On March 17, 2020, the Department of Health and Human Services, Office of Civil Rights (OCR) issued guidance related to how Covered Entities can comply with HIPAA and the Privacy Rule and still disclose protected health information (PHI) about individuals infected with or exposed to COVID-19 to law enforcement, paramedics, other first responders, and public health authorities (Essential Providers).
You May Be Contacted – OIG Seeks Interviews With Hospitals Regarding COVID-19 Response
Representatives of the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) are reaching out to speak with hundreds of hospital officials nationwide to provide feedback to HHS and to Congress about the most difficult challenges that hospitals are currently facing in responding to COVID-19. The OIG emphasizes that
Texas Comptroller Postpones Medical Billing Sales Tax Policy Until Texas Legislature Weighs in in 2021
Texas Comptroller Glenn Hegar announced last week that he will delay the implementation of a sales tax on medical billing services until the Texas Legislature considers the proposed change when it meets in a regular session in 2021. The Comptroller’s staff will work with industry leaders leading up to the 140-day session in order to develop language that could amend the state’s sales tax statutes. The regular session of the Texas Legislature is scheduled to begin January 12, 2021, and end June 1, 2021.
Our prior article discussed the Texas Comptroller’s policy change in the fourth quarter of 2019, which would have rendered medical billing services subject to Texas sales tax, after longstanding reliance on rulings which exempted such services.
COVID-19: CMS Waiver Information for LTCHs and IRFs
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
COVID-19: CMS Waiver Information for Providers
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.
Telehealth News Alert: New Coronavirus (COVID-19) Considerations for Telehealth Providers
As the novel coronavirus outbreak continues, the federal government and commercial health insurers have taken significant steps to increase Americans’ access to treatment and testing. In the past week, the federal government and private insurers have issued a number of guidance documents expanding coverage and payment requirements in an effort to minimize the spread of the virus. As with any changes in coverage and reimbursement, healthcare providers offering telehealth services should carefully review these changes and take steps to ensure that all regulatory and coverage requirements are met prior to submitting claims for reimbursement.
I. Medicare
On March 6, 2020, the bipartisan Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 (“Coronavirus Appropriations Act”) was signed into law authorizing federal spending to combat the ongoing coronavirus outbreak in the United States. This Act, among other things, gives the United States Department of Health and Human Services’ (“HHS”) secretary the authority to temporarily waive certain Medicare requirements for telehealth services.
The Centers for Medicare and Medicaid Services (“CMS”) currently reimburses a limited set of telehealth services provided to Medicare beneficiaries subject to certain criteria under section 1834(m) of the Social Security Act. Generally, the patient receiving telehealth services must be located at one of eight “originating sites”, which include hospitals, physicians’ offices, and rural health clinics. In addition, the originating site must meet certain geographic requirements which have essentially limited the availability of telehealth to patients in rural areas. These requirements have long posed a hurdle to the expansion of telehealth despite the industry’s demand for lessened restrictions. However, with the rapid spread of the coronavirus and the possibility of facing large scale isolations and quarantines, lawmakers have signaled their willingness to expand access to telehealth to fight against this public health crisis.
Within the Coronavirus Appropriations Act is the Telehealth Services During Certain Emergency Periods Act of 2020, which sets forth the waiver authority for the secretary of HHS regarding the certain telehealth requirements. Under the Telehealth Services During Emergency Periods Act, the secretary is authorized to temporarily waive the originating site and geographic requirements for telehealth services provided to Medicare beneficiaries located in an identified “emergency area” during an “emergency period” when provided by a qualified provider. To qualify for the waiver, the provider must have treated the patient within the previous three years or be in the same practice (i.e., as determined by tax identification number) of a practitioner who has treated the patient in the past three years. The bill also lessens the telecommunications requirements by allowing Medicare beneficiaries to receive telehealth services via their smartphones (i.e., telephones that allow for real time, audio-video interaction between the provider and the beneficiary). Because the federal government has declared a nationwide public health emergency as a result of the coronavirus, the waiver will apply across the country until there is no longer a nationwide public health emergency.
Hospital Sued for Requiring Older Doctors to Undergo Medical Screenings
A teaching hospital in Connecticut affiliated with Yale Medical School is facing age and disability discrimination allegations after imposing mandatory medical testing for doctors 70 and older who seek medical staff privileges. The U.S. Equal Employment Opportunity Commission (“EEOC”) has filed suit against Yale New Haven Hospital, claiming that subjecting older physicians to medical testing before renewing their staff privileges violates anti-discrimination laws.
According to the EEOC, the hospital’s “Late Career Practitioner Policy” dictates that medical providers over the age of 70 must undergo both neuropsychological and ophthalmologic examinations – a policy the federal agency claims violates both the Americans with Disabilities Act (“ADA”) and Age Discrimination in Employment Act (“ADEA”). The EEOC claims that the individuals required to be tested are singled out solely because of their age, instead of a suspicion that their cognitive abilities may have declined. The agency further charges that the policy also violates the ADA because it subjects the physicians to medical examinations that are not job-related or consistent with business necessity.
Thrilled to Announce the Launch of Hospice Insights: The Law and Beyond
We are thrilled both to welcome four new hospice attorneys to Husch Blackwell and for the launch of their new podcast “Hospice Insights: The Law and Beyond.”
In this first episode, Meg Pekarske, Bryan Nowicki, Erin Burns and Andrew Brenton discuss the exciting opportunities resulting from their move to Husch Blackwell. The episode is available
Considering the Journey to Improved Customer Experience in Healthcare
There is a trend in healthcare toward customer-centrism—placing the interests of the consumer before all other considerations. The trend may be slow in its growth, but for those healthcare organizations that embrace the idea and obsess over improving the consumer’s experience throughout their healthcare journey, there can be a payoff. But improving consumer experience in healthcare takes a commitment and courage to venture outside of traditional comfort zones.
For years, the polarized debate over healthcare policy has included advocacy for a more consumer-directed healthcare system. The argument in favor says consumers and providers alike must have more skin in the game—financial responsibility—and better information with which to make more consumer-like decisions. For providers, the “skin” means risk-based contracts. For consumers, it means higher deductibles and other out-of-pocket cost exposure. There has been significant movement in this direction.
New Texas Law Poses Limitations on Surprise Billing
This is the first of three blogs in a series discussing the shift many states are beginning to make towards limiting “Surprise” or “Balance Billing.” This first blog will focus on Texas Senate Bill 1264, which looks to end surprise billing in the State of Texas in certain circumstances. The second blog in this series will look at the similar law California passed in 2017 to see what kind of effects that law has had. The final blog in this series will discuss other proposed state and federal laws that look to continue the trend towards ending surprise billing.