Public Health Emergency Ending May 11 – Will Impact Several PHE-Related Waivers

On January 30, the Biden Administration announced its plans to end the Public Health Emergency (PHE). This administration guidance meets the Administration’s promise of 60 days’ notice of the end of the PHE. Based on the guidance, the PHE will end on May 11, 2023.

What the upcoming PHE termination means for providers:

  1. The end of the PHE also marks the end of Section 1135 National Blanket Waivers. The two substantive SNF waiver provisions left in Section 1135 are the Medicare fee-for-service 3-Day Stay and Spell of Illness waivers. These waivers technically fall under Section 1812(f) but are tied to the Section 1135 waiver. As of May 11, SNFs may no longer use the 3-Day Waiver or the Spell of Illness waiver. In terms of Medicare Advantage plans, PHE waiver provisions were rolled back in 2022.
    1. WHCA/WiCAL has reached out to AHCA/NCAL to discuss the prospects in Washington DC of maintaining this important waiver beyond the PHE termination.
  2. Several COVID-related regulatory guidances will lapse upon termination of the PHE, including widespread notifications on COVID cases per F885, enhanced enforcement for F880, and an end or scale-back NHSN COVID reporting.
    1. Note: AHCA is advocating with CMS that CMS end these requirements earlier than the May 11 PHE termination date.
  3. The end of the PHE also ends Medicaid Flexibilities provided to states, including expedited State Plan Amendment review, and will impact any Medicaid rate add-ons attached to the national PHE. Of note, the Medicaid Federal Medical Assistance Percentage (FMAP) increase of 6.2% is no longer attached to the PHE and is unaffected by the May 11 date. The Consolidated Appropriations Act of 2023 delinked the enhanced FMAP from the PHE and set a year-long phase down schedule for the FMAP noted in the table below.

AHCA/NCAL is also reaching out to the administration to understand the implications, if any, for COVID-19 vaccine and antiviral access and administration. Advocacy efforts will continue to ensure long term care remains a high priority and that burden for reporting is decreased.

AHCA/NCAL continues to work with state affiliates to secure state support for the long term care sector and will continue to keep members apprised of any other news pertaining to the PHE.