HHS expands access to telehealth services in response to COVID-19

By Paul W. Pitts, Rebecca E. Dittrich, James F. Hennessy, Sonia Nguyen & Jamie Knauer

March 25, 2020

As discussed in our client alert, recent legal developments have greatly expanded funding for and access to telehealth services during the COVID-19 crisis. Among the changes instituted by HHS are expanded Medicare coverage and payment for services, reduced or waived cost-sharing obligations for physicians, and loosening of the HIPAA enforcement policies for covered entities (which can now use any non-public facing platform, e.g. Skype, to deliver telehealth services). In addition, CMS released new guidance…

Health Industry Washington Watch

CMS Offers Guidance to Health Care Providers on Limiting Elective Surgeries, Other Nonessential Procedures During Coronavirus Outbreak

By Lesley Reynolds & Janine Tougas

March 25, 2020

In a recent guidance, the Centers for Medicare & Medicaid Services (CMS) encouraged health care providers (HCPs) to limit elective surgeries and nonessential procedures during the 2019 novel coronavirus (COVID-19) outbreak. CMS offered a number of recommendations to help HCPs decide how to best serve patients requiring emergent or urgent attention. In addition to clinical evaluation, CMS asked HCPs to consider factors like current and projected COVID-19 cases in their area; current and projected supply…

Health Industry Washington Watch

MedPAC recommends Medicare payment updates for 2021 – but all rate bets are off in light of COVID-19

By Debra A. McCurdy

March 24, 2020

.A gang of doctors is doing surgery.Doctors do the operation to the patient

The Medicare Payment Advisory Commission (MedPAC) released its 2021 Medicare provider rate update recommendations on March 13, 2020 – the same day President Trump declared a national emergency due to COVID-19. MedPAC’s recommendations were based on an assessment of various Medicare “payment adequacy indicators” that are unlikely to reflect the state of the health care industry in 2021, given the tremendous strain COVID-19 is placing on hospitals, nursing homes, clinicians, and other provider types…

Health Industry Washington Watch

HHS waives requirements for health care providers under section 1135 in response to COVID-19

By Carol Loepere, Scot Hasselman, Nicole Aiken-Shaban, Rebecca E. Dittrich, Arielle Lusardi, Shaylynn Veeder & Kristin Parker

March 23, 2020

Shortly after President Trump declared a national emergency related to COVID-19, CMS issued blanket waivers under section 1135 of the Social Security Act that are intended to ensure there are sufficient health care items and services available to meet the increased need, as well as reduce related administrative burdens on health care providers. Our comprehensive client alert on this topic discusses: the 11 categories of blanket waivers issued by CMS – which significantly impact skilled…

Health Industry Washington Watch

CDC Offers Guidance to Health Providers on ICD-10 Coding for Coronavirus/COVID-19 Encounters

By Rebecca E. Dittrich & Scot Hasselman

February 28, 2020

The Centers for Disease Control and Prevention (CDC) recently released official diagnosis coding guidance for health care encounters and deaths related to the 2019 novel coronavirus (COVID-19), potentially in anticipation of more frequent cases in the United States. The guidance identifies specific ICD-10-CM codes to be used to code encounters. CDC advises that patients presenting with certain signs and symptoms, but where a definitive diagnosis has not been made, should be coded as follows: R05…

Health Industry Washington Watch

Potential Tensions Lie Ahead Between Federal and State Authorities Over the Application of CDC Quarantine Powers

By Scot Hasselman, Jessica Christensen & Rebecca E. Dittrich

February 26, 2020

According to the U.S. Centers for Disease Control and Prevention (CDC), although there have been imported cases of Covid-19 detected in the United States, “at this time, the virus is NOT currently spreading in the community in the United States.”[1] However, on Tuesday, February 25, 2020, Nancy Messonier, the CDC’s Director of National Center for Immunization and Respiratory Diseases, urged American businesses and families to start preparing for the possibility of a large…

Health Industry Washington Watch

CMS Releases Proposed Medicare Advantage and Part D Rules for Contract Year 2021 and 2022

By Debra A. McCurdy

February 17, 2020

CMS has put on display a proposed rule that would update Medicare Advantage (MA) and Medicare Part D prescription drug benefit policies for contract year 2021 and 2022. CMS projects that its proposed policies would decrease federal spending by $4.4 billion over 10 years, primarily as a result of a proposal to remove outliers prior to calculating Star Rating system cut points. Other major provisions of the proposed rule include the following: CMS proposes to…