Physician Practices and Non-Physician Practitioners

On May 12, 2020 the Centers for Medicare & Medicaid Services (CMS) issued additional 1135 blanket waivers which are applicable to a wide variety of health care providers. These COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers are retroactively effective from March 1, 2020 through the end of the public health emergency (PHE). The waivers in this issuance do not require a request be sent or a notification be made to any of the CMS regional offices.  Each waiver must be consistent with the state’s emergency preparedness or pandemic plan.

Continue Reading CMS Adds Additional Blanket Waivers for Health Care Providers

Although Wisconsin hospitals have remained busy providing COVID-related treatment and services for the last two months, many Wisconsin health care providers chose to postpone elective surgeries and procedures in compliance with CMS guidance. Notably, Wisconsin never expressly prohibited elective surgeries or procedures at any point during the last few months; however, Emergency Orders #12 and #28 specified that individuals may obtain services at ambulatory surgery centers for response to urgent health issues or related COVID-19 activities. Further, guidance from the Wisconsin DHS Division of Public Health issued on March 20 recommended that dental practices postpone all elective and non-urgent care treatment.  With the issuance of the Badger Bounce Back Plan (the “BBB Plan”), Wisconsin facilities and providers have expressed their intent to prep for elective services and procedures. 
Continue Reading Bouncing Back into Healthcare in Wisconsin

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security Act (the CARES Act) into law. Section 3221 of the CARES Act ratified fundamental changes to the Public Health Service Act, codified at 42 U.S.C. § 290dd-2 and associated regulations, which govern the confidentiality requirements of substance use disorder records, commonly known as 42 C.F.R. Part 2, or simply, “Part 2.” Substance use disorder (SUD) records are defined broadly as “[r]ecords of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance abuse education, prevention, training, treatment, rehabilitation, or research.” The changes are significant and align with the increasing movement to align the Part 2 rules with the Health Insurance Portability and Accountability Act (HIPAA). The CARES Act requires the Department of Health and Human Services (HHS) to revise the Part 2 regulations within 12 months to comply with the CARES Act.
Continue Reading CARES Act Changes to Federal Substance Use Privacy Law

physiciansRecent clarifications by Arizona state officials seemingly relaxed restrictions for certain physician practices adhering to the March 21, 2020 executive order prohibiting all non-essential or elective surgeries.  Such direction from the governor’s office should give physician groups much needed relief in continuing certain elective procedures, such as those related to pain management services, in outpatient settings.
Continue Reading Arizona Physician Practices Should Exercise Discretion in Continuing Elective Procedures in Clinics and Outpatient Treatment Centers

Updated Thursday, April 2, 2020

CMS 1135 waivers allow the U.S. Dep’t of Health and Human Services Secretary to temporarily waive or modify certain Medicare, Medicaid, Children’s Health Insurance Policy (CHIP), and Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure that sufficient health care items and services are available to meet needs during a declared public health emergency.  Individual health care providers and associations may trigger additional waivers through feedback and requests to the Assistant Secretary for Preparedness and Response or CMS Regional Offices.
Continue Reading COVID-19 Update: Kansas 1135 Waivers and State Flexibilities

Updated Thursday, April 2, 2020

CMS 1135 waivers allow the U.S. Dep’t of Health and Human Services Secretary to temporarily waive or modify certain Medicare, Medicaid, Children’s Health Insurance Policy (CHIP), and Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure that sufficient health care items and services are available to meet needs during a declared public health emergency.  Individual health care providers and associations may trigger additional waivers through feedback and requests to the Assistant Secretary for Preparedness and Response or CMS Regional Offices.
Continue Reading COVID-19 Update: Missouri 1135 Waivers and State Flexibilities

Updated April 3, 2020

In response to the growing Coronavirus pandemic, the Small Business Administration (“SBA”) will make loans available to businesses that employ fewer than 500 people (and in certain instances a larger number of employees) through the new Paycheck Protection Program (“PPP”). In this post we address some of the most frequently-asked questions about the PPP, and how eligible healthcare entities can apply.
Continue Reading The Time to Act is Now: Small Business Administration Loans to Healthcare Organizations

On March 24, 2020, the Wisconsin Department of Health Services (DHS) prepared correspondence to the Center for Medicare and Medicaid Services (CMS) seeking waivers of certain Medicaid requirements pursuant to Section 1135 of the Social Security Act (42 U.S.C. § 1320b-5) due to the COVID-19 pandemic. The correspondence to CMS was shared on March 24, 2020 with the Wisconsin Legislature Joint Committee on Finance seeking their approval to submit the Section 1135 Waiver to CMS. The letter to CMS prepared by DHS states that Wisconsin is implementing all the blanket waivers issued by CMS on March 13, 2020 in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), to the extent applicable.
Continue Reading Wisconsin DHS requests authority to seek additional Medicaid Waivers from CMS

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.
Continue Reading Texas Comptroller Postpones Medical Billing Sales Tax Policy Until Texas Legislature Weighs in in 2021