Extension of the Flexibility in Evaluating “Close Proximity of Time” To Evaluate Changes in Healthcare Following the COVID-19 Public Health Emergency

On July 23, 2021, we issued a temporary final rule (TFR) with request for comments to lengthen the ``close proximity of time'' standard in the Listing of Impairments (the listings) for musculoskeletal disorders because the COVID-19 national public health emergency (PHE) caused many individuals to experience barriers that prevented them from timely accessing in-person healthcare. That prior TFR is effective until six months after the effective date of a determination by the Secretary of Health and Human Services (HHS) that a PHE resulting from the COVID-19 pandemic no longer exists. The Secretary of HHS made that determination, and the COVID-19 national PHE ended on May 11, 2023. However, healthcare practices in a post-PHE world are still evolving. We are therefore issuing this new TFR to extend the flexibility provided by the prior TFR until May 11, 2025, so we can evaluate changes in healthcare practices and determine the proper ``close proximity of time'' standard for the musculoskeletal disorders listings.