New Guidance for Temporary Use of IFEDs During COVID-19

Thoughtware Alert Published: May 01, 2020
Stethoscope on a chart

Current regulations don’t recognize independent freestanding emergency departments (IFED) as certified Medicare providers. However, on April 21, 2020, CMS issued guidance allowing IFEDs “in Colorado, Delaware, Rhode Island, and Texas to temporarily provide care to Medicare and Medicaid patients to address any surge.” 

According to a recent Quality, Safety & Oversight Group memo, any of the three options below may implemented by a licensed IFED to become certified:  

  1. Become a hospital-affiliated emergency department (ED) as an outpatient department of a Medicare/Medicaid-certified hospital:
    1. Follow the same hospital laws and regulations unless otherwise waived
    2. Hospital and licensed IFED would work together with the state to obtain approval for the IFED to become hospital-affiliated
    3. There’s no requirement for the ED to submit a separate enrollment application to CMS
  2. Enroll as a Medicaid-certified clinic:
    1. Apply as a type of clinic that provides ED services in the state using the emergency State Plan Amendment template. The toolkit and template are located here
    2. The state may define the types of clinics that it would elect to cover
  3. Temporarily enroll in Medicare to provide inpatient and outpatient hospital care. In addition, the IFED must:
    1. Meet Medicare’s Conditions of Participation for hospitals
    2. For outpatient observation services, will be required to provide a Medicare Outpatient Observation Notice to all Medicare beneficiaries and Medicare Advantage enrollees, where applicable
    3. Must submit its intent to the applicable Medicare Administrative Contractor (MAC) by calling the MAC’s provider enrollment hotline and following the instructions noted in the COVID-19 Medicare Provider Enrollment Relief Frequently Asked Questions (FAQs) document 

As with most topics related to COVID-19, changes are being made rapidly. Please note that this information is current as of the date of the publication. For more information, reach out to your BKD Trusted Advisor™ or use the Contact Us form below.

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