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

75/25 Medicare Impact Survey thumbnail 75/25 Medicare Impact Survey AAHomecare is spearheading a nation-wide initiative to measure the impact of the expired Medicare fee-for-service 75/25 blended rate for non-bid non-rural areas on the HME community and Medicare patients' access to medically necessary equipment. Medicare Advantage Plans Under Scrutiny for HME Denials thumbnail Medicare Advantage Plans Under Scrutiny for HME Denials The coverage of HME by Medicare Advantage plans has recently come under fire. At the VGM Heartland Conference on June 11, stakeholders highlighted a critical issue; Medicare Advantage plans are allegedly denying coverage unjustly. Government Relations Advocate for the Breast Cancer Patient Equity Act thumbnail Government Relations Advocate for the Breast Cancer Patient Equity Act The week of June 3rd, Nikki Jensen, VP of Essentially Women and Ike Isaacson, SVP of VGM Government & Regulatory Relations traveled to Washington D.C. to advocate for the Breast Cancer Patient Equity Act. Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin thumbnail Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin Last week, Williams Brothers Healthcare organized a meet-and-greet event featuring Representative Erin Houchin (R-IN-9) to address crucial topics related to HME services and the challenges faced by providers. OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence thumbnail OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence Over the past few legislative sessions, Oklahoma Medical Equipment Providers Association (OMEPA) has navigated a legislative rollercoaster. Their commitment to building relationships and advocating for patients has led to significant wins. Audit Climate – Taking The Temperature thumbnail Audit Climate – Taking The Temperature As we near the midpoint of 2024, what are the main billing/reimbursement headaches being faced by providers? [Vlog] Oxygen Policy Update thumbnail [Vlog] Oxygen Policy Update Listen in as Ronda Buhrmester clarifies the language of the oxygen policy around the co-signature that is highly recommended. Elimination of Noncompete Agreements - FTC Final Rule thumbnail Elimination of Noncompete Agreements - FTC Final Rule A 570-page final rule released by the FTC on April 23 will effectively put an end to the use of noncompete agreements between employers and employees. The final rule is scheduled for publication in the Federal Register on May 7, 2024, and will go into effect 120 days from publication (September 4, 2024), barring the results of any legal challenges to the rule.