The emergency care act transition roadmap.

The Emergency Care Act Transition Roadmap

The Emergency Care Act was an important piece of legislation that was passed in response to the COVID-19 pandemic. This act allowed our government to take a more proactive approach to contain the spread of the virus, providing financial support to those affected by the virus and creating guidelines for social distancing and other measures designed to reduce the spread of the disease.

As the pandemic has begun to recede in many parts of the world, there has been a growing sense that the Emergency Care Act is no longer necessary. Many people argue that the powers granted to the government under this act represent an overreach of government authority and that they are no longer needed now that the pandemic is under control.

Fact Sheet from U.S. Department of Health & Human Services:

Based on current COVID-19 trends, the Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19, declared under Section 319 of the Public Health Service (PHS) Act, to expire at the end of the day on May 11, 2023. Our response to the spread of SARS-CoV-2, the virus that causes COVID-19, remains a public health priority, but thanks to the Administration's whole of government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from the emergency phase.

The biggest question remains the issue of Medicaid coverage:

Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision.

Total Medicaid/CHIP enrollment grew to 91.3 million in October 2022, an increase of 20.2 million or more than 28.5% from enrollment in February 2020.

States need to get ready, so they are in compliance with new funding conditions, reporting requirements, and tools meant to bolster coverage retention. Some of the new requirements include reporting average wait time, the volume of calls, and abandonment rates. States that do not comply will expose themself to corrective action plans by the federal Centers for Medicare & Medicaid Services.

The HHS estimates that 17.4% or 15 million people enrolled in Medicaid and Children’s Health Insurance Program stand to lose their coverage.

Addition Info – What will not be affected:  

  • Access to COVID-19 vaccinations and certain treatments, such as Paxlovid and Lagevrio, will generally not be affected.
  • FDA’s EUAs for COVID-19 products (including tests, vaccines, and treatments) will not be affected.
  • Major Medicare telehealth flexibilities will not be affected.
  • Medicaid telehealth flexibilities will not be affected.
  • The process for states to begin eligibility redeterminations for Medicaid will not be affected.
  • Access to buprenorphine for opioid use disorder treatment in Opioid Treatment Programs (OTPs) will not be affected.
  • Access to expanded methadone take-home doses for opioid use disorder treatment will not be affected.

Addition Info – What will be affected:  

  • Certain Medicare and Medicaid waivers and broad flexibilities for healthcare providers are no longer necessary and will end.
  • Coverage for COVID-19 testing for Americans will change.
  • Reporting of COVID-19 laboratory results and immunization data to the CDC will change.
  • Certain FDA COVID-19-related guidance documents for the industry that affect clinical practice and supply chains will end or be temporarily extended.
  • FDA’s ability to detect early shortages of critical devices related to COVID-19 will be more limited.
  • Public Readiness and Emergency Preparedness (PREP) Act liability protections for may be impacted.
  • The ability of health care providers to safely dispense controlled substances via telemedicine without an in-person interaction is affected; however, there will be rulemaking that will propose to extend these flexibilities.

Lori Intravichit, CEO of Sunlit Cove Healthcare, said:

As the debate over the future of the Emergency Care Act continues, it is important to remember that the act was put in place in response to an unprecedented crisis. While it may be true that some of the measures taken under this act were overly restrictive or went too far, it is also true that the act played an important role in helping to slow the spread of the virus and to protect public health. It is important to remember the lessons we have learned during this crisis and continue to work together to protect public health and safety in the coming years.

In conclusion, as we all try to navigate what all this will mean for the revenue cycle management, contact us or give us a call at (727) 278-3009 to make sure your organization is ready for this transition.
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Sunlit Cove Healthcare Consultants

We provide management and consulting services to help healthcare businesses run efficiently. Navigating the dynamic and complex revenue cycle management is a challenge for many health plans, health care vendors, and providers. Our consulting services are available to assist with your day-to-day operations and provide expertise in growth and change management. We manage all aspects of your enterprise from the development of the revenue cycle management process to the completion of your business cycle.

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