Navigating the end of PHE waivers and flexibilities on the April NAHRI Quarterly Call

NAHRI members learned about the latest association news, tips for managing the unwinding of COVID-19 public health emergency (PHE) waivers, and more on the April 25 NAHRI Quarterly Call.

Association updates

The call opened with NAHRI Director Nicole Votta sharing the latest NAHRI news.

NAHRI is currently accepting applications for its Advisory Board. Serving on the NAHRI Advisory Board is an excellent opportunity to elevate your career, strengthen your professional network, and truly make an impact on the industry. Applicants must be current NAHRI members. The application must be completed in one sitting—it will not save your progress if you exit before completing it. Applicants must fill out the entire application, as skipping even one question will disqualify your application. If you must stop before completing it, you will need to start a new application. To ensure you’re prepared to complete the application, please have the following information and documents ready:

• Resume
• Professional bio and headshot
• Statements explaining:
  
  • Why you’re applying to the NAHRI Advisory Board
  • What you plan to contribute to the NAHRI Advisory Board
  • Current revenue integrity issues you would work with NAHRI Advisory Board members to address

Learn more about the application process here and hear from current Advisory Board members about the benefits of serving here. Ready to apply? Access the application at https://www.surveymonkey.com/r/XVPC26F. The application will close May 7.

The 2023 Revenue Integrity Symposium (RIS) will be held September 18–19 at the Sheraton Charlotte in Charlotte, North Carolina. RIS is the premier event for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking. The event will feature the top-level educational sessions, industry-leading experts, and networking opportunities attendees have come to expect from RIS. See the full agenda for more details. Attendees can register by June 12 to take advantage of our early bird discount—and NAHRI members receive an additional discount. Learn more about our current discounts including group pricing options.

2023 Revenue Integrity Week (June 5–9) is just around the corner. This is a week to recognize revenue integrity professionals and their valuable contributions to the healthcare field. This year’s theme is Hit the Road to Revenue Integrity: Mapping a Course to Success. The 2023 toolkit is available on the NAHRI site now, where you can download logos, banners, and games.

Give your colleagues a shout-out during Revenue Integrity Week and thank them for their hard work in the revenue integrity field through NAHRI’s Peer Recognition Program. Nominate your peers at https://www.surveymonkey.com/r/XC9HRJP. Nominators and nominees will be entered into a drawing, and the winners will be announced during Revenue Integrity Week. See the official contest rules here.

If you’ve been considering sitting for NAHRI’s Certification in Healthcare Revenue Integrity (CHRI), now’s the time. Register for the CHRI exam May 19–June 9 and be entered into a drawing for a chance to win a seat at the 2023 RIS or an upcoming open registration HCPro Medicare Boot Camp. See contest rules here. Learn more about the CHRI application and exam process, study options, and more.

Navigating the end of COVID-19 PHE waivers and flexibilities

Then, NAHRI Advisory Board members Ronald L. Hirsch, MD, FACP, CHCQM, CHRI, vice president of R1 RCM and John D. Settlemyer, MBA, MHA, CPC, CHRI, assistant vice president, revenue cycle, with Atrium Health, discussed the challenges facing provider organizations as they begin to unwind COVID-19 PHE waivers and flexibilities and tips for staying compliant.

The COVID-19 PHE was declared in January 2020, and CMS acted quickly to roll out various waivers to support provider organizations. These waivers and flexibilities cover a broad range of healthcare activities and impact nearly every aspect of hospital operations.

On January 30, the White House announced its intention to end the PHE on May 11. Although many of CMS’ waivers will end simultaneously with the termination of the PHE, others have been extended through the 2023 fiscal year or the 2024 calendar year. Although these extensions give hospitals much-needed breathing room to wind down programs gradually, it does make it challenging to keep track of which waivers will be in effect at what times.

Rules for telehealth services will be particularly tricky, Hirsch and Settlemyer agreed. Organizations need to pay close attention to these claims. Billing and coding staff will need education, and they should have easy to access resources and references. Physicians and nonphysician practitioners will also need targeted education about documentation and coding changes.

Although the number of hospitalized COVID-19 patients has dramatically declined, organizations will need to keep an eye on all accounts for COVID-19 inpatients who are admitted prior to May 11 and discharged after May 11, Hirsch and Settlemyer said.

To help keep track of significant PHE waivers and their end dates, NAHRI released a series of resources for acute care hospitals and critical access hospitals, rural health clinics and Federally Qualified Health Centers, and physician services. These charts break waivers down by facility type and service (i.e., inpatient or outpatient), the nature of the service, the extension/ending date, special issues, and the source authority (i.e., CMS fact sheet). Free to NAHRI members, these resources are ideal to be used as a guide for internal monitoring and auditing and to help plan and allocate resources needed to adjust affected programs and services, Settlemyer advised.

A recording of the April Quarterly Call is available for NAHRI members. Listening to or presenting on Quarterly Calls awards 1 CHRI CEU. Register now for our 2023 series of calls. If you’d like to present on an upcoming call, please contact NAHRI at nahri@hcpro.com. Presenting on a NAHRI Quarterly Call also awards CEUs.

Stream more past calls here.

Editor’s note: Find more NAHRI resources and news on the COVID-19 PHE and billing for COVID-19-related services here.