CMS issues new COVID-19 guidance, including nursing home staff testing requirements

On August 24, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a new interim final rule with comment period on numerous facility responsibilities regarding COVID-19 testing, reporting and operational procedures. The new guidance includes the following:

• Nursing facility testing. Earlier recommendations regarding testing for employed and contracted staff, service providers and volunteers in skilled nursing facilities are being converted into mandatory requirements. The frequency of the required testing will be based on the infection percentage in the county where the nursing facility is located. Resident testing must also be performed when an outbreak or incidence of symptoms appear. Failure to follow these testing requirements can result in a fine of up to $8,000 per instance of non-compliance. Facilities must have procedures for addressing residents and staff who refuse or are unable to be tested. In these instances, steps must be taken to maintain the health and safety of staff and residents.
• Nursing facility testing reporting. Nursing facilities must report their testing results to the Department of Health and Human Services. Failure to report may result in revocation of Medicare and Medicaid billing privileges. 
• CLIA testing reporting. Clinical laboratories must report their testing results daily or face daily penalties of up to $1,000.
• Hospital outbreak tracking. The Conditions of Participation for both hospitals and critical access hospitals are modified to cover the tracking “incidence and impact of COVID-19 to assist public health officials in detecting outbreaks”.
• Ordering of testing. “The orders of pharmacists and other practitioners that are allowed to order laboratory tests [under state scope of practice laws] can fulfill the” Medicare requirements for ordering COVID-19 tests.

Other elements of the rule also deal with updates and extensions on various quality reporting systems, impacts on small-group insurance plans, and incorporation of aspects of the public health emergency into the Merit-Based Incentive Payment System. 

A comment period on these rules will run for sixty days from the official Federal Register publication date, which is set for September 2, 2020.