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pdfRevisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
1.
Page
#
2
Section
Select Your PHE
2.
5
Select Your PHE
3.
2-3
Waiver/Flexibility
Request Type
Action to be
performed
Updated
Content (8-312021)
Updated
Content (8-312021)
Updated
Content (8-312021)
Changes to the Application
Added to PHE dropdown:
Hurricane Ida 2021 (LA and M S) 08/26/2021 – 11/24/2021
Added to PHE dropdown:
Hurricane Ida 2021 (LA and M S) 08/26/2021 – 11/24/2021
Added the following waiver types:
•
Ambulance Services - Medicare Ground
Ambulance Data Collection System
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Ambulance Services - Ambulance Treat in Place
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ASCs - Medical Staff
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ASCs - Nursing Services
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Care for Patients in Extended Neoplastic
Disease Care Hospitals
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Care for Patients in Extended Neoplastic
Disease Care Hospitals - Comprehensive Care
for Joint Replacement (CJR) Model
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CMHS - Quality assessment and performance
improvement (QAPI)
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CMHS - Provision of Services
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CMHS - 40 Percent Rule
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ESRD Facilities - Training Program and Periodic
Audits
•
ESRD Facilities - Defer Equipment Maintenance
& Fire Safety Inspections
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ESRD Facilities - Emergency Preparedness
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ESRD Facilities - Ability to Delay Some Patient
Assessments
1
Reason for the Change
Added new PHE to waivers
Added new PHE to inquiry
Added new waiver types
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
•
ESRD Facilities - Time Period for Initiation of
Care Planning and Monthly Physician Visits
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ESRD Facilities - Dialysis Home Visits to
Assess Adaptation and Home Dialysis Machine
Designation
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ESRD Facilities - Home Dialysis Machine
Designation – Clarification
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ESRD Facilities - Special Purpose Renal
Dialysis Facilities (SPRDF) Designation
Expanded
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ESRD Facilities - Dialysis Patient Care
Technician (PCT) Certification
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ESRD Facilities - Transferability of Physician
Credentialing
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ESRD Facilities - Expanding Availability of
Renal Dialysis Services to ESRD Patients Furnishing Dialysis Services on the Main
Premises
•
ESRD Facilities - Clarification for Billing
Procedures
•
Flexibility for Medicare Telehealth Services Eligible Practitioners
•
Flexibility for Medicare Telehealth Services Audio-Only Telehealth for Certain Services
•
Flexibility for Inpatient Rehabilitation Facilities
Regarding the “60 Percent Rule”
•
HHAs - Initial Assessments
2
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
•
HHAs - Waive Onsite Visits for HHA Aide
Supervision
•
HHAs - Allow OTs, PTs, and SLPs to Perform
Initial and Comprehensive Assessment for all
Patients
•
HHAs - 12-hour Annual In-service Training
Requirement for Home Health Aides
•
HHAs - Detailed Information Sharing for
Discharge Planning for Home Health Agencies
•
HHAs - Clinical Records
•
HHAs - Training and Assessment of Aides
•
HHAs - Quality Assurance and Performance
Improvement (QAPI)
•
Hospice - Comprehensive Assessments
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Hospice - Waive Non-Core Services
•
Hospice - Waived Onsite Visits for Hospice Aide
Supervision
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Hospice - Hospice Aide Competency Testing
Allow Use of Pseudo Patients
•
Hospice - 12 hour Annual In-service Training
Requirement for Hospice Aides
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Hospice - Annual Training
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - EMTALA
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Verbal Orders
3
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Reporting
Requirements
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Patient Rights [Only
for hospitals that are considered to be impacted
by a widespread outbreak of COVID-19]
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Sterile Compounding
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Detailed Information
Sharing for Discharge Planning for Hospitals and
CAHs
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Limiting Detailed
Discharge Planning for Hospitals
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Medical Staff
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Medical Records
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Flexibility inPatient
Self Determination Act Requirements (Advance
Directives)
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Physical Environment
4
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Telemedicine
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Physician Services
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Anesthesia Services
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Utilization Review
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Written Policies and
Procedures for Appraisal of Emergencies at Off
Campus Hospital Departments [With respect to
surge facilities only]
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Emergency
Preparedness Policies and Procedures
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Quality Assessment
and Performance Improvement Program
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Nursing Services
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Food and Dietetic
Services
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Respiratory Care
Services
5
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Expanded Ability for
Hospitals to Offer Long-term Care Services
(“Swing-Beds”) for Patients Who do not Require
Acute Care but do Meet the Skilled Nursing
Facility (SNF) Level of Care Criteria as Set Forth
at 42 CFR 409.31
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Medicare Graduate
Medical Education (GME) Affiliation Agreement
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - CAH Personnel
Qualifications
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - CAH Staff Licensure
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - CAH Status and
Location
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Temporary Expansion
Locations
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Responsibilities of
Physicians in CAHs
•
Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - Long Term Care
6
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
Hospitals - Site Neutral Payment Rate
Provisions
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Hospitals, Psych. Hospitals, and CAHs, including
Cancer Ctrs and LTCHs - CoP for COVID-19
Vaccinations
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Hospitals Classified as Sole Community
Hospitals (SCHs)
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Hospitals Classified as Medicare-Dependent,
Small Rural Hospitals (MDHs)
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ICF/IID - Staffing Flexibilities
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ICF/IID - Suspension of Community Outings
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ICF/IID - Suspend Mandatory Training
Requirements
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ICF/IID - Modification of Adult Training Programs
and Active Treatment
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Inpatient Rehabilitation Facility – Intensity of
Therapy Requirement (“3-Hour Rule”)
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LTC Facilities and SNFs and/or NFs - PASARR
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LTC Facilities and SNFs and/or NFs - Physical
Environment
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LTC Facilities and SNFs and/or NFs - Resident
Groups
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LTC Facilities and SNFs and/or NFs - Training
and Certification of Nurse Aides
•
LTC Facilities and SNFs and/or NFs - Physician
Visits in Skilled Nursing Facilities/Nursing
Facilities
7
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
•
LTC Facilities and SNFs and/or NFs - Resident
Roommates and Grouping
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LTC Facilities and SNFs and/or NFs - Resident
Transfer and Discharge
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LTC Facilities and SNFs and/or NFs - Physician
Services - Physician Delegation of Tasks in
SNFs
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LTC Facilities and SNFs and/or NFs - Physician
Services - Physician Visits
•
LTC Facilities and SNFs and/or NFs - Physician
Services - Note to Facilities
•
LTC Facilities and SNFs and/or NFs - Quality
Assurance and Performance Improvement
(QAPI)
•
LTC Facilities and SNFs and/or NFs - In-Service
Training
•
LTC Facilities and SNFs and/or NFs - Detailed
Information Sharing for Discharge Planning for
Long-Term Care (LTC) Facilities
•
LTC Facilities and SNFs and/or NFs - Clinical
Records
•
LTC Facilities and SNFs and/or NFs - Paid
Feeding Assistants
•
Medicaid and CHIP (as of 3/13/2020)
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Medicare Appeals in Fee for Service (FFS),
Medicare Advantage (MA) and Part D
8
Reason for the Change
Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform
Issue #
Page
#
Section
Action to be
performed
Changes to the Application
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Modification of 60-Day Limit for Substitute Billing
Arrangements (Locum Tenens)
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Physical Environment for Multiple
Providers/Suppliers - Inspection, Testing &
Maintenance (ITM) under the Physical
Environment Conditions of Participation Specific Physical Environment Waiver
Information
•
Practitioner Locations
•
RHCs and FQHCs - Certain Staffing
Requirements
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RHCs and FQHCs - Physician Supervision of
NPs in RHCs and FQHCs
•
RHCs and FQHCs - Temporary Expansion
Locations
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Specific LSC for Multiple Providers - Waiver
Information - Alcohol-based Hand-Rub (ABHR)
Dispensers
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Supporting Care for Patients in LTCHs
•
Specific LSC for Multiple Providers - Waiver
Information - Fire Drills
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Specific LSC for Multiple Providers - Waiver
Information - Temporary Construction
9
Reason for the Change
| File Type | application/pdf |
| Author | Alexander Rooke |
| File Modified | 2021-08-31 |
| File Created | 2021-08-31 |