CMS Narrows Hospice QAPI, Waives COVID-19 Testing Rule

The U.S. Centers for Medicare & Medicaid Services (CMS) is allowing hospices to narrow the scope of their required Quality Assurance and Performance Improvement (QAPI) programs during the pandemic to focus on infection control and adverse events. The agency will also allow any health care professional who is authorized by state law to order a COVID-19 test.

The QAPI requirement in the Medicare Conditions of Participation is separate from the Hospice Quality Reporting Program. Under the QAPI rule, hospices must maintain an ongoing organization-wide, data-driven quality assessment and performance improvement program.

“This modification decreases the burden associated with the development and maintenance of a broad-based QAPI program, allowing the providers to focus efforts on aspects of care delivery most closely associated with COVID-19 and tracking adverse events during the [public health emergency],” the agency indicated in a statement. 


CMS on Thursday took steps to allow health care providers to ramp up COVID-19 testing and further expand telehealth services in some settings.

A number of the actions contained in the CMS announcement were pursuant to Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. The agency indicated that its primary goals during the pandemic include expanding the health care workforce, ensuring sufficient hospital capacity, increasing access to telehealth, reducing administrative burdens and expanding virus testing in the home and community.

“Many of CMS’s temporary changes will apply immediately for the duration of the public health emergency declaration. Providers and states do not need to apply for the blanket waivers announced [Thursday] and can begin using the flexibilities immediately,” CMS indicated in a statement.


The new flexibilities will allow any health care professional, if they are authorized by state law, to order a COVID-19 test or other laboratory tests necessary to establish that diagnosis. A physician or licensed independent practitioner’s order will not be required in order to seek Medicare reimbursement for those tests. 

Also announced today, the agency will allow some additional services to be performed via telehealth, including those provided by physical therapists, occupational therapists, and speech language pathologists.

CMS indicated that any further additions to allowable telehealth services will be done on a sub-regulatory basis, meaning no formal rulemaking or congressional action would be necessary.