The CARES Act including a provision authorizing APPs to order, certify and re-certify Medicare Home Health was signed into Law on March 27, 2020. The new Law will improve timely access to care for our vulnerable patients by permanently retiring this cumbersome federal barrier to NP practice. The Centers for Medicare and Medicaid Services will provide guidance and rule-making to enact and implement this new Law within six months.
As an interim measure, before permanent rule-making has been finalized, CMS under the COVID-19 National Emergency Declaration has temporarily waived the Medicare and Medicaid home health requirements thereby allowing Nurse Practitioners to Order, Certify and Re-Certify Medicare and Medicaid Home Health during this time of emergency.
a. The Emergency orders will only allow Home Health orders to be implemented in States where it is currently in accordance with State regulations.
b. The 32nd Annual Legislative Update of 2020, by Dr. Susanne Phillips, has current information on States with Statutory or Regulatory Authorization to order Home Health Services.
c. Per this report: https://journals.lww.com/tnpj/Fulltext/2020/01000/32nd_Annual_APRN_Legislative_Update__Improving.6.aspx
i. States with Authorization to order Home Health include: AK, DE, CA, FL, MN, MO, MT, PA, OR, SD, WA, WY.
ii. States where Authorization is not specifically prohibited include: AZ, CO, NH, VT.
iii. States with NO Authorization include: AL, IA, KS, ME, NC, OK, RI, VA, WV.
These actions are considered temporary during the National Covid-19 Emergency, but will in essence provide a bridge until CMS finalizes its permanent rulemaking to enact and implement the CARES Act by September 2020.
Information regarding this can be found on CMS website at: https://www.cms.gov/files/document/covid-home-health-agencies.pdf