Skip to main content

VGM & ASSOCIATESHealthcare MSO

Search GO

Search GO

VGM & ASSOCIATESHealthcare MSO LEARN ABOUT VGM

Public Health Emergency Extended 90 More Days, Will This be the Final Time?

Published in Government Relations on October 14, 2022

On Thursday, Oct. 13, 2022, HHS Secretary Xavier Becerra announced an extension of the COVID-19 Public Health Emergency (PHE). This extension will last another 90 days from October 13, 2022. Anytime there is a PHE declaration, it can only last for 90 days at a time but can be extended or renewed. It has already been renewed multiple times.

There are several provisions 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
Medicare’s 50/50 blended rate for rural areas
COVID-19 testing at no cost to the patient
Waivers of certain telehealth restrictions
Waivers related to Medicare medical policies (LCD)

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

Reimbursement is based on the beneficiary's permanent address on file with SSA.

The next reconsideration for renewal is in January 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 looking for claims that are still being submitted with the CR modifier and “COVID-19” in the claimed narrative, looking to see what the CR is still being appended. 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 post-PHE. We do know that HHS Secretary Becerra has stated that there will be a 60-day notice prior to the termination of the PHE. We also know CMS will provide instructions near the 60-day notice of termination that will guide suppliers on the next steps.

Here is other important information from Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement with VGM & Associates, that you DON'T want to miss!

Ronda Vlog: Update on Sleep Studies for New CPAP Patients
Live Chat with Ronda: Open Mic Live Chat Oct. 28
Ronda Podcast: A Chat With Ronda Buhrmester About Important Reimbursement Updates and Getting Paid Faster
Ronda’s next appearance: Speaking at Medtrade East in Atlanta – October 2022

From Our Experts

CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program thumbnail

CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program On June 30, 2025, CMS filed the anticipated Proposed Rule that includes updates to the Competitive Bidding Program (CBP). Public comments are due 60 days from June 30, 2025. Below is a high-level summary of the rule. It is critical to note that, according to the Proposed Rule Fact Sheet dated June 30, 2025, CMS has stated that they have not announced the specific product categories they are bidding or the specific timeframe for the next competition. Those specifics will be forthcoming in a fu

Senate Narrowly Passes HR1, Sending It Back to House for Final Approval thumbnail

Senate Narrowly Passes HR1, Sending It Back to House for Final Approval President Donald Trump's sweeping legislative package, formally titled the One Big, Beautiful Bill Act, now referred to as HR1., cleared the Senate today in a dramatic 51–50 vote, with Vice President JD Vance casting the tie-breaking vote. The bill now returns to the House, where lawmakers must decide whether to adopt the Senate's revised version or negotiate further changes before it can reach the president's desk.

Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule thumbnail

Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule Senate Parliamentarian Elizabeth MacDonough advised this week that multiple Medicaid provisions in the Senate's reconciliation bill would violate Senate procedure by violating the Byrd Rule. The Byrd Rule is a Senate-specific procedural process that allows Senators to prevent or block inclusion of extraneous provisions in reconciliation bills. Other provisions are still under review.

Evaluating the Value of a Payer Contract thumbnail

Evaluating the Value of a Payer Contract In our last article, Key Payers Denied Your Application Citing Their Network Is Closed – Now What?, we discussed strategies for addressing payer contracting denials due to a closed network. As indicated, this process can be an extremely time-consuming exercise with no guarantees and mixed results. Below are a few things to consider as you evaluate whether a contract is worth the extra effort.

Webinar: "Navigating The New CMS Landscape: RADs, HMVs, and Supplier Survival" on June 25 at 1 p.m. CT. The Centers for Medicare & Medicaid Services (CMS) has released its final National Coverage Determination (NCD) for RADs and HMVs used in treating chronic respiratory failure due to COPD. While the rule potentially expands access to bilevel ST therapy (RADs), it also introduces complex compliance requirements, tighter usage criteria, and increased documentation burdens—without additional reimbursement.

The Return of Competitive Bidding thumbnail

The Return of Competitive Bidding The Centers for Medicare & Medicaid Services (CMS) appear to be laying the groundwork for another round of the Competitive Bidding Program (CBP). While full implementation will take a couple of years, an official announcement is expected this summer—potentially as early as July.

Out With The Old RAC, In With The New thumbnail

Out With The Old RAC, In With The New On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 3 includes the following Medicare Administrative Contractor (MAC) jurisdictions: JJ, JM, and JN. RAC Region 4 includes jurisdictions: JE, JF, and JL. And RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM.

Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? thumbnail

Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? At VGM Group, Inc. we have the pleasure of serving our members and partners throughout the country.  One of the many ways we do this is through legislative advocacy, working with our partners to create a more equitable and effective healthcare system. All our VGM units are dedicated to advancing our partners' businesses, streamlining operations, and working every day to enhance reimbursement for the quality in-home healthcare our industry provides all people.

Give your business an advantage over the competition.

Become a Member