Photo of Joseph (Joe) V. Geraci

Joseph (Joe) V. Geraci

 

When Joe began his legal practice as in-house counsel for a psychiatric hospital system, he dealt firsthand with the challenges of healthcare operations that his clients face daily. While physicians, hospitals and health systems focus on healing, Joe sorts through the nuts and bolts of hospital operations to help his clients make sense of the industry’s complex regulations. He is board certified in healthcare law by the Texas Board of Legal Specialization and brings this in-depth background to his legal and business solutions.

On Monday, June 30, 2020, HHS spokesman Michael Caputo tweeted that HHS intends to extend the COVID-19 public health emergency before it expires on July 25, 2020. Once extended, the public health emergency will be effective for an additional 90 days. Extending the emergency declaration will allow providers to continue to use waivers and flexibilities issued to assist them in responding to the COVID-19 pandemic.

The U.S. Department of Health and Human Services (HHS) will soon make targeted distributions of the next tranche of the Provider Relief Fund to hospitals and other facilities that have been particularly affected by caring for those with the coronavirus. By 11:59 p.m. ET, hospitals will need to complete the HHS information request on ICU beds, COVID-19 positive patients, etc. Specifically, to be eligible to receive a portion of the $10 billion of the next $70 billion in funding from the CARES Act, providers need to submit the information via a CMS portal. This is not a guarantee of payment—rather, CMS is using this information to decide how to allocate the remaining funds.

Today, the Texas Governor, Greg Abbott, issued an Executive Order that significantly loosens his previous restrictions on the performance of elective surgeries by modifying prior language and adding an additional exception to the prohibition.  Specifically, the new Order states that, effective April 21, 2020 and continuing until 11:59 pm on May 8, 2020.

All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician; provided, however, that this prohibition shall not apply to either of the following:

Hallway in a hospitalOn Friday, 3/13/20, CMS issued blanket 1135 waivers that impact acute care hospitals as a result of President Trump’s declaration of a state of an emergency due to COVID-19. The blanket waivers temporarily allow acute care hospitals to relocate acute care inpatients to their excluded distinct part units (DPUs), and patients from the DPUs to the acute care hospital to respond to the COVID-19 emergency. In addition, to these CMS blanket waivers, on 3/13/20, the Texas Hospital Association (THA) requested additional waivers from CMS and the Texas Health and Humans Services Commission (HHSC) from other federal and state requirements. EMTALA has also issued guidance on setting up alternative screening sites to respond to the COVID-19 emergency. Further, HHSC has issued guidance on what visitors are allowed in the hospital.

The Families First Coronavirus Response Act (the Act) was passed and signed into law on March 18 and will go into effect on April 2, 2020 and continue until December 31, 2020. As our colleagues Josef Glynias and Paul Pautler noted in their excellent summary, this Act has two provisions which speak to employee leave and may have significant implications for employers, including healthcare providers. The Department of Labor has not yet issued guidance on this Act, and we will update this blog as guidance is issued.

On Friday, March 13, 2020, CMS issued blanket waivers under 42 U.S.C. 1320b-5 that impact long term acute care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs) as a result of President Trump declaring a state of an emergency due to COVID-19. The blanket waivers temporarily allow facilities operating inpatient rehabilitation units to exclude patients admitted

Centers for Medicare and Medicaid Services (CMS) has issued broad waivers to assist in the national COVID-19 response. They impact all provider types and generally remove regulatory burdens that could restrict access to care. For example, the waivers remove bed limits on Critical Access Hospitals and will allow Long Term Hospitals to exclude from the 25 ALOS calculation patients who were admitted or discharged to “meet the demands of the emergency.” Restriction on the separation of patients in excluded units in IPPS hospitals are waived. The requirement for three days of hospitalization to receive skilled nursing coverage is also waived. There are a number of other waivers.

Clearing a building site inside a crowded city can often be efficiently done by “imploding” existing structures utilizing high explosives.  While the science of demolition by implosion is mature and can be implemented safely, neighboring property owners have legitimate concerns about damage from flying debris, dust, ground vibration and air blast overpressure.  At the same

On February 22, 2012, the Supreme Court in Douglas v. Independent Living Center of Southern California vacated and remanded to the Ninth Circuit a series of cases that challenge provider reimbursement cuts in California’s Medicaid program.  At issue in the case was whether providers and recipients had standing to sue state officials under the Supremacy