS would use the information to triage, respond to and report requests or inquiries for Medicare, Medicaid and Children’s Health Insurance Program beneficiaries. It plans to add a second form to collect information about healthcare facilities’ operational status to help providers deliver critical care during emergencies.

HHS can waive or change certain Medicare, Medicaid or CHIP requirements during a disaster or emergency to ensure enough healthcare items or services are available to beneficiaries. The agency can suspend or change conditions of participation, program participation and preapproval requirements, Stark self-referral sanctions and performance deadlines, among other things. Providers can get reimbursed and avoid penalties for delivering those items and services during the emergency if they do it in good faith.