SPECIAL ALERT: Healthcare System Braces for End of COVID-19 PHE

HHS issued a comprehensive fact sheet on what providers can expect.

It’s a bit ironic that being mired in a federally declared Public Health Emergency (PHE) eventually came to feel, well, almost…normal.

The irony is compounded by the trepidation in the healthcare industry regarding what happens when the PHE, which was initiated in response to the emergent COVID-19 pandemic more than three years ago, on January 27, 2020, finally ends today.

The U.S. Department of Health and Human Services (HHS) earlier this week issued a comprehensive fact sheet outlining what will change when that happens – and what won’t.

“Due to the Biden-Harris Administration’s whole-of-government approach to combatting COVID-19, we are now in a better place in our response than at any point of the pandemic and well-positioned to transition out of the emergency phase and end the COVID-19 PHE,” the introduction to the fact sheet read.

The introduction went on to note that the federal response to the PHE featured “the largest adult vaccination program in U.S. history,” with more than 270 million Americans receiving at least one shot of a COVID-19 vaccine. Officials noted that the response also included more than 15 million administrations of lifesaving treatments, the distribution of 750 million free COVID-19 tests shipped directly to more than 80 million households, and an additional 50 million diagnostic tests performed in-person at pharmacy and community-based sites.

“As a result of these and other efforts, COVID-19 is no longer the disruptive force it once was,” officials noted. “Since January 2021, COVID-19 deaths have declined by 95% and hospitalizations are down nearly 91%.”

The fact sheet went on to note that the PHE’s end isn’t expected to curtail access to COVID-19 vaccinations or certain treatments like Paxlovid or Lagevrio. Likewise, the Food and Drug Administration (FDA) Emergency Use Authorizations (EUAs) for COVID-19 products (tests, vaccines, treatments, etc.) will remain in place, as will major telehealth flexibilities.

But other Medicare and Medicaid waivers and flexibilities that HHS said were “no longer necessary” will end, and certain COVID-19 data reporting and surveillance will change.

An example of one such soon-to-be-gone exception, as highlighted in a recent article by RACmonitor contributor Dr. Juliet B. Ugarte Hopkins, is enforcement of the “Three-Midnight Rule,” which, pre-COVID, meant that for Medicare to cover services provided at a skilled nursing facility (SNF), a patient required three consecutive midnights of inpatient care in an acute hospital setting.

Ugarte Hopkins noted that many providers had hoped that the Rule would be permanently eliminated following the end of the PHE – but no such luck.

“You can be sure lobbying efforts will continue to work against the Three-Midnight Rule, but in the meantime, here’s what you need to understand starting May 11 when the PHE ends: (first), Medicare will cover SNF costs for patients who have passed at least three midnights in an acute hospital setting in inpatient status and the patient requires skilled services for a medical condition which is either related to the hospital stay or was being treated in a SNF before the hospitalization; which must be given by or under the supervision of skilled nursing or therapy staff; (or) which are needed daily,” she wrote. “(Also), if a patient does not immediately transfer to a SNF from the hospital at discharge, they have 30 days to utilize the benefit.”

There are no shortage of other similar considerations providers are sure to encounter, many of which may not become apparent until they realize that certain waivers no longer exist.

To review the HHS fact sheet in its entirety, go online to https://www.hhs.gov/about/news/2023/05/09/fact-sheet-end-of-the-covid-19-public-health-emergency.html

There have been nearly 105 million cases of COVID-19 in the U.S. since the pandemic began, resulting in more than 1.13 million deaths, according to the Centers for Disease Control and Prevention. There are currently an estimated 7,200 individuals hospitalized for COVID-19 in the U.S.