April 21, 2020
CMS Issues Guidelines for Resuming Elective Surgeries
On Sunday, April 19, the Centers for Medicare & Medicaid Services (CMS) issued new guidelines, Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I (PDF) for healthcare facilities in states and regions with relatively low and stable incidence of COVID-19. The guidelines were released shortly after the Administration’s phased approach to reopening the country, Opening Up America Again was issued on April 16.
The new guidelines update earlier recommendations provided by CMS on March 18 limiting non-essential surgeries and medical procedures to expand capacity to care for COVID-19 patients and conserve adequate staff and supplies. Health care facilities and providers that are in areas with high numbers of COVID-19 cases are encouraged to continue following these recommendations issued by CMS last month.
In states or regions that have met the Gating Criteria outlined in the Administration’s guidelines, health care facilities may proceed with Phase 1. While the maximum use of telemedicine is still strongly encouraged, the new CMS guidelines are intended to guide healthcare facilities as they consider resuming in-person care of non-COVID-19 patients in regions with low incidence of COVID-19. For care that cannot be accomplished virtually, the new CMS guidelines recommend that non-COVID-19 care should be offered to patients as clinically appropriate and within facilities that have the available resources. In addition to coordinating with state and local public health officials, all aspects of care including adequate facility readiness, workforce availability, testing capacity and the availability of personal protective equipment (PPE) and other supplies must be considered while deciding to resume in-person care of patients requiring non-COVID-19 care. These facilities should have the ability to quickly respond to a surge in COVID-19 cases.
The CMS guidelines encourages all facilities to continually evaluate whether their region remains a low risk of incidence and should be prepared to cease non-essential procedures if there is a surge of COVID-19 cases.
The American Society of Anesthesiologists (ASA) recently released a joint statement with other health care stakeholders, Roadmap for Resuming Elective Surgery after COVID-19 Pandemic.
ASA continues to monitor the COVID-19 pandemic as well as regulatory and legislative developments impacting physician anesthesiologists.