With the extension of the COVID-19 public health emergency (PHE), DMAS applied for the extension of the state-based waivers allowing regulatory flexibility to providers. Per an October 22 Medicaid Memo, approval of those existing waivers was granted until January 1, 2021.  The flexibilities were initially established in May.

DMAS will continue to extend the following flexibilities until January 20, 2021:

1. Suspend Pre-Admission Screening and Resident Review (PASRR) Level I and Level II Assessments for 30 days. Note: This applies to nursing facility admissions only. Those choosing home and community based options for care must still have a completed screening for Long Term Services and Supports. Such screenings shall be conducted either through telehealth or telephone services. Consent for performing the screening and authorization to distribute the screening to providers may be confirmed through verbal consent and witnessed by two members of the entity legally authorized to perform the screening.
2. Extend minimum data set authorizations for nursing facility and skilled nursing facility (SNF) residents.
3. Waive 42 CFR 483.20(k) allowing nursing homes to admit new residents who have not reached Level 1 or Level 2 Preadmission Screening. Level 1 assessments may be performed post- admission. On or before the 30th day of admission, new patients admitted to nursing homes with a mental illness or intellectual disability should be referred promptly by the nursing home to state PASRR program for Level 2 Resident Review.
4. Waive the requirements at 42 CFR 483.35(d) (with the exception of 42 CFR 483.35(d)(1)(i)), which require that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under § 483.35(d).
5. Waive the requirement for the Medicaid LTSS Screening for individuals admitted to a nursing facility directly from hospital inpatient status.
6. Medicaid LTSS Screenings will continue as requested and needed for the Commonwealth Coordinated Care (CCC) Plus Waiver, the Program for All-inclusive Care for the Elderly
   (PACE), and nursing facility admissions directly from the community.
7. Community-based and hospital LTSS Screeners may continue to accept verbal consent on the Individual Choice Form, DMAS-97 verified by two witnesses.
8. Health Plans experiencing difficulty enrolling individuals for nursing facility care or changing nursing facility level of care, may attach the DMAS-80 to a secure email sent to
   CCCPlusmcos@dmas.virginia.gov. The DMAS-80 will be reviewed by DMAS staff and assistance provided.

Additional flexibilities outlined in the memo apply to home health and hospice, durable medical equipment, pharmacy, behavioral health and addiction and recovery treatment services, and telehealth.