By Jean C. Hemphill and Philip E. Legendy on Posted in Health Plans,Healthcare Providers / SuppliersSummary On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) published notice that it will postpone for another three months the finalization of a methodology to audit Medicare Advantage (MA) diagnosis coding data. The final rule could impact payors and providers in unexpected ways, and could fundamentally alter the economics of MA. [&hellip… Continue Reading »
By Jean C. Hemphill, Edward I. Leeds and Paige A. Haughton on Posted in COVID-19,Healthcare,HIPAA,HIPAA and Data Security,Wellness ProgramsThe U.S. Department of Health and Human Services (HHS) has released guidance to address how the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule applies to various entities’ requests for information related to an individual’s COVID-19 vaccination status. HHS emphasized that the Privacy Rule applies only to covered entities, including health plans and most [&hellip… Continue Reading »
By Jean C. Hemphill and Edward I. Leeds on Posted in American Rescue Plan Act (ARP),COBRA,COVID-19The subsidy for COBRA coverage under the American Rescue Plan Act comes to an end on September 30, 2021. There is no indication at this time that the subsidy will be extended. That means that, beginning October 1, plan and COBRA administrators may start collecting premium payments from individuals who qualified for COBRA because of [&hellip… Continue Reading »
By Jean C. Hemphill and Edward I. Leeds on Posted in COBRA,COVID-19,Health Plans,Healthcare Providers / SuppliersThe IRS issued a new notice that provides guidance on a few issues that were not fully addressed in its earlier notice on the Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy requirements set forth in the American Rescue Plan Act (ARPA). ARPA generally requires the cost of coverage under COBRA between April 1, 2021, and September 30, 2021, to [&hellip… Continue Reading »
By Jean C. Hemphill, Edward I. Leeds and Jessica M. DuBois on Posted in Health Plans,Healthcare Providers / Suppliers,NondiscriminationThe U.S. Department of Health and Human Services (HHS) has announced that its Office for Civil Rights (OCR) will begin enforcing Section 1557 of the Affordable Care Act to prohibit discrimination based on sexual orientation and gender identity. Section 1557 prohibits many health care providers and certain health plans from discriminating against individuals on the [&hellip… Continue Reading »
By Jean C. Hemphill, Edward I. Leeds and Eric K. Temmel on Posted in HIPAA,HIPAA and Data SecurityThe new year began with an unusual amount of activity related to the Health Insurance Portability and Accountability Act (HIPAA). Health care providers, health plans, health care clearinghouses, and business associates subject to HIPAA will need to consider three significant developments—one regulatory, one legislative, and one judicial—relating to the Privacy and Security Rules under HIPAA [&hellip… Continue Reading »
By Jean C. Hemphill and Edward I. Leeds on Posted in COVID-19,Healthcare,LegislationThis alert is the latest in a series from our Employee Benefits and Executive Compensation and Health Care Practice Groups about the most recent federal stimulus bill. We provided an overview of how the law addresses new substantive requirements for health plans and health care providers, see the Health Insurance/Provider Provisions section here. We addressed [&hellip… Continue Reading »
By Edward I. Leeds and Jean C. Hemphill on Posted in COVID-19,HIPAAThe Office of Civil Rights of the U.S. Department of Health and Human Services has issued guidance clarifying how HIPAA’s Privacy Rule permits covered entities (in particular, health care providers and health plans) or their business associates to contact former COVID-19 patients about plasma donation to treat or potentially treat patients. The guidance follows the FDA’s approval of blood [&hellip… Continue Reading »
By Jean C. Hemphill on Posted in CARES Act,COVID-19Note: This is an update to our April 13 alert here. CARES Act 2.0, signed into law on April 24, 2020, authorized additional funding of certain programs established in the initial CARES Act, including supplemental funding for health care providers. The new law also provides more than $300 billion in additional funding for the Paycheck Protection [&hellip… Continue Reading »
By Denise M. Keyser, Jean C. Hemphill and Brian D. Pedrow on Posted in COVID-19Tuesday evening, April 14, 2020, New Jersey Governor Murphy signed into law Bill No. S2333, which provides health care professionals, facilities, and systems civil immunity for care given to those affected by COVID-19. The new law additionally authorizes the Director of Consumer Affairs to issue orders temporarily suspending professional and occupational licensing registration requirements. The [&hellip… Continue Reading »
By Jean C. Hemphill on Posted in CARES Act,COVID-19The CARES Act signed into law by President Trump on March 27, 2020, provides for $100 billion in funding for financial relief to Medicare health care providers impacted by COVID-19. On April 10, 2020, the Administration announced that $30 billion of this funding will be disbursed immediately to providers through direct deposit—these direct deposits will [&hellip… Continue Reading »
By Jean C. Hemphill on Posted in CARES Act,COVID-19On March 27, 2020, Congress passed the CARES Act (the Act), an approximately $2 trillion bill drafted in response to the COVID-19 crisis, with the goal of providing much needed relief for the United States economy. A significant portion of the bill relates to the health care workforce, providing for provisions related to the reauthorization [&hellip… Continue Reading »
By Jean C. Hemphill and Edward I. Leeds on Posted in COVID-19,HIPAA,HIPAA and Data SecurityOn March 20, 2020, the Office for Civil Rights (OCR) issued guidance in furtherance of its Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency. OCR issued the guidance as frequently asked questions (FAQs) published by the Department of Health and Human Services (HHS). This guidance further explains how OCR will exercise [&hellip… Continue Reading »
By Jean C. Hemphill on Posted in COVID-19CMS Adult Elective Surgery and Procedures Recommendations: Limit All Non-Essential Planned Surgeries and Procedures, Including Dental, Until Further Notice On March 18, 2020, the Centers for Medicare and Medicaid Services (CMS) issued recommendations to limit all non-essential adult surgeries and dental procedures during the 2019 Novel Coronavirus (COVID-19) outbreak. This guidance comes as health care [&hellip… Continue Reading »
By Jean C. Hemphill and Edward I. Leeds on Posted in COVID-19,HIPAAThe Office of Civil Rights, U.S. Department of Health and Human Services, issued an update to its February bulletin, which outlined how the HIPAA privacy rules apply in a state of emergency. The March bulletin largely reiterates the February bulletin and also sets forth a limited waiver of sanctions and penalties against covered hospitals that do not comply [&hellip… Continue Reading »
By Jean C. Hemphill on Posted in COVID-19With the spread of COVID-19, barriers to testing, treating, and getting paid for coronavirus-related care and containment efforts are being identified and addressed by federal and state regulators on a daily basis. Most recently, The firm’s Health Care Group is monitoring these developments and advising clients across the industry on regulatory and transactional matters, including health benefits… Continue Reading »
