Weekly Federal and State COVID-19 Waiver and Emergency Regulation Updates

Verisys' Compliance Team gathers information from a variety of state and federal sources and updates our COVID-19 Resource Page daily with those updates. We have compiled the most recent updates from the past week in this email to assist your organization in serving patients during the pandemic and maintaining compliance as you bring additional providers on board to serve on the frontlines.

FEDERAL

1135 waivers: Several states submitted an additional 1135 waiver request to CMS. The approved waivers have been published by the Centers for Medicare and Medicaid Services. Unless otherwise stated, all waivers are retroactively effective March 1, 2020.

Indiana  (approved 5/13/2020):

• Temporarily allow services to be provided in settings that have not been determined to meet the home and community-based settings criteria. 
• Georgia (approved 5/14/2020):Temporarily allow payment for personal care services rendered by legally responsible individuals provided that the state makes a reasonable assessment that the caregiver is capable of rendering such services. 
• Missouri (approved 5/14/2020):Temporarily waive written consent required under home and community based service programs and permit documented verbal consent as an alternate. 
• Alaska (approved 5/15/2020):Temporarily waive written consent required under home and community based service programs and permit documented verbal consent as an alternate.
• Temporarily allow services to be provided in settings that have not been determined to meet the home and community-based settings criteria. 
• Rhode Island (approved 5/18/2020):Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days.
• Temporarily allow services to be provided in settings that have not been determined to meet the home and community-based settings criteria.
• Virginia (approved 5/19/2020): Suspend pre-admission screening and annual resident review (PASRR) Level I and Level II Assessments for 30 days.
• Waive criminal background checks associated with temporarily enrolling providers.
• Waive site visits to temporarily enroll a provider.
• Permit providers located out-of-state/territory to provide care to an emergency State’s Medicaid enrollee and be reimbursed for that service.
• Streamline provider enrollment requirements when enrolling providers.
• Postpone deadlines for revalidation of providers who are located in the state or otherwise directly impacted by the emergency.
• Waive payment of application fee to temporarily enroll a provider.
• Waive conditions of participation or conditions for coverage for existing providers for facilities for providing services in alternative settings, including using an unlicensed facility, if the provider’s licensed facility has been evacuated

STATE BOARD REGULATIONS

Board of Pharmacy

Kansas

5/18/2020: 2020 Renewals are scheduled to proceed as normal. Facilities will be eligible to renew registrations from May 18 - June 30, 2020. Once approved, facilities will be expected to print the renewed registration through the online portal – they will NOT be mailed. Pharmacists will be eligible to renew licenses from June 1 - June 30, 2020. A renewed pharmacist license will still be mailed to the address of record.

The Board is awaiting guidance from the Governor’s office regarding Executive Order 20-26 implementation in relation to licensure requirements, reciprocity, scope of practice, COVID-19 testing, and more.

Source: COVID-19 Information Memo 

Maryland

5/15/2020:  Temporary Policy Regarding Non-Standard PPE Practices for Sterile Compounding by Pharmacy Compounders not Registered as Outsourcing Facilities During the COVID-19 Public Health Emergency

Source: Guidance

05/19/2020: Authorizing Covid-19 Testing By Licensed Pharmacists

Source:  Executive Order 20-05-19-01 

Mississippi

5/13/2020:  During the Meeting of the Mississippi Board of Pharmacy on May 12, 2020, the Board unanimously agreed to suspend the LIVE Continuing Education Requirement for pharmacists in 2020. Pharmacists, upon request, will still be required to submit evidence of five (5) hours of opioid abuse and prevention/ drug of abuse/ addiction-related issues and a total of 15 hours for the year 2020.

Source: 2020 CE Requirements UpdateMontana

5/15/2020:  Temporary Emergency Suspension Of Telepharmacy Monthly Inspections 

Source: Emergency RuleOhio

5/15/2020:  Authorized licensees conducting sterile compounding to reuse certain personal protective equipment (PPE). The waiver was updated to align with recently released PPE conservation guidance issued by the FDA.

Authorized automatic exemptions to rule authorizing the compounding of drugs in shortage (4729-16-10) under certain conditions.Formally adopted FDA’s “Temporary Policy for Compounding of Certain Drugs for Hospitalized Patients by Outsourcing Facilities During the COVID-19 Public Health Emergency“ for Ohio-licensed outsourcing facilities

Source: COVID-19 Response Efforts

05/18/2020:  Technician trainees who are set to have their registrations expire any time between 3/9/2020 through 7/31/2020 (previously 5/31/2020) will be provided an automatic six-month extension to the trainee’s registration.

Source: COVID-19 Response EffortsOklahoma

5/12/2020:  An OSBP COVID-19 waiver is no longer necessary for Hydroxychloroquine/Chloroquine prescriptions.

Source: Executive Order 2020-13

Board of Medicine

Alaska 5/5/2020:

Drug Addiction Treatment Act waived providers may prescribe controlled substances for opioid use disorder treatment when an in-person exam is not possible. An oral and urine toxicology are still required. 

Illinois 5/13/2020:

Revises Elective Surgeries Guidelines for Hospitals, Health Care Facilities, Health Care Professionals, and Health Care Volunteers

Source: Executive Order 2020-37

Kansas 5/01/2020:

Providers will have up to 90 days after the emergency period ends to complete continuing education credits that are required for renewal. 

Source:  Continuing Education Memo 

Maryland 5/8/2020:

Out of state providers may prescribe controlled dangerous substances without obtaining a controlled dangerous substances registration in Maryland.

Source: Maryland Waiver of CDS Registration Requirement 

Pennsylvania 5/12/2020:

Physicians do not need to provide paper prescriptions within 72 hours of issuing an emergency prescription by telephone.

Source: Oral Prescription Waiver 

Tennessee 5/12/2020:

The waivers that expanded the scope of practice for nurses and physicians assistants are no longer in effect. 

Source:  Covid-19 Bulletin 

Board of Nursing

Alaska

5/06/2020:  The Board of Nursing adopted, as an emergency regulation, changes in 12 AAC 44.770, .925, and .990, dealing with standards of practice for telehealth. The emergency regulation took effect on May 7, 2020 and will expire September 3, 2020. The Board intends to make the emergency regulation permanent.

Source:  Emergency Regulations Memo

05/08/2020:  The Alaska State Board of Nursing per authority of SB241 Sec. 6 (b)(2) decreases the 2020 license renewal requirement to provide 30 hours of continuing education to 15 hours of continuing education for both licensed practical nurses and registered nurses. The Board waives the and audit requirements of 12 AAC 44.610.- 12 AAC 44.620. for the November 30, 2020, license renewal. 

Source:  Continuing Education Guidance

05/11/2020:  The Alaska State Board of Nursing per authority of SB241 Sec. 6 (b)(2). The Board accepts the modifications to the curriculum presented by SDSU and this refresher course meets the requirements of 12 AAC 44.317 Reinstatement of a Lapsed or Retired License Status and 12 AAC 44.640 Alternative Methods for the Continuing Competency Requirements.

Source:  Refresher Course GuidanceMichigan

5/14/2020: (EO 86) To facilitate the use of telehealth medical treatment the following regulations have been lifted:

• Written consent for treatment is not required
• Providers may use asynchronous store-and-forward technology to send medical information
• Remote patient monitoring may be conducted
• A physician is not required to conduct an in person evaluation before prescribing medication, including controlled substances. 
• Providers licensed in another state may treat patients in Michigan via telehealth. 

Source: Michigan Executive Order 86New Mexico

5/11/2020:  The board is issuing graduate permits upon receipt of required paperwork. 

Source url: NM Permits and PreceptorshipsTennessee

5/12/2020:  The waivers that expanded the scope of practice for nurses and physicians assistants are no longer in effect. 

Source:  Covid-19 Bulletin 

Disclaimer: This information has been gathered from a variety of sources. Although Verisys has made every effort to provide complete, accurate, and up-to-date information, Verisys makes no warranties, express or implied, or representations as to the accuracy or reliability of this information. The information is fluid and evolving. Verisys assumes no liability or responsibility for any errors or omissions in the information contained in this resource.

The information contained in this newsletter comprises all the information that we have found during those dates. It may not constitute a complete list of every regulation instituted by every board during the last week.