Federal News and Information

Centers for Medicare and Medicaid Services (CMS)

Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost

Today, the Centers for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine and there is no applicable copayment, coinsurance or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.


FY 2023 Hospice Wage Index and Quality Reporting Proposed Rule 

  • Proposed Rate increase: 2.7%
  • Proposed hospice cap amount for the FY 2023 cap year is $32,142.65
  • The HOPE tool is still under review.
  • The Hospice CAHPS® tool is proposed to be available in electronic format

To review the proposed rules, go to:  https://public-inspection.federalregister.gov/2022-07030.pdf.


CMS Returning to Certain Pre-COVID-19 Policies in Long-term Care and Other Facilities

The Centers for Medicare & Medicaid Services (CMS) is taking steps to restore certain minimum standards for compliance with CMS requirements. Restoring standards will be accomplished by phasing out some temporary emergency declaration waivers that have been in effect throughout the COVID-19 Public Health Emergency (PHE).

Waivers are being terminated for nursing facilities, inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities.

CMS is ending specific waivers in two groups: one group of waivers will terminate 30 days from the issuance of this new guidance, and the other group will terminate 60 days from issuance. These timeframes give providers and state agencies time to adjust their operations to the reinstituted requirements.  CMS will consider temporary waivers depending on the circumstances in the long term care environment, individual situations and communities.

Inpatient hospice providers are expected to take immediate steps so that they may return to compliance with the reinstated requirements according to the timeframes listed in this QSO. It is recommended that providers continue to follow CDC guidance for preventing the spread of COVID-19 especially during activities that may increase patient or resident contact.  Please review this information at:  https://www.cms.gov/files/document/qso-22-15-nh-nltc-lsc.pdf.


US Department of Homeland Security

Reminder to all hospice providers~

COVID-19 Funeral Assistance

Under the Coronavirus Response and Relief Supplemental Appropriations Act of 2021 and the American Rescue Plan Act of 2021, FEMA is providing financial assistance for COVID-19 related funeral expenses incurred on or after January 20, 2020.  For more information go to:  https://www.fema.gov/disaster/coronavirus/economic/funeral-assistance.


Texas News and Information

Texas Medicaid Hospice and Congressional HR 2471Telehealth and Face to Face Visits

A couple of weeks ago, TNMHO shared the following information with you:  Congress passed HR 2471, Consolidated Appropriations Act 2022.  A section of this legislation includes an extension of the flexibility for you to do face to face physician recertification virtual for 151 days after the end of the PHE.  The PHE is predicted to end sometime this summer.  It is unknown if Texas Medicaid will follow HR 2471.  You can read the act at: https://www.congress.gov/bill/117th-congress/house-bill/2471/text.

In addition, as noted in the posting, we reached out to Texas Medicaid hospice policy to ascertain whether they would be following HR 2471.  Medicaid hospice responded with the following:  we will not allow an extension of the telehealth COVID-19 flexibilities or allow telehealth permanently.

Supportive Palliative Care and Palliative Care Accreditation

Hospice providers who provide in-home supportive palliative care (SPC) must hold a license home health (LHH) category.  This must be done prior to seeking a palliative care accreditation with an accreditation company (AO).  Please note the following information:

  • State statute which does not provide for provisional licensure, HCSSAs must have a license to provide any services to even one client in Texas.
  • Each of the AOs is aware of changes in state licensing standards and interpretations posted on the Health and Human Services Commission (HHSC) website to ensure their standards and practices in the state are appropriate.
  • The accreditation process includes a review of service delivery in addition to the review of policies and procedures in accordance with the AO standards which must meet or exceed state licensing standards. Although the AO may have a procedure whereby it begins the accreditation process with a prospective agency to provide guidance and initial discussion, this is not dictated by HHSC.
  • The steps a hospice agency seeking to provide SPC to non-hospice elected clients may include reaching out to the desired AO for guidance and information prior to obtaining the LHH category, but no accreditation can be conveyed without appropriate licensure.

Reminder to all providers who are or were accredited!

Accreditation Notification

If you were accredited, but lost the accreditation, you MUST notify the Texas Health and Human Services Commission Licensing Division via TULIP.  Update TULIP to show that you had a change in information.

COVID-19 Mitigation, Response Rule Revised Effective April 3 for ALFs

HHSC Long-term Care Regulation has published a revised assisted living facility COVID-19 Mitigation and Response Emergency Rule.   It was effective April 3, 2022.

The revised rule:

  • Defines the term “up-to-date”.
  • Removes the definition of personal protective equipment and specific references to the CDC.
  • Removes the requirements to have plans to get and maintain a certain amount of PPE.
  • Removes the requirement to document staff and visitor screenings.
  • Removes the requirement to screen residents at least once a day.

Uses the term “notify” instead of “report” for contacting HHSC regarding a confirmed case of COVID-19.  To access, go to:  https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/long-term-care/alf-covid-19-response-emergency-rule.pdf.


HHSC Provides Guidance for Revised HCSSA COVID-19 Response Emergency Rule (PL 2022-21)

HHSC Long-term Care Regulation has published PL 2022-21 Guidance Regarding Revised HCSSA COVID-19 Response Emergency Rule. This letter provides guidance and describes the key changes in regulations adopted in emergency rule 26 TAC §558.960 (relating to HCSSA Response to COVID-19), which became effective on March 24, 2022.  Areas addressed are:  infection control, screening and non-essential visits.  To access, go to:  https://www.hhs.texas.gov/sites/default/files/documents/pl2022-21.pdf.


Disclaimer:  The Texas and New Mexico Hospice Organization publishes the Regulatory Update as an information only item.  TNMHO has no attorneys nor does it represent the state and federal governments.  All legal questions or concerns should be directed to your attorney or the governments involved.