The New World of House Calls: Telehealth, COVID19, Fraud, and the Anti-Kickback Statute

On April 30th, the federal government released new changes in covered services in response to the COVID19 pandemic in addition to those previously announced in March. These changes are in effect for the duration of the COVID19 pandemic, which for is indefinite for the time being. Such changes include, generally, the following:

Continue reading

Louisiana Will Loosen Restrictions on Non-Emergency Healthcare Services Starting April 27, 2020

The Louisiana Department of Health (LDH) has issued multiple directives significantly restricting non-emergency healthcare services in light of the COVID-19 crisis. The limitations have been reinforced by additional directives from the Louisiana State Board of Medical Examiners emphasizing the importance of discontinuing services and by the Louisiana Attorney General who launched a COVID-19 Task Force to enforce LDH restrictions on providers. Continue reading

CARES Act Relief: Conditions, Compliance, and Potential Whistleblower Complaints

Laws and regulations are changing rapidly. After the publication of this article, they are subject to change. Check back regularly for updates.

The CARES Act (Coronavirus Aid, Relief, and Economic Security Act), the Coronavirus Preparedness and Response Supplemental Appropriations Act, and the Families First Coronavirus Response Act all provide funds to healthcare providers. In applying for funds under these Acts, the HHS has set up “Relief Fund Payment Terms and Conditions.” As with any government grant program, compliance with the terms and conditions form the basis of the government’s eventual evaluation of any complaint it may receive or any audit it may conduct regarding the healthcare provider’s use of the grant funds.

Continue reading

COVID-19 UPDATE: CMS Issues Recommendations to Re-Open Health Care Systems to Follow up Previous Guidance on Non-Essential Surgical Procedures

On Sunday, April 19th, the Centers for Medicare & Medicaid Services (CMS) issued new recommendations specifically for communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again and that have low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations are an update to earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials and to also review the availability of Personal Protective Equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.

The new CMS recommendations can be found here: https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf

Written By: Clay Countryman

Countryman, Clay headshot

Covid -19 ASC Update: CMS Issues Guidance For Ambulatory Surgery Centers Enrolling As Hospitals During The Covid-19 Pandemic

On Monday, April 6, 2020, CMS issued guidance regarding Ambulatory Surgery Centers (ASCs) that choose to temporarily enroll with Medicare as a hospital during the COVID-19 Public Health Emergency. (www.cms.gov/). CMS previously announced on March 30, 2020 several temporary new rules and CMS waivers adopted under 1135 emergency waiver authority that allow ASCs to either contract with hospitals to provide services to hospital patients in ASC facilities or to enroll and bill as hospitals and provide inpatient and outpatient hospital services during the COVID-19 Public Health Emergency (PHE). Continue reading

Clinical Research – Government and Industry Team to Provide Hope in the Crisis

Necessity is the mother of invention, and it’s hard to remember a time when humanity has been more motivated to resolve a crisis. Times like this, though, generally bring out the best in all of us – the best in government, the best in industry, and the best in individuals. The COVID-19 research and development response by all partners is helping provide hope during these difficult times. A few of these promising developments are as follows:

Convalescent Plasma Research – researchers and health care providers looking to COVID-19 survivors’ blood plasma for a possible therapy in the fight against the virus. The FDA is allowing emergency Investigational New Drug applications for serious or life-threatening COVID-19 infections. The FDA recently published guidance to researchers on COVID-19 Convalescent Plasma. Continue reading

HIPAA – COVID-19 Update

HIPAA – Waiver of security and privacy rules relating to telehealth – OCR has announced that it will not penalize health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency. This applies to widely available communications apps, such as FaceTime or Skype, when used in good faith for any telehealth treatment or diagnostic purpose, regardless of whether the telehealth service is directly related to COVID-19. The waiver covers security issues, BAA requirements with the video communication vendors, and other noncompliance issues that relate “to the good faith provision of telehealth services during the COVID-19 nationwide public health emergency.” Continue reading