COVID-19 - Overview of SNF 3-Day Stay and Benefit Period Waivers
When there’s a public health emergency (PHE), sections 1135 or 1812(f) of the SSA allow the US Secretary of Health and Human Services (HHS) to issue blanket waivers to help beneficiaries access care. In response to the declaration of the COVID-19 national PHE, HHS issued a nationwide blanket waiver of the 3-Day Prior Hospitalization and 60-day break in Benefit Period requirements to qualify for SNF Part A benefits effective March 1, 2020. When a blanket waiver is issued, providers don't have to apply for an individual waiver for the duration of the PHE. The PHE was recently renewed and will apply till at least January 20, 2021.
This webinar will provide a brief overview of the background of these important waivers and will also provide specific details about when and how it would be appropriate for SNFs to apply the waivers to assure that Medicare beneficiaries are able to access skilled SNF Part A benefits in a manner that also minimizes risks for unnecessary exposure or transmission of the COVID-19 virus. Examples of how the 3-Day Stay and Benefit Period waivers can or cannot apply in common situations will be discussed. Additionally, details related to documentation, MDS assessment scheduling, and claims coding and sequencing requirements specific to these waivers will be reviewed.
While providing a general overview of these waivers, the target audience for this webinar includes SNF personnel responsible for making coverage eligibility decisions, as well as MDS scheduling personnel and billing office personnel responsible for assuring compliance with the modified requirements necessary for claims applying these waivers to be properly processed by CMS.
This webinar is available to AHCA/NCAL members only.
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Daniel Ciolek, PT, MS, PMP
Associate Vice President, Therapy Services, AHCA
Dan Ciolek is the Associate Vice President of Therapy Advocacy with the American Health Care Association. Mr. Ciolek's clinical and healthcare policy experience spans 30 years. He has practiced as a physical therapist clinician, manager, and business owner in a variety of settings including acute inpatient, inpatient rehabilitation, skilled nursing facility, home health, outpatient, and industrial health. He previously earned the Geriatric Physical Therapy Specialist certification, and is currently a certified Project Management Professional. Before joining AHCA in 2013, Dan served in the Subject Matter Expert and Project Manager capacities in numerous Centers for Medicare and Medicaid contracts. Specific to therapy services, Dan's CMS work has included: national outpatient therapy utilization analysis for PT, OT, and SLP services; medical review; workgroup facilitation; development of policy recommendations; development of Medicare Learning Network and 1-800-Medicare content, and Physician Quality Reporting System reporting enhancements. Additionally, Dan has contributed to therapy health policy activities at the University, State, Chapter and National levels. These activities included: elected and appointed positions; adjunct faculty/lecturer; author of professional articles; invited speaker; technical expert panelist, and invited contributor of health policy concepts to professional and provider organizations. Dan's advocacy efforts have been recognized through his receipt of two national professional awards for Policy Making and Advocacy for Older Adults. Overall, Dan is recognized as a leading expert in therapy policy and research, including a focus on reimbursement issues. His efforts have contributed directly to numerous Medicare policy changes.