COVID-19 Forces ET3 Delay


Citing the immediate needs of COVID-19 response for participating EMS systems, the Centers for Medicare & Medicaid Services (CMS) announced the launch of its ET3 model will be pushed back from May 1 until fall 2020.

CMS also reemphasized the recent release of an interim final rule and ensuing comment period for a number of new waivers and flexibilities it’s enacting to increase the flexibility of the American healthcare system to respond to the COVID-19 pandemic.

The changes are intended to support the work of state and local public health authorities by empowering hospitals and healthcare systems to deliver services at other locations to clear room for COVID-19 patients who need acute care at primary facilities. The goal is to expand treatment capacity and allow separation of COVID patients from others. CMS’s waivers and flexibilities “will permit hospitals and healthcare systems to expand capacity by triaging patients to a variety of community-based locales, including ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories.”

Find the release announcing the new rules here and more on coronavirus waivers and flexibilities here. The modifications are enabled by section 1135 of the Social Security Act and known as 1135 waivers. Find specific waivers for EMS/ambulance organizations here. They include temporarily expanding the list of allowable ground ambulance transport destinations during the COVID-19 public health emergency to include any destination equipped to treat patients in a manner consistent with relevant state and local EMS protocols.

These sites may include alternative parts of hospitals, critical-access hospitals, and skilled nursing facilities; community mental health centers; federally qualified health centers; rural health clinics; physician’s offices; urgent care facilities; ambulatory surgical centers; alternative dialysis locations; and the beneficiary’s home.

Home, CMS notes, may be an appropriate destination for a COVID-19 patient who is discharged from the hospital but under quarantine. There must be a medically necessary ground transport for an ambulance service to be covered.

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