HHS Extends COVID Public Health Emergency, Hospice Relief Continues

U.S. Secretary of Health & Human Services (HHS) Alex Azar has signed an order extending the public health emergency stemming from the COVID-19 pandemic. This will allow regulatory flexibilities for hospice providers and other health care organizations to remain in place from July 25 through Oct. 23. Without this extension, the emergency declaration had been set to expire this month. 

The federally declared emergency allows CMS to keep in place 1135 waivers for certain hospice rules, pursuant to provisions in the Social Security Act.

“As a result of the continued consequences of Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Alex M. Azar II, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective July 25, 2020, my January 31, 2020, determination that I previously renewed on April 21, 2020, that a public health emergency exists and has existed since January 27, 2020, nationwide,” Azar attested in the extension order.


For the duration of the COVID-19 national emergency declaration, hospices are exempt from requiring a registered nurse or other skilled professional to make an annual, onsite supervisory visit for each aide.

CMS also modified the requirement mandating that hospice annually assess the skills and competence of all individuals furnishing care, and to provide in-service training and education programs where required, and permitted providers to narrow the scope of their required Quality Assurance and Performance Improvement (QAPI) programs to focus on infection control and adverse events.

The agency further indicated that it would allow clinicians to use telehealth to fulfill requirements that are typically done face-to-face, including recertifications by physicians.


Stakeholders in the hospice space applauded the extension. The National Hospice & Palliative Care Organization for instance had recently written to the HHS secretary requesting a continuation of the public health emergency.

“NHPCO is grateful to Secretary Azar for his leadership during the coronavirus pandemic and for taking decisive action by renewing the COVID-19 public health emergency declaration. The continued support of the administration has enabled hospices to provide high quality hospice and palliative care to patients and families in their homes and communities, despite unprecedented challenges,” said NHPCO President and CEO Edo Banach.

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