As many of us are starting to see the small light at the end of the tunnel, many hospitals are still reeling from the stress of the last year. Following the recent release of “Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23–27, 2020” (the “Report”), a
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OIG Warns Telehealth Industry: “With Great Power Comes Great Responsibility”
On February 4, 2021, the Department of Justice (“DOJ”), Office of Public Affairs, issued a Press Release (the “DOJ Press Release”) announcing that Kelly Wolfe, President of Regency, Inc., a medical billing company located in Florida, pleaded guilty to conspiracy to commit healthcare fraud through a “pernicious telefraud scheme”[1] involving fraudulent Medicare and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) claims for medically unnecessary durable medical equipment (“DME”) supplies. As a result of Wolfe’s criminal plea, Wolfe could face up to 13 years in federal prison. …
Senior Living Communities, Liability for COVID-19 Countermeasures, and the PREP Act: Is the Tide Turning for Providers?
In a February 10, 2021 ruling (the “Garcia Ruling”) out of the CDCA Court for the Central District of California (the “CDCA Court”) in the case of Gilbert Garcia et al v. Welltower OpCo Group LLC, et. al., 20-02250JVS (C.D. Ca. Feb. 10, 2021), the CDCA Court held that the Public Readiness and Emergency…
New Guidance on Health Plans’ COVID-19 Coverage Obligations
On February 26, 2021, the Departments of Labor, Health and Human Services (HHS), and the Treasury issued Frequently Asked Questions (FAQs) on the implementation of the Families First Coronavirus Response Act (“FFCRA”), the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”), and other health coverage issues related to COVID-19.
COVID-19 Diagnostic Testing
FFCRA…
Vertical Deals in Healthcare: Key Antitrust Takeaways for Private Equity Firms
As it continues to grapple with the COVID-19 pandemic, the healthcare sector will face increased antitrust scrutiny from the Biden administration, with the Federal Trade Commission (the “FTC”) and Department of Justice, Antitrust Division (the “DOJ”) (together the “Agencies”) as the Agencies ramp up their reviews not just of “horizontal” transactions (i.e., deals between competitors),…
The Honeymoon Phase Is Over: OIG to Audit COVID-19 Part B Telehealth Services
Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency. Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth. However, the honeymoon phase of relaxed oversight may be coming to an end as the world…
The “State” of Telehealth: Texas
Texas Governor Wants to Make Permanent Changes to Telemedicine Access
As part of his 2021 of the State address, Texas Governor, Greg Abbott, introduced his intention to permanently expand telemedicine services that were made available during the COVID-19 public health emergency (the “Pandemic”).
Specifically, on March 13, 2020, the Governor waived certain regulations and…
The Other Shoe Drops: OIG To Audit COVID-19 Telehealth Home Health Services
In response to the ongoing COVID-19 public health emergency (the “PHE”) first declared on March 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued blanket Section 1135 Waivers to expand, albeit on a temporary basis during the PHE, the range of healthcare professionals who can provide Medicare-covered telehealth services to include physical therapists,…
The “State” of Telehealth
This article is the first post in our new “State” of Telehealth series in which we discuss innovation on a state level on the expansion of telehealth access, coverage and reimbursement.
On January 14, 2021, the New Jersey Senate Committee approved a proposed bill (Bill S-2559, the “Bill”) that, if signed into law,…
New Telehealth Series: The “State” of Telehealth
The Sheppard Mullin telehealth team is proud to announce the creation of a new series focusing on developments in telehealth on a state level. The series will include, among other things, blog posts and webinars on state telehealth related matters.
As we recently reported in our December 7, 2020 (“Permanent Expansion of Medicare Telehealth …
No Surprises Act Comes as a Surprise – Consolidated Appropriations Act Includes New Restrictions on Surprise Bills
On December 28, 2020, the Consolidated Appropriations Act, 2021 (“Appropriations Act”) was passed into law. The Appropriations Act included the No Surprises Act (“Act”), which seeks to protect patients from surprise medical bills in situations where patients have little or no control over who provides their care, including nonemergency services provided by out-of-network providers at…
The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?
In our December 7, 2020 Blog Post, “Permanent Expansion of Medicare Telehealth Services,” we discussed the 2021 Medicare Physician Fee Schedule Final Rule (the “Final Rule”) and the regulatory changes made therein by the Centers for Medicare and Medicaid Services (“CMS”) to expand Medicare telehealth coverage within the confines of existing…
“Hope Is On The Horizon”: California Governor Gavin Newsom Announces COVID-19 Vaccine Distribution Plan
N.B. Concurrent with the posting of this article, the Vaccines and Related Biological Products Advisory Committee of the Food and Drug Administration (“FDA”) has decided to recommend to the FDA that the FDA approve the emergency use authorization applications submitted by Pfizer and BioNTech. It is being reportedd that the FDA may formally approve the…
And We Have Lift-Off: Improvements in Healthcare Revenue Cycle Management to Address COVID-19 Challenges
G force is used to describe the acceleration of an object relative to gravity. The Wright brothers understood that the lift of the airplane had to be greater than the force of gravity. In much the same way, the pull of gravity that healthcare providers are facing today is COVID-19.
Although there are exceptions to…
Primary Care First: CMS’s New Value-Based Approach to Primary Care
As highlighted in a May 2020 Milbank Memorial Fund white paper titled, “How Payment Reform Could Enable Primary Care to Respond to COVID-19,” the COVID-19 public health emergency has driven transformation in the provision of primary care services across the country. Whether it’s the use of telehealth technology to facilitate “virtual visits” or…
Office of the National Coordinator for Health IT Extends Compliance Deadlines under Interoperability Final Rule
In an effort to provide additional relief to a health care system strained by the COVID-19 pandemic, the Office of the National Coordinator for Health IT (“ONC”) released an Interim Final Rule with Comment Period (“IFC”) on October 29, 2020 that extends the compliance dates under the 21st Century Cures Act Interoperability, Information Blocking, and…