03.19.20

Cantwell, WA Delegation Urge Quick Consideration of Health Care Waivers to Allow for More Efficient Health Care Delivery Responding to COVID-19

As state hospitals struggle with shortages of staffing and supplies, members urge action to help health system adapt

WASHINGTON, D.C. – Today, U.S. Senator Maria Cantwell (D-WA) joined Congresswoman Kim Schrier (D-WA-08) and the full Washington congressional delegation in sending a letter to the Centers for Medicare & Medicaid Services (CMS) urging “quick consideration” of Washington state’s 1135 waivers that were submitted on Sunday.

“We are facing extreme stress to the health care system, including staffing, supplies, space and equipment. Federal law requirements must quickly be waived or altered. We need immediate action to provide the flexibility needed to ensure hospitals can maximize care delivery in this crisis,” the members wrote.

Washington state first reported a novel coronavirus (COVID-19) case on January 21st. The virus has now spread to 22 counties in Washington state, with 1,187 confirmed cases and 66 deaths. Hospitals and the health care system are struggling with ongoing shortages of staffing and supplies as the number of cases continues to increase. In their letter, the members ask for immediate relief in a number of areas to give hospitals more flexibility so they can expand their capacity to treat patients with COVID-19 and respond to critical health care needs. 

“The system is experiencing an overwhelming volume of patients seeking care,” the members concluded. Health care providers are working long shifts and stretching supplies. We respectfully urge the government to act quickly to do its part.”

After the letter sent by the state’s entire congressional delegation on March 19, the Centers for Medicare and Medicaid Services (CMS) approved Washington’s request for an 1135 health care waiver later that day. The waiver will allow Washington state hospitals to screen and triage patients at off-site locations, ensuring that hospitals have the needed capacity to treat patients during the outbreak and free up inpatient beds, mitigating the impact of shortages of personal protective equipment (PPE), and reducing the risk of transmission among patients and with providers.

It also includes flexibilities under Medicaid and the Children’s Health Insurance Programs (CHIP) that will help free up hospital beds, waive requirements for cost-sharing associated with coronavirus testing and screening, minimize disruptions to behavioral health and long-term care services, and mitigate provider shortages in the state.

The full text of the letter is below and HERE.

Dear Administrator Verma:

We are writing to urge quick consideration of the two requested waivers submitted Sunday, March 15, by Washington Hospitals and Health Systems and Medicare, Medicaid Providers and Health Systems under section 1135 of the Social Security Act. The health care delivery system in Washington State is at a crisis point as result of the COVID-19 outbreak. We are facing extreme stress to the health care system, including staffing, supplies, space and equipment. Federal law requirements must quickly be waived or altered. We need immediate action to provide the flexibility needed to ensure hospitals can maximize care delivery in this crisis.

The trajectory of the COVID-19 outbreak in Washington State is very similar to that in Northern Italy, where the healthcare system quickly became overwhelmed. Washington State hospitals are struggling with ongoing shortages of staffing and supplies as more and more COVID-19 cases in the state are confirmed. Washington hospitals’ waiver request would give hospitals added flexibility as they seek to respond to the critical health care needs presented by the COVID-19 pandemic. We require immediate relief in the following areas:

  • Hospital and Skilled Nursing Facility Medicare Conditions of Participation
  • Telehealth
  • Home Health
  • HIPAA Security Requirements
  • Delivery of Services in Alternative Clinic Locations
  • Medicaid/Children’s Health Insurance Program
  • Teaching Hospitals
  • Timely Filing Requirements for Billing
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
  • Modifications to the existing 1115 waiver

Please see the attached request letters that were submitted previously to your office. The requested waivers will allow our health system to adapt to the rapidly escalating challenges presented by this pandemic.  Our system is experiencing an overwhelming volume of patients seeking care. The system is responding by cancelling elective surgeries and many types of routine care. Health care providers are working long shifts and stretching supplies. We respectfully urge the government to act quickly to do its part. As we struggle with staffing, supplies, and facilities, a blanket waiver of the federal requirements is necessary to allow Washington’s hospitals to properly focus their efforts on curtailing the spread of the pandemic. 

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