CMS Launches Automated Web Tool for 1135 Waiver Requests and Public Health Emergency-Related Inquiries During Crises Like COVID-19

CMS launched a web-based platform to help standardize “Section 1135” waiver requests and other Public Health Emergency (PHE)-related inquiries the agency receives. Under Section 1135 of the Social Security Act, the secretary of health and human services may waive selected provisions of Titles XVIII, XIX, and XXI of the Act in the event of an emergency declared by the president and the secretary. Available from CMS.gov’s Waivers and Flexibilities webpage, the web tool’s user-friendly submission process will reduce the burden on providers by streamlining how they document and submit 1135 waiver requests and PHE-related inquiries. It also will enhance how CMS reviews waivers and inquiries, which can now be submitted any time, any place, and for an array of qualifying emergencies.

PHE-related inquiries and 1135 waiver requests increase exponentially during federal disasters such as hurricanes, wildfires, earthquakes, and emergent events like the COVID-19 PHE. As these crises unfold, health providers often seek to modify certain program requirements (described at section 1135(b) of the Act) to provide the best care possible for their patients. By creating a central online platform for these waiver requests and inquiries, the new web tool replaces a manual process with multiple entry points and delivers on CMS’s strategic initiative to reduce unnecessary regulatory burden. Doing so will better equip providers to focus on taking care of patients, especially in times of crisis.

While the information providers share for 1135 waiver requests and other PHE-related inquiries will remain the same, the new web portal allows for instant inquiry or waiver application delivery and remote review for submissions on or after January 11, 2021. These improvements, coupled with faster tracking and reporting, will help CMS ensure accelerated innovation and improved health system responsiveness, especially when services and supports are constrained during national emergencies and shorter, location-specific crises like natural disasters. As a result, patients and providers will have faster access to information and care—including, for example, services or facilities that might need to meet certain prior approval requirements under normal circumstances, saving critical time and resources when an emergency occurs.

With very limited exception, the new web system should be used for all 1135 waiver requests and/or PHE-related inquiries submitted on or after January 11, 2021. Waiver requests related to Physician Self-Referral (Stark Law) should not be submitted via the new web portal. For these requests, please visit: https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Spotlight for additional information.