OHA receives CMS approval for further 1135 waiver requests

Posted on: 4/3/20


OHA received approval on March 28 for numerous 1135 waiver requests with the help of the Indiana Hospital Association and 16 other hospital associations. To read the approval letter, click here. This is extremely unusual as CMS has never granted waivers to hospital associations. However, with 3,000 or more individual waivers pending at CMS, the combined application of 16 hospital associations was fast tracked within hours. The state hospital association group request for 1135 approval is available here. CMS also approved a blanket waiver for STARK provisions on March 30.

In submitting the combined application, each association determined that the Medicare requirements contained in the list of Additional Approved Waivers pose challenges for health care delivery in their states and that individual providers may submit additional requests based on their unique circumstances.

Individual providers may submit additional requests beyond the OHA based on their unique circumstances.

In regards to the effective date for these waivers, CMS stated “This authority took effect as of 6 p.m. Eastern Daylight Time on March 17, 2020, with a retroactive effective date of March 1, 2020. Once the national emergency terminates, including any extensions, section 1135 waivers will no longer be available.”

OHCA receives approval for separate 1135 waiver request
As we reported last week, the OHCA submitted an 1135 waiver to CMS for the SoonerCare population. The only commonality in the hospital association waiver request and the OHCA waiver request was around EMTALA and Suspending Pre-Admission Screening and Annual Resident Review (PSAR), which was already covered by current law. CMS will likely issue additional blanket waivers in the future. To view the OHCA approval letter, click here.

Topics covered in the OHA 1135 waiver include:
  • EMTALA
  • Verbal Orders
  • Patients’ Rights
  • Discharge planning for Hospitals and CAHs; detailed information sharing waived
  • Medical Staff Privileges
  • Physical Environment – Flexibility during surge to allow usage of non-hospital areas
  • Skilled Nursing Facilities
  • Home Health
  • Hospice
Please see the linked documents above for exactly what was approved by CMS for Medicare regulations in these topics. (Sandra Harrison, Scott Tohlen)