The COVID-19 pandemic created a cataclysmic effect on home healthcare agencies, clinicians, and patients. The Centers for Medicare and Medicaid Services (CMS) responded by issuing emergency waivers that allowed patient care to continue during that extraordinary time. After more than 3 years, the COVID-19 public health emergency ended May 11, 2023. Because home healthcare agencies were able to demonstrate that patient care was positively affected by the temporary changes made during the public health emergency, many of the provisions have been extended or made permanent.
According to the Consolidated Appropriations Act of 2023 (CMS, 2023a; 2023b):
* Home healthcare agencies can continue to utilize remote patient monitoring, telephone calls (audio-only), and two-way audio-video technology as part of the plan of care, if they don't replace in-person home visits as part of the plan of care.
* Certain telehealth visits can be delivered audio-only (i.e., telephone) if someone is unable to use both audio and video (i.e., a smartphone or computer).
* Face-to-face encounters can continue to be conducted via two-way audio-video telecommunication between providers and patients.
* Patients can be considered homebound if they have a suspected or confirmed case of COVID-19, or if the patient has a disease that increases their vulnerability to COVID-19.
* Nurse practitioners and clinical nurse specialists as well as physician assistants and physicians can certify and recertify patient eligibility and establish the Plan of Care.
* CMS now permanently allows Occupational Therapists to perform the initial and comprehensive assessment according to Division CC, section 115 of CAA 2021.
* Supervising healthcare professionals may be available virtually using real-time audio/video rather than being physically present.
Home healthcare agencies should continue to document how patient care is positively affected by these waivers and advocate for permanent adoption of the changes that have been extended until December 2024.
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