CMS Waives Hospice Rules Amid COVID-19 Emergency

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued an 1135 waiver to relax certain rules and conditions of participation (CoPs) for hospices and other health care providers after the White House declared a national emergency in response to the COVID-19 pandemic

Declaration of a national disaster allows the U.S. Secretary of Health and Human Services (HHS) to waive these requirements under section 1135 of the Social Security Act. Among the CMS actions that could impact hospice is suspension of non-emergency survey inspections and rules for replacing damaged or lost durable medical equipment.

“It remains vital that our health care system be equipped to respond effectively to the additional cases that do arise, that federal requirements designed for periods of relative calm do not hinder measures needed in an emergency,” said CMS Administrator Seema Verma. “These temporary blanket waivers – offered to providers, and clinicians across the country – are reserved for the rarest of situations. They represent a massive mobilization of our country’s resources to combat this terrible virus. In a time of emergency, the health system needs maximum flexibility to respond appropriately.”


The waiver also allows for the expanded use of telemedicine to help limit close contact between providers and patients that could potentially spread the virus. Further provision to expand telehealth will be forthcoming from CMS in the near future, Verma said.

Hospice groups such as the National Hospice & Palliative Care Organization (NHPCO) had sent a letter earlier this week to the White House to request the emergency declaration to allow for the 1135 waivers. The National Association for Home Care & Hospice made a similar request to CMS.  

“We applaud the Administration for taking swift action by making an emergency declaration invoking the 1135 waiver authority,” said NHPCO President & CEO Edo Banach. “We will continue to work with the Administration to identify areas where additional flexibility will enable hospice providers to prioritize the health and safety of their patients, caregivers, and staff in private homes and facilities in their communities across the nation. Ensuring access to community-based care is needed now more than ever.”


To date, 1,647 cases of the virus have been identified in 46 states and the District of Columbia, leading to 47 deaths.

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