On March 24, 2020, the Wisconsin Department of Health Services (DHS) prepared correspondence to the Center for Medicare and Medicaid Services (CMS) seeking waivers of certain Medicaid requirements pursuant to Section 1135 of the Social Security Act (42 U.S.C. § 1320b-5) due to the COVID-19 pandemic. The correspondence to CMS was shared on March 24, 2020 with the Wisconsin Legislature Joint Committee on Finance seeking their approval to submit the Section 1135 Waiver to CMS. The letter to CMS prepared by DHS states that Wisconsin is implementing all the blanket waivers issued by CMS on March 13, 2020 in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), to the extent applicable. The fourteen (14) additional Section 1135 waivers sought in the March 24, 2020 DHS letter to CMS are as follows:
- Provider Participation, Billing Requirements and Conditions of Payment
- Provider Screening and Enrollment Requirements
- Service Authorization and Utilization Controls
- Benefits Flexibilities
- Administrative Flexibilities
- Eligibility Flexibilities
- Managed Care Flexibilities for Acute and Primary and Long-Term Care Health Maintenance Organizations (HMOs), Managed Care Organizations (MCOs) and Prepaid Inpatient Health Plans (PIHPs)
- Adult Long-Term Care/Home and Community Based Services Flexibilities.
- Children’s Long-Term Care/Home and Community Based Services Flexibilities.
- Temporary authority on behalf of our hospital providers specific to:
Discharge Planning, Medicare Conditions of Participation (CoPs),
Physician Referrals,
Flexibility for Teaching Hospitals,
Flexibility in Patient Self Determination Act Requirements, and
Flexibility in Equipment Requirements - Temporary authority on behalf of our nursing home providers specific to:
Frequency of Physician Visits,
Requirements for facility hiring and use of nurse aides,
Medical Director,
Notice before transfer,
Orientation for transfer or discharge,
Bed hold policy,
Regular in-service education,
Nurse Staffing,
Drug Regimen Review,
Paid feeding assistants, and
Maintenance reviews. - Temporary authority on behalf of the nurse aide training and testing programs
- Temporary authority on behalf of our home health agencies
- Temporary authority to waive several Life Safety Codes on behalf of WI hospitals, hospices, nursing homes, intermediate care facilities for individuals with intellectual disabilities, and critical access hospitals
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