DHS COVID-19 PROVIDER RESOURCES // OMAP
Medical Assistance Bulletin 09-20-05, 10-20-02, 14-20-01, 31-20-05,
33-20-03: Home Health Services, Medical Supplies,
Equipment and Appliances Prescribed by Nonphysician Practitioners
Effective: March 1, 2020; Issued: May 1, 2020
Important Reminder: All providers must revalidate the Medical Assistance (MA) enrollment of each service location every five years. Providers should log into PROMISe™ to check the revalidation dates of each service location and submit revalidation applications at least 60 days prior to the revalidation dates. Enrollment (revalidation) applications may be found at https://www.dhs.pa.gov/providers/Providers/Pages/PROMISeEnrollment.aspx.
Purpose
The purpose of this bulletin is to advise providers that certain non-physician
practitioners may prescribe home health services, medical supplies, equipment and
appliances, effective with dates of service on and after March 1, 2020.
Scope
This bulletin applies to physicians, physician assistants (PA), certified registered nurse
practitioners (CRNPS), certified nurse midwives (CNM), podiatrists who render services to
beneficiaries in the MA Fee-for-Service and managed care delivery systems. Providers who
render services in the managed care delivery system should address any questions with the
applicable MA Managed Care Organization.
Background
On March 6, 2020, Governor Tom Wolf issued a public health emergency declaration in
response to the presence of COVID-19 in Pennsylvania. On January 31, 2020, a national
public health emergency was declared. On March 13, 2020, COVID-19 was declared a
nationwide emergency under the Stafford Act retroactive to March 1, 2020.
Discussion
The Centers for Medicare & Medicaid Services (CMS) issued the interim final rule (IFR),
“Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the
COVID–19 Public Health Emergency”, on April 6, 2020. 85 Fed. Reg. 19230 (Apr. 6, 2020).
The IFR, in part, amends federal Medicaid regulations related to home health services in an
effort to:
- Expand the workforce and continue CMS’ efforts to align Medicaid with Medicare rules
for who can order medical supplies, equipment, and appliances, and therapeutic
services;
- Allow smoother access to services for Medicaid beneficiaries, including those who are
dually eligible for Medicare and Medicaid; and
- Eliminate administrative burden to states and providers when dealing with
inconsistencies between the Medicare and Medicaid programs.
The IFR amends 42 CFR § 440.70 to allow licensed practitioners practicing within their scope
of practice, such as, but not limited to, nurse practitioners and physician assistants, to order
Medicaid home health services during the existence of the national public health emergency
for the COVID–19 pandemic.
Procedure
Effective with dates of service on and after March 1, 2020, PAs, CRNPs, CNMs and
podiatrists may prescribe home health services in Pennsylvania’s MA Program. Home health
services are comprised of nursing services, home health aide services, physical therapy,
occupational therapy, speech pathology and audiology services, as well as, medical supplies,
equipment and appliances.
The IFR authorizes the amendment to 42 CFR § 440.79 until the end of the national
public health emergency. The Department may re-issue these guidelines as appropriate.
Information on MA Program coverage related to COVID-19, to include an FAQ document, can
be found on the Department of Human Services website here.
The Pennsylvania Department of Health has a dedicated page for COVID-19 that provides
regular updates. Click here for the most up to date information regarding COVID-19.
Comments and Questions