OVERVIEW OF REQUIREMENTS Eligible facilities and providers are mandated to meet the following requirements under the IFR: Develop a process/plan for vaccinating all eligible staff Develop a process/ plan for providing exemptions and accommodations for those who are exempt
Full Answer
What procedures can be performed at a Medicare approved facility?
Being certified as a Medicare approved facility is required for performing the following procedures: carotid artery stenting, VAD destination therapy, certain oncologic PET scans in Medicare-specified studies, and lung volume reduction surgery.
Does Medicare cover complex medical procedures?
In recent years, Medicare has issued several national coverage determinations providing coverage for services and procedures of a complex nature, with the stipulation that the facilities providing these services meet certain criteria.
What qualifies as skilled nursing care for Medicare?
It must be given by, or under the supervision of, skilled nursing or therapy staff. You get these skilled services in a SNF that’s certified by Medicare. A hospital-related medical condition treated during your qualifying 3-day inpatient hospital stay, even if it wasn't the reason you were admitted to the hospital. .
What services are covered by Medicare?
Medicare-covered services include, but aren't limited to: Semi-private room (a room you share with other patients) Meals Skilled nursing care Physical therapy (if needed to meet your health goal) Occupational therapy (if needed to meet your health goal) Speech-language pathology services (if they're needed to meet your health goal)
What services does Medicare cover?
Medicare-covered services include, but aren't limited to: Semi-private room (a room you share with other patients) Meals. Skilled nursing care. Physical therapy (if needed to meet your health goal) Occupational therapy (if needed to meet your health goal)
How many days do you have to stay in a hospital to qualify for SNF?
Time that you spend in a hospital as an outpatient before you're admitted doesn't count toward the 3 inpatient days you need to have a qualifying hospital stay for SNF benefit purposes. Observation services aren't covered as part of the inpatient stay.
How long do you have to be in the hospital to get SNF?
You must enter the SNF within a short time (generally 30 days) of leaving the hospital and require skilled services related to your hospital stay. After you leave the SNF, if you re-enter the same or another SNF within 30 days, you don't need another 3-day qualifying hospital stay to get additional SNF benefits.
Can you give an intravenous injection by a nurse?
Care like intravenous injections that can only be given by a registered nurse or doctor. in certain conditions for a limited time (on a short-term basis) if all of these conditions are met: You have Part A and have days left in your. benefit period.
Can you get SNF care without a hospital stay?
If you’re not able to be in your home during the COVID-19 pandemic or are otherwise affected by the pandemic, you can get SNF care without a qualifying hospital stay. Your doctor has decided that you need daily skilled care. It must be given by, or under the supervision of, skilled nursing or therapy staff. You get these skilled services in ...
When will phase 3 of the LTC be implemented?
Phase 3 includes additional regulatory provisions that could be implemented as early as November 28, 2019.
What is CMS 3347-P?
Today the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilties: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P). The proposed rule would remove requirements for participation identified as unnecessary, obsolete, or excessively burdensome on long-term care (LTC) facilities, also known as “nursing homes”. The rule is part of the agency’s five-part approach to ensuring a high-quality LTC facility system that focuses on strengthening requirements for such facilities, working with states to enforce statutory and regulatory requirements, increasing transparency of facility performance, and promoting improved health outcomes for facility residents. CMS expects the provisions in the rule, if finalized, to achieve $616 million in savings annually for these facilities.
Covered Individuals
The Rule applies to staff of the aforementioned covered facilities, regardless of whether their positions are clinical or non-clinical, and includes employees, licensed practitioners, students, trainees, and even volunteers.
Important Dates
Under the Rule, all eligible staff must receive their first dose of a two-dose primary vaccination series by December 5, 2021, prior to providing any care, treatment, or other services.
No Testing Opt-Out
Under the Rule, there is no opt-out test option available to covered employees. Thus, unless an individual qualifies for an exemption because of a disability, medical condition, or sincerely held religious belief, practice, or observance, as defined by federal law and on which we reported, vaccination against COVID-19 is mandatory.
Proof of Vaccination Status
Employers should promptly notify their staff of their obligations under the Rule. This means ensuring that individuals are timely notified of their obligation to receive their first dose of a two-dose vaccination against COVID-19 by December 5, 2021, and to be fully vaccinated by January 4, 2022.
Policies and Procedures
Employers must update their policies and procedures to ensure that they contain:
CMS Enforcement Mechanisms
Compliance with the Rule will be ensured through established state surveyors, who will review the covered entity’s records of staff vaccinations. Surveyors may also conduct interviews with staff to verify their vaccination status.
What Employers Should Do Now
Employers should first determine whether the Rule applies to their entity, and if so, to which particular staff it applies. As noted above, the Rule encompasses a broad range of providers and suppliers, and covers most staff who interact or encounter other staff or patients. Fully remote workers are not covered by the Rule.
The Rule’s Applicability: Providers and Suppliers
- The Rule requires full COVID-19 vaccination by January 4, 2022, of covered staff at health care facilities that participate in Medicare and Medicaid programs. This includes Medicare- and Medicaid-certified providers and suppliers (hereinafter “covered facilities”), such as: 1. ambulatory surgical centers; 2. hospices; 3. Programs of All-Inclusive C...
Covered Individuals
- The Rule applies to staff of the aforementioned covered facilities, regardless of whether their positions are clinical or non-clinical, and includes employees, licensed practitioners, students, trainees, and even volunteers. It also includes individuals who provide treatment or other services for the facility under contract or other arrangements, such as independent contractors. For exa…
Important Dates
- Under the Rule, all eligible staff must receive their first dose of a two-dose primary vaccination series by December 5, 2021, prior to providing any care, treatment, or other services. All eligible staff must be fully vaccinated, as defined below, by January 4, 2022, unless exempted by federal law (which is consistent with the requirement of the OSHA ETS).
Definition of “Fully Vaccinated”
- An individual is considered “fully vaccinated” for COVID-19 under the CDC’s guidance 14 days after receipt of a single-dose vaccine (Janssen/Johnson & Johnson) or the second dose of a two-dose primary vaccination series (Pfizer-BioNTech/Comirnaty or Moderna). At this time, the definition of “fully vaccinated” does not include authorized boosters.
No Testing Opt-Out
- Under the Rule, there is no opt-out test option available to covered employees. Thus, unless an individual qualifies for an exemption because of a disability, medical condition, or sincerely held religious belief, practice, or observance, as defined by federal law and on which we reported, vaccination against COVID-19 is mandatory. In this respect, the Rule more closely resembles th…
Proof of Vaccination Status
- Employers should promptly notify their staff of their obligations under the Rule. This means ensuring that individuals are timely notified of their obligation to receive their first dose of a two-dose vaccination against COVID-19 by December 5, 2021, and to be fully vaccinated by January 4, 2022. To ensure individuals are vaccinated in compliance with the Rule, providers and suppliers …
Policies and Procedures
- Employers must update their policies and procedures to ensure that they contain: 1. A process for ensuring that covered staff (except for those who have pending requests for, or who have been granted, exemptions to the vaccination requirement) have timely received their COVID-19 vaccinations by the aforementioned dates; 2. A process to mitigate the transmission and sprea…
CMS Enforcement Mechanisms
- Compliance with the Rule will be ensured through established state surveyors, who will review the covered entity’s records of staff vaccinations. Surveyors may also conduct interviews with staff to verify their vaccination status. Furthermore, surveyors will review the providers’ or suppliers’ policies and procedures to ensure each component of the Rule has been addressed. Surveyors …
What Employers Should Do Now
- Employers should first determine whether the Rule applies to their entity, and if so, to which particular staff it applies. As noted above, the Rule encompasses a broad range of providers and suppliers, and covers most staff who interact or encounter other staff or patients. Fully remote workers are not covered by the Rule. Employers must update their policies and procedures to en…