VGM & ASSOCIATESHealthcare MSO
Full Menu Search

PHE Renewed for Another 90 Days Pushing it to April 2023

Published in Government Relations on January 11, 2023

On Wednesday, Jan. 11, 2023, HHS Secretary Xavier Becerra announced an extension of the COVID-19 Public Health Emergency (PHE). This extension will last another 90 days from January 11. PHE declarations, and subsequent extensions such as this one, only last for 90 days at a time but can be further renewed as many times as necessary. The COVID-19 PHE has been renewed multiple times since early 2020. 

What PHE Extenstion Means For DMEPOS Suppliers 

There are several provisions which impact our industry that are tied to the duration of the PHE that will remain in place due to the extension of the PHE, including:  

  • Medicare’s 75/25 blended rates for non-rural, non-CBA areas (these increased reimbursement rates will no longer end immediately when the PHE is ultimately declared over) 
  • COVID-19 testing at no cost to the patient  
  • Waivers of certain telehealth restrictions  
  • Waivers related to Medicare medical policies (LCD)  

A full list of those waivers can be found here. 

Remember, the competitive bid areas (CBAs) continue with the existing payment methodology, known as the single payment amount (SPA); the PHE extension does not affect payments in these areas.  

Reimbursement rates are determined based on the beneficiary's permanent address on file with SSA.  

The next reconsideration for the PHE renewal will occur in April 2023. 

While the PHE has been renewed for another 90 days, it would be a suitable time for suppliers to begin preparations for the PHE to be terminated. This means running reports to look for claims that are still being submitted with the CR modifier and “COVID-19” in the claimed narrative. Also, be familiar with the patients living in the non-rural, non-CBA areas because these areas will be affected by the reimbursement rates changing (that decrease in reimbursement will likely happen at the end of 2023). We do know that HHS Secretary Becerra has stated that a 60-day notice will be announced prior to the termination of the PHE. We also know CMS will provide instructions near that 60-day notice of termination that will guide suppliers regarding the policies and waivers outlined above after the PHE has expired. 

TAGS

  1. hhs
  2. phe
  3. vgm
  4. vgm government

Get Connected

Stay up-to-date on the latest resources and news provided by VGM & Associates.

Sign Up for Email

From Our Experts

PAMES Raises Critical Concerns Over Sole-Source Supply Shift thumbnail PAMES Raises Critical Concerns Over Sole-Source Supply Shift PAMES and DME suppliers across Washington are taking an important stand on behalf of both providers and patients. The Tacoma Daily Index recently reported on the state's plan to move to a sole-source contract for incontinence and urological supplies. Under this decision, the Health Care Authority intends to transition all Medicaid recipients to receiving these products from a single vendor. CMS Rule Phases Out Fax Machines, Snail Mail to Save Taxpayers $781.98 Million a Year thumbnail CMS Rule Phases Out Fax Machines, Snail Mail to Save Taxpayers $781.98 Million a Year As reported by CMS: “The Centers for Medicare & Medicaid Services (CMS) is slashing wasteful spending and antiquated paperwork by swapping out faxing and mailing for streamlined electronic transactions. This action lets providers spend less time on administrative hassle and more time caring for patients. SBA Advocacy: Your Input Matters thumbnail SBA Advocacy: Your Input Matters Make your voice heard about how the CBP has affected your business. New Bipartisan Senate Bill Aims to Improve Access to Diabetes Technology & Education for Medicare Beneficiaries thumbnail New Bipartisan Senate Bill Aims to Improve Access to Diabetes Technology & Education for Medicare Beneficiaries U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME), Cochairs of the Senate Diabetes Caucus, have introduced the Diabetes Interventions Addressing Barriers to Enrollment, Technology, and Education Services (DIABETES) Act, S.4037. VGM Reintroduces the Fraud, Waste & Abuse Reporting Resource Center thumbnail VGM Reintroduces the Fraud, Waste & Abuse Reporting Resource Center VGM Government Relations is proud to announce the reintroduction of its Fraud, Waste & Abuse (FWA) Reporting Resource Center—a newly refreshed online hub designed to protect the integrity of the DMEPOS industry and reinforce our unwavering commitment to ethical, compliant care. Celebrating Another DME Champion of Change: Thom Harvill of Above and Beyond Medical thumbnail Celebrating Another DME Champion of Change: Thom Harvill of Above and Beyond Medical We're proud to once again recognize a true Champion of Change in the DME industry: Thom Harvill of Above and Beyond Medical in Tennessee. Thom has dedicated many years to the DME community—consistently showing up, speaking out, and pushing the industry forward. He's the kind of advocate who never stops asking, “Who else can I reach out to about this?” Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse thumbnail Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse This week, the Trump administration, through the Centers for Medicare & Medicaid Services (CMS), announced a significant deferral of federal Medicaid matching funds to Minnesota alongside the release of a new Request for Information (RFI) tied to the administration's Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative. These actions along with the changes to DMEPOS accreditation and enrollment signal the administration's aggressive posture on Medicaid and Medicare... VGM Response To CMS Moratorium On New DMEPOS Provider thumbnail VGM Response To CMS Moratorium On New DMEPOS Provider The federal moratorium on new DME suppliers presents a defining moment for us as an industry—an opportunity to demonstrate that the VGM members serving patients are the gold standard. We have long shown that our members operate with integrity, excellence in compliance, and unmatched commitment to service, efficiency, and patient outcomes. Now, we must elevate that message.

Give your business an advantage over the competition.

Become a Member