Beginning at about 3 PM eastern time, President Donald Trump held a press briefing in the Rose Garden of the White House, in which he declared a national emergency around the coronavirus pandemic, conferring on Alex Azar, Secretary of Health and Human Services, extraordinary powers to set aside existing regulations and allow for greater flexibility for the leaders of hospitals, clinics, and nursing homes. Among other elements that the President referenced were a broader facilitation of telehealth services to help patient care organizations, and around Medicaid provider engagement.
The national emergency declaration allowed Secretary Azar and Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), to initiate a number of steps.
A press release posted to CMS’s website on Friday evening began thus:
“The Trump Administration today announced aggressive actions and regulatory flexibilities to help healthcare providers and states respond to and contain the spread of 2019 Novel Coronavirus Disease (COVID-19). The Centers for Medicare & Medicaid Services (CMS) is taking these actions following President Trump’s declaration of a national emergency due to COVID-19 earlier today.”
The release quoted Administrator Verma as stating that, “Following President Trump’s leadership during this health emergency, CMS is taking immediate steps to give our nation’s providers, healthcare facilities, and states maximum flexibility. It is vital that federal requirements designed for periods of relative calm do not hinder measures needed in an emergency. The nationwide waivers we are activating today will be a godsend for those on the frontlines of the fight against this new virus.”
The press release went on to say that “The President’s declaration empowers the Secretary of Health and Human Services (HHS) to authorize CMS to take proactive steps through 1135 waivers and rapidly expand the Administration’s aggressive efforts against COVID-19 led by the White House Coronavirus Task Force. The HHS Secretary is authorized to waive certain Medicare, Medicaid and Children’s Health Insurance Program (CHIP) program requirements and conditions of participation under Section 1135 of the Social Security Act once the President declares an emergency through the Stafford Act or National Emergency Act, and the Secretary declares a Public Health Emergency (PHE). HHS Secretary Alex M. Azar issued a PHE on January 31, 2020. As a result of this authority, CMS will activate blanket waivers, which will ease certain requirements for impacted providers. These waivers will allow CMS to take several key administrative actions in response to the national emergency declaration.” Among those will be that “CMS will temporarily waive or modify certain Medicare, Medicaid, and CHIP requirements. CMS will also issue several blanket waivers, listed on the website below, and the CMS Regional Offices will review other provider-specific requests. These waivers provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit: www.cms.gov/emergency.”
Two other elements in the CMS announcement were these:
“Provider Enrollment Flexibilities: CMS will temporarily suspend certain Medicare enrollment screening requirements including site visits and fingerprinting for non-certified Part B suppliers, physicians and non-physician practitioners. In addition, CMS will allow licensed providers to render services outside their state of enrollment. CMS will also establish a toll-free hotline for providers to enroll and receive temporary Medicare billing privileges.
Flexibility and Relief for State Medicaid Agencies: The national emergency declaration also enables CMS to grant state and territorial Medicaid agencies a wider range of flexibilities under section 1135 waivers. States and territories are now encouraged to assess their needs and request these available flexibilities, which are outlined in the Medicaid and CHIP Disaster Response Toolkit. Examples of flexibilities available to states under section 1135 waivers include the ability to permit out-of-state providers to render services, temporarily suspend certain provider enrollment and revalidation requirements to promote access to care, allow providers to provide care in alternative settings, waive prior authorization requirements, and temporarily suspend certain pre-admission and annual screenings for nursing home residents. For more information and to access the toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html.”
CMS also provided a “COVID-19 Emergency Declaration Health Care Providers Fact Sheet on its page, which can be accessed here.
Shortly after the event in the Rose Garden, the Associated Press’s Andrew Taylor, Zeke Miller, Jill Colvin, and Lisa Mascaro wrote, in a report published just minutes after the hour-plus-long event took place, that:
“President Donald Trump on Friday declared the coronavirus pandemic a national emergency, as Washington struggles with providing Americans with relief and officials race to slow the spread of the outbreak. Speaking from the Rose Garden, Trump said, ‘I am officially declaring a national emergency.’ He said it would free up as much as $50 billion for state and local governments to respond to the outbreak. Trump also waived interest on federally held student loans and moved to prop up energy markets, by directing the Department of Energy to buy oil to fill the strategic petroleum reserve ‘right up to the top.’” The AP reporters wrote that Trump this afternoon “also announced a new public-private partnership to expand coronavirus testing capabilities, as his administration has come under fire for being too slow in making the test available. Trump said, ‘I don’t take responsibility at all’ for the slow roll-out of testing.”
Meanwhile, POLITICO’s Anita Kumar and Daniel Lippman wrote that Trump “outlined a series of agreements with private companies, including Google and Walgreen's, in part to allow Americans to be tested more quickly for the coronavirus. He mentioned a website Google was setting up ‘to determine whether a test is warranted,’ and said major retailers like Walmart would set aside part of their parking lots for testing sites. Trump said he expected 1.4 additional tests to be available next week and five million within a month,” they wrote.
“Trump's decision comes amid condemnation over the administration's failure to provide adequate testing and resources for the coronavirus, which has killed more than 5,000 people worldwide and infected tens of thousands,” the POLITICO reporters wrote. “Health experts have also reprimanded Trump for repeatedly downplaying what has now been deemed a global pandemic. ‘I don’t take responsibility at all,’ Trump said of the struggles to produce enough tests, blaming existing rules set by prior administration for limiting his options. Senate Minority Leader Chuck Schumer (D-N.Y,), who had urged Trump to act more forcefully, offered rare praise for the president but warned him not to go too far. ‘As other steps are considered, the president must not overstep his authority or indulge his autocratic tendencies for purposes not truly related to this public health crisis,’ he said in a statement.”
eveloping story as it emerges.
