Public Health Emergency Ending May 11

COVID-19; Advocacy

Yesterday, the Biden Administration announced its plans to end the Public Health Emergency (PHE). This administration guidance meets the Administration’s promise of 60 days’ notice of the end of the PHE. Based on the guidance, the PHE will end on May 11, 2023.  

  • The end of the PHE also marks the end of Section 1135 National Blanket Waiver. The two substantive SNF waiver provisions left in Section 1135 are the Medicare fee-for-service 3-Day Stay and Spell of Illness waivers. These waivers technically fall under Section 1812(f) but are tied to the Section 1135 waiver. As of May 11, SNFs may no longer use the 3-Day Waiver or the Spell of Illness waiver. In terms of Medicare Advantage plans, PHE waiver provisions were rolled back in 2022.   
  • Temporary Nurse Aide statewide waivers could be extended by CMS to May 11 if the state requests and there is evidence of need. Currently, the state waivers for 18 states end between March 20 and April 7. 
  • The end of the PHE also ends Medicaid Flexibilities provided to states, including expedited State Plan Amendment review, and will impact any Medicaid rate add-ons attached to the national PHE. Of note, the Medicaid Federal Medical Assistance Percentage (FMAP) increase of 6.2% is no longer attached to the PHE and is unaffected by the May 11 date. The Consolidated Appropriations Act of 2023 delinked the enhanced FMAP from the PHE and set a year-long phase down schedule for the FMAP noted in the table below. 

AHCA/NCAL is requesting CMS end requirements that were implemented during the PHE that are no longer necessary and to end this no later than the conclusion of the PHE. This includes widespread notifications on COVID cases per F885, enhanced enforcement for F880, and end or scale back NHSN COVID reporting.

AHCA/NCAL is also reaching out to the administration to understand the implications, if any, for COVID-19 vaccine and antiviral access and administration. Advocacy efforts will continue to ensure long term care remains a high priority and that burden for reporting is decreased.

AHCA/NCAL continues to work with state affiliates to secure state support for the long term care sector and will continue to keep members apprised of any other news pertaining to the PHE.