HHS: COVID-19 Emergency, And Related Waivers, May Last Through 2021

Inside Health Policy

January 25, 2021 12:42 am

The COVID-19 public health emergency is expected to continue through the end of 2021, Acting HHS Secretary Norris Cochran wrote in a Jan. 22 letter to governors, signaling the temporary 6.2% bump in federal Medicaid matching funds and a slew of other Medicare and Medicaid emergency waivers put in place during the pandemic will not end soon. HHS will give states 60 days’ notice before the public health emergency ends so they can plan for the end of the higher Medicaid match rates, Cochran said.

A year-long extension of the PHE would leave in place emergency use authorizations for diagnostics, treatments, and vaccines and potentially could lead to new HHS policies to help states respond to the COVID-19 emergency.

“To assure you of our commitment to the ongoing response, we have determined that the PHE will likely remain in place for the entirety of 2021, and when a decision is made to terminate the declaration or let it expire, HHS will provide states with 60 days’ notice prior to termination,” Cochran’s letter says.

Cochran says the 60-days’ notice of the PHE’s end will help provide stability for states, as they can plan for the end of the 6.2% bump in federal Medicaid funding. That funding increase stops at the end of the quarter when the public health emergency ends.

“With the extension and additional advance notice, we seek to provide you with increased budgetary stability and predictability during this challenging time,” Cochran tells governors.

Congress required states to keep Medicaid beneficiaries continuously enrolled throughout the COVID-19 public health emergency as a condition of receiving more federal Medicaid money. Experts predict up to 30% of Medicaid beneficiaries could lose insurance once the COVID-19 public health emergency ends, unless the Biden administration steps in.

Cochran notes that the extended public health emergency means waivers for Medicare, Medicaid and CHIP will remain in place, along with other waivers. This includes 1135 waivers and PREP Act waivers, both of which have been used to ease telemedicine during the pandemic, particularly in Medicare.

A recent Commonwealth Fund analysis from Jennifer Podulka, senior consultant for Health Management Associates, says that for Medicare alone, more than 200 legislative and regulatory changes have been put in place since the start of 2020. Most Medicare providers have been affected, Podulka says, though hospitals and post-acute care providers have seen the most changes.

“The Biden administration has inherited this slate of temporary COVID-related Medicare regulatory changes and will have to decide whether and how to extend these policies given the state of the pandemic and its impact on health care providers. As the new administration addresses the ongoing pandemic with the new phase of vaccinations underway, it is likely that regulatory and subregulatory changes will continue to be introduced and modified to reflect the administration’s COVID and Medicare policies,” Podulka says.

Cochran’s letter says HHS’ goal is to make sure enough health care services and items are available during the emergency to meet the needs of those on Medicare, Medicaid and CHIP and their providers.