President Biden’s announcement of the end of the Covid-19 public health emergency (PHE) on May 11 will have a significant effect on seniors. Some changes will be immediate, others won’t take place for about two years. Simply improve care for seniors, others may simply charge them more and end some of the vital benefits they enjoyed during the pandemic.
Biden’s resolution grants a few more months of urgency. Hill’s Republicans had been pushing management to end the PHE even earlier.
The maximum immediate loss will be the reversal of the so-called three-day rule. The biggest may be just the drastic cuts in Medicare telehealth bills and the loss of Medicaid benefits for many. Here are some of the changes:
Prior to the physical emergency, Medicare only paid for post-acute care at a skilled nursing facility (SNF) if a beneficiary had been admitted to the hospital for the first time for at least 3 days. This requirement is the subject of great confusion among seniors and the frustration of nursing homes and hospitals that were blamed for rules that were not their fault.
For example, a user treated in a hospital, but underArray was not considered admitted and therefore did not comply with the 3-day rule. Even if you were in a hospital bed for 3 days under the care of a doctor and a hospital nurse. Separate Medicare regulations seriously penalize hospitals that admit patients who, after an exam, decide to be eligible only for one stay.
Once the PHE ends, the 3-day rule returns. Again, Medicare beneficiaries will have to pay out of pocket for the desired nurse care, unless they are first admitted to the hospital for at least 3 days.
The use of virtual telehealth doctor visits skyrocketed after 2020 in large part because Medicare pays for care. An estimated 28 million Medicare beneficiaries had telehealth visits in the first year of the pandemic alone.
While Medicare’s broader strength to pay for telehealth expires 151 days after PHE expires (don’t ask), a separate law extends benefits through 2024. After that, Congress will need to know if Medicare will continue to pay for telehealth. .
Treatment of covid-19. During PHE, test kits and treatment drugs like Paxlovid were available to Medicare beneficiaries. People enrolled in Medicare would now have to pay certain fees. Vaccines will be available.
Leave the planning. As part of the emergency, Medicare waived many regulations that required hospitals and nursing homes to provide secure discharge data to patients in need of post-acute care. While those regulations were ignored even before the pandemic, the emergency allowed hospitals to provide even less data. Starting in May, they will again have to provide more detailed discharge data to patients and their families.
Retirement homes. Medicare waived a series of staffing and education standards for skilled nursing services in the early days of PHE. Many have already been restored and the rest will return at the end of the emergency.
Home care and palliative care. Training and evaluation programmes for assistants that had been interrupted at HEP will be restored. The palliative care centre, which has been allowed to eliminate benefits such as physiotherapy and occupational treatment and voluntary visits, will again have to provide these services.
Medicaid enrollment: In an effort to make Medicaid more available during the pandemic, the federal government increased its contributions to the joint federal/state program. But the money came with a problem: States had to agree not to remove anyone from their Medicaid. It lists the public fitness emergency.
In May, states will again exclude registrants who do not meet all eligibility requirements. One concern: What will happen to those who don’t get (or respond) to notices that their eligibility is being reviewed?For example, the mail may not stick to an elderly user moving into a nursing home. Or an older user with dementia may not open the mail in a timely manner. A separate law allows states to begin reconsidering Medicaid eligibility starting April 1. More federal investments will be eliminated for the rest of this year.
Medicaid State Flexibility: Medicaid recipients are only entitled to long-term care in nursing homes. States can only provide home care benefits with a federal government exemption.
During the pandemic, states were granted enough flexibility to forgo the types of home-based projects they can offer, even if some weren’t explicitly allowed by law. But it will end with PHE. Some exemption authorizations will disappear immediately, others will expire after 60 days, and others will continue for six months.
But overall, states will be slow to get federal approval to expand their Medicaid long-term care services in-network and at home.
There will also be many other replacements. PHE has given Medicare and Medicaid new flexibility to improve patient care and ease the burden on providers in those normal times. Their disappearance will replace the way other seniors receive care, for better or worse.
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