PHE [Ended], Marking Expiration of Most Home Health, Hospice Waivers

McKnight’s Home Care | By Liza Berger
Katie Wehri of the National Association for Home Care & Hospice has a message for providers concerning the expiration of pandemic era waivers: a grace period to comply is not the same as an extension.
“Getting the providers to understand the difference between an extension and what I call a transition period, I think, is really important for them to not miss any requirements,” NAHC’s director of home care and hospice regulatory affairs told McKnight’s Home Care Daily Pulse.
Today marks the last day of the public health emergency, the end of many waivers instituted for home health and hospice agencies during the pandemic. Those waivers that have been extended are the exception and not the norm, Wehri pointed out. To get a handle on the rules surrounding compliance, Wehri suggests that providers first take a look at the waivers and flexibilities that have been available, eliminate the ones that are not applicable and identify the ones that are. Then providers should “figure out when [the waivers] end and when they have to be in full compliance with the requirements.”  
To help home health and hospice providers get up-to-speed on the conclusion of pandemic-era waivers and flexibilities, NAHC finalized a chart this week listing all the regulations and their compliance dates. Wehri noted that just one regulation – 418.76 (h), which waives the requirement of a hospice aide supervisory visit every two weeks — is up in the air.
The government has continued to update waivers in the last few days. Just last week, the Centers for Medicare & Medicaid Services issued guidance for surveyors regarding 418.78 (e) — the 5% volunteer requirement for hospices. While it expects volunteer levels to return to  pre-pandemic requirements by the end of the year, CMS said that surveyors can use their judgment to determine if a hospice is compliant with the requirement. 
And this week, in advance of the end of the PHE, the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) extended telemedicine flexibilities for prescribing controlled medications for six months, though Nov. 11. 
NAHC is also interpreting new guidance from the Centers for Disease Control and Prevention on healthcare workers. CMS recently disclosed that the COVID-19 vaccine mandate for CMS-certified facilities is ending. Details, it said, would be forthcoming.