CMS Issues Key Protective Mask Guidance for Healthcare Workers

Jackie Pappalardi and Lisa Volk in Clinical & Quality

Guidance expands types of facemasks healthcare workers can use to protect themselves and patients.

Late yesterday, the Centers for Medicare & Medicaid Services (CMS) took additional action to ensure America’s healthcare workers are prepared to fight the spread of Novel Coronavirus 2019 (COVID-19). Specifically, CMS sent a memorandum to State Survey Agencies (SAs), which are responsible for inspecting nursing homes and other healthcare facilities serving Medicare and Medicaid beneficiaries. The memo clarifies the application of CMS policies in light of recent Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) guidance expanding the types of facemasks healthcare workers may use in situations involving COVID-19 and other respiratory infections. These are proactive steps to take as part of the White House Task Force’s efforts to ensure a maximum supply of facemasks and respirators are available to enable healthcare providers to safely treat patients without exposing themselves or others to COVID-19.

“CMS is working in lockstep with the CDC, FDA, and other Trump Administration partners to protect both patients and the dedicated healthcare workers who are battling the spread of Coronavirus,” said CMS Administrator Seema Verma. “Today we provided practical information to state inspectors and healthcare facilities on the range of facemasks that can be temporarily used. CMS has been rapidly adapting our guidance to strengthen our nation’s defense against Coronavirus, and today’s action is no exception. We’re working to make sure the healthcare system has the equipment it needs to keep patients and healthcare workers safe.”

The memo CMS issued today aligns CMS policy with recent changes to CDC and FDA facemask and respirator guidance in light of COVID-19 and supply demands. To help reduce burden on healthcare facilities at this time, the CMS memo implements CDC guidance by stating that facemasks, which protect the wearer from splashes and sprays, are an acceptable temporary alternative to respirators, which filter the air, for most medical services until demand for respirators lessens.

Due to the updated CDC guidance on allowable facemasks and respirators, CMS is also alerting state surveyors that they are not required – on a temporary basis – to validate the date of a facility’s last annual test of the fit of N95 masks worn by workers in Medicare- and Medicaid-certified facilities. CMS is temporarily suspending surveyor validation of the test to minimize the discarded masks associated with such testing. 

Additionally, the FDA approved a CDC request for an emergency use authorization (EUA) to allow healthcare workers to use certain industrial respirators during the COVID-19 outbreak in healthcare settings. The FDA concluded that respirators approved by the National Institute for Occupational Safety and Health (NIOSH), but not currently meeting the FDA’s requirements, may be effective in preventing healthcare workers from airborne exposure to serious or life-threatening disease, including COVID-19. This FDA approval allows healthcare personnel to use the NIOSH-approved respirators not currently regulated by the FDA. As a result, in addition to N95 respirator masks, healthcare personnel have other masks at their disposal in order to safely treat patients without exposing themselves or others to COVID-19.

The CMS memo on facemask and respirator guidance issued today, and earlier CMS actions in response to the COVID-19 virus, are part of ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website

Summary of CMS’s COVID-19 response actions to date:

March 9, 2020: CMS delivered guidance on the screening, treatment and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19 in a hospice setting. CMS also issued additional guidance specific to nursing homes to help control and prevent the spread of the virus.

https://www.cms.gov/newsroom/press-releases/cms-issues-clear-actionable-guidance-providers-about-covid-19-virus 

On March 9, 2020: CMS issued a press release highlighting the telehealth benefits in the agency’s Medicare program for use by patients and providers.  Expanded use of virtual care, such as virtual check-ins, are important tools for keeping beneficiaries healthy, while helping to contain the community spread of the COVID-19 virus.

https://www.cms.gov/newsroom/press-releases/telehealth-benefits-medicare-are-lifeline-patients-during-coronavirus-outbreak

On March 9, 2020: CMS published guidance to hospitals with emergency departments (EDs) on patient screening, treatment and transfer requirements to prevent the spread of infectious disease and illness, including COVID-19. Medicare-participating hospitals are to follow both CDC guidance for infection control and Emergency Medical Treatment and Labor Act (EMTALA) requirements.

https://www.cms.gov/newsroom/press-releases/cms-issues-call-action-hospital-emergency-departments-screen-patients-coronavirus

March 6, 2020: CMS issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory tests and other services related to the 2019-Novel Coronavirus (COVID-19). https://www.cms.gov/newsroom/press-releases/covid-19-response-news-alert-cms-issues-frequently-asked-questions-assist-medicare-providers

March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs.  https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus

February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19. https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test

February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt

February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov

NYSHFA/NYSCAL CONTACTS:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15