On March 20, 2020, the Wisconsin Department of Health Services (DHS) released revised guidance to prevent and control COVID-19 in Long Term Care Facilities and Assisted Living Facilities.  This revision is based on the knowledge that older and medically vulnerable adults have a significantly higher risk of severe illness and death from COVID-19.

Stethoscope and Tablet_600x600-2On March 17, 2020, U.S. Department of Justice, Drug Enforcement Agency (DEA) released guidance clarifying that restrictions under the Ryan Haight Act (the Act) are removed in response to the COVID-19 pandemic, allowing health care practitioners to prescribe controlled substances to patients through the use of telemedicine without any “in-person medical evaluation.” The Act generally prohibits practitioners from dispensing controlled substances through the internet without an in-person evaluation, unless an applicable exception is met. One exception to the Act occurs in the event of a public health emergency, which was triggered when HHS Secretary Alex Azar declared an emergency in response to COIVD-19 effective January 31, 2020. Practitioners now have the go-ahead to prescribe controlled substances through telemedicine technology without compliance with the Act’s requirements, but only for the duration of the public health emergency due to COVID-19.

physicians

COVID-19 Update: CMS Waiver Information for Private Practice Physicians and Non-Physician Practitioners

By Hal Katz and Tamar E. Hodges

President Donald Trump declared the coronavirus pandemic a National Emergency on March 13, 2020. This declaration granted the Department of Health and Human Services (HHS) Secretary Alex Azar authority to relax certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements set forth in Section 1135 of the Social Security Act. The primary purpose of this waiver is to give providers greater flexibility to meet the needs of Medicare, Medicaid, and CHIP beneficiaries during an emergency.  CMS may issue “blanket waivers” after a declaration of a public health emergency when it determines many “similarly situated providers” would require certain waivers. CMS requires providers to put the state licensing agency and CMS Regional Office on notice if it intends to modify their operations in light of such waivers, although the blanket waivers are essentially automatic and, therefore, do not require the provider to submit a request. The waiver is in effect through the duration of the emergency or until CMS terminates the waiver.

Telehealth

The Husch Blackwell Hospice Team has been receiving reports from hospices throughout the country that nursing facilities are prohibiting hospice workers from entering the facility to provide essential end-of-life care to hospice patients. Such access is being denied pursuant to visitor restrictions. However, hospice personnel are not visitors but are recognized by the Centers for Medicare and Medicaid Services (“CMS”) as essential health care personnel who must be given access.

On March 20, 2020, the Texas Health and Human Services Commission issued Provider Letter 20-23, providing clear guidance to Texas’ assisted living communities on how to reduce the risk of the spread of COVID-19. Finding that; “…COVID-19 presents a significant health and safety risk to ALF residents” and that “the best method of protecting [residents] from infection is to keep the infection out of the facility”, the provider letter adopts guidelines that are similar to those put in place several days ago for nursing facilities. Significantly, the letter determines that; “[a] resident’s right to visitation can be restricted in order to protect the health and safety of residents”.

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.

These are extraordinary times. COVID-19, or the novel coronavirus, has disrupted the life of every American and every business. Hospices are no exception. In fact, they are on the frontlines, responsible for providing care to the elderly, a population extremely susceptible to COVID-19. The Husch Blackwell Hospice Team is fundamentally a group of problem solvers,…

The CDC’s latest Morbidity and Mortality Weekly Report released Wednesday, March 18, 2020, reiterated that both residents and the workforce of long term care facilities remain most vulnerable to the exposure and spread of COVID-19.  According to the Report, “[s]ubstantial morbidity and mortality might be averted if all long-term care facilities take steps now to prevent exposure of their residents to COVID-19. The underlying health conditions and advanced age of many long-term care facility residents and the shared location of patients in one facility places these persons at risk for severe morbidity and death.”

On March 17, 2020, President Trump announced the expansion of Medicare telehealth coverage to allow providers to virtually visit with Medicare beneficiaries amid the COVID-19 pandemic. The telehealth benefits expansion is in accordance with the President’s emergency declaration under the Stafford Act and the recently passed Coronavirus Preparedness and Response Supplemental Appropriations Act. By expanding telehealth benefits for Medicare beneficiaries, the Trump administration hopes to alleviate pressure on healthcare facilities that deal with urgent cases and ensure that elderly beneficiaries may seek care while minimizing exposure to the virus.