More Relief on the Way: H.R. 266 – Paycheck Protection Program and Health Care Enhancement Act Signed by the President

HHS Stimulus Payment action required on Second Round

HHS Stimulus Payment action required on Second RoundBy: Susan St. John

The newest relief for small business and health care providers was passed by the Senate on April 21st, by the House on April 23rd, and became law on April 24, 2020. This new Act, provides for $484 billion in additional relief to small businesses and healthcare providers. $100 billion of the relief has been allocated to the Department of Health and Human Services and of that amount $75 billion is earmarked “to reimburse health care providers for health related expenses or lost revenues that are attributable to the coronavirus outbreak.” The remaining $25 billion will be used for expenses to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 test to effectively monitor and suppress COVID-19.

The $75 billion provided under the Act will remain available until expended and will be used to prevent, prepare for, and respond to coronavirus to reimburse necessary expense or lost revenues incurred as a result of COVID-19. However, if a health care provider has already had expenses or lost revenues incurred due to COVID-19 reimbursed from other sources or that other sources are obligated to reimburse (like the CARES Act), any funds received from the $75 billion cannot be used as a “double dip” by that health care provider.

A big difference for health care providers with this Act, is that unlike the CARES Act that provided a direct deposit to health care providers based on Medicare fee for services reimbursement, no application necessary, this Act requires the health care provider to apply for relief funds. Eligible health care providers include public entities, Medicare or Medicaid enrolled suppliers and providers, profit and not-for-profit entities that provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 (so as to accommodate the “lost revenues” provision, this could mean any patient treated since January 31, 2020, and is not necessarily limited to patients treated for COVID-19 symptoms without testing confirmation). Health care providers should act quickly and apply for funds as soon as possible as the HHS Secretary will review applications and make payments on a rolling basis. Payment may be a pre-payment, prospective payment, or a retrospective payment as determined by the HHS Secretary. Health care providers must submit an application that includes statements justifying the need of the provider for the payment. The provider must have a valid tax id number (could be an individually enrolled physician). As with the CARES Act, HHS will have the ability to audit how relief funds are expended and must start reporting obligations of funds to the House and Senates Committees on Appropriations within 60 days from the date of enactment of this Act. Reporting will continue every 60 days thereafter.Continue reading

Stark Law waived to facilitate COVID related medical services

stark law waiver

stark law waiverBy: Jeff Cohen

The Secretary of Health and Human Services issued blanket waiver of the Stark Law on March 30th in order to facilitate COVID related medical services.  The waivers apply only to financial relationships and referrals related to COVID.  The circumstances and conditions under which the waivers apply are strictly and narrowly described.  Moreover, the waivers have no impact in the presence of fraud or abuse.  With respect to physicians wanting to provide designated health services (e.g. clinical lab services) related to COVID detection and treatment, for instance–

  1. the federal requirement that the DHS be provided in the same building as the physician office is waived; and
  2. the financial relationship limitations between the physician (or family member) and the DHS provider is waived.

The waiver also contains specific examples of waived interactions between providers and hospitals, including—Continue reading

Telehealth/Telemedicine extends until May 8, 2020 in Florida

Telehealth Telemedicine extension

Telehealth Telemedicine extensionBy: Susan St. John

Breaking News: The State Surgeon General issued Emergency Order 20-004 at approximately 6:01 p.m. on April 15, 2020. Emergency Order 20-004 extends all the provisions of Emergency Order 20-002 until May 8, 2020, unless further extended. Thus, certain practitioners licensed in other states may provide telehealth services to persons in Florida without having to register with the Department of Health. Also, Emergency Order 20-003, issued March 21, 2020, named additional clinical practitioners licensed in other states that may provide telehealth services to persons in Florida. The following professionals that hold an active, valid, and unencumbered license in another state, that are not under investigation or current discipline, and have not had their license revoked in any jurisdiction, may provide telehealth services in Florida:Continue reading

Webinar | Virtual Practice Workshop: Turning Challenges into Opportunities

Turning Challenges into Opportunities Webinar
Turning Challenges into Opportunities WebinarHosted by Candela and Crystal Clear Digital Marketing, Florida Healthcare Law Firm attorney Chase Howard will be a panelist.
Back by popular demand, join us for another Virtual Practice Workshop & uncover the growth opportunities you can capitalize on now, while also protecting your practice in today’s disruptive landscape.
AGENDA: 2:00 PM – 3:00 PM | EXPERT ROUNDTABLE Industry influencers share tools, resources & strategies for improving patient engagement, creating treatment demand & taking advantage of growth opportunities to meet the needs of today’s changing climate. Moderators: David Pataca, MSL, LSO, Executive Regional Director, Candela Medical Audrey Neff, Marketing Director, Crystal Clear Presenters: Chase Howard, Attorney, Florida Healthcare Law Firm Ilanit Samuels, Medical Director & PA-C, MCMS, Baumann Cosmetic Dermatology Dr. Tali Arviv, MD, Arviv Medical Aesthetics
3:00 PM – 4:00 PM | SALES & MARKETING STRATEGIES TO STAY RELEVANT DURING COVID-19 Presenter: Audrey Neff, Marketing Director, Crystal Clear

April 21 @ 2:00 pm – 4:00 pm

Free

A Few Nuances to the Paycheck Protection Program Established Pursuant to the CARES Act

By: Susan St. John

The Paycheck Protection Program under the CARES Act (the “Act”) allows a small business to apply for a low interest rate loan to sustain the business during the economic disruption caused by COVID-19. This program focuses on payroll costs as opposed to revenues of the small business. Allowable uses of the PPP loan funds include the following:

  1. Payroll costs;
  2. costs related to the continuation of group health care benefits during periods of paid sick, medical, or family leave, and insurance premiums;
  3. employee salaries, commissions, or similar compensating;
  4. payments of interest on any mortgage obligation (which shall not include any prepayment of or payment of principal on a mortgage obligation);
  5. rent (including rent under a lease agreement);
  6. utilities; and
  7. interest on any other debt obligations that were incurred before the covered period.

The Act defines payroll costs as follows:

  1. the sum of payments of any compensation with respect to employees that is a:
    1. salary, wage, commission, or similar compensation;
    2. payment of cash tip or equivalent;
    3. payment for vacation, parental, family, medical, or sick leave;
    4. allowance for dismissal or separation;
    5. payment required for the provision of group health care benefits, including insurance benefits;
    6. payment of any retirement benefit; or
    7. payment of State or local tax assessed on the compensation or employees; and
  2. the sum of payments of any compensation to or income of a sole proprietor or independent contractor that is a wage, commission, income, net earnings from self-employment, or similar compensation and that is in an amount that is not more than $100,000 in 1 year, as prorated for the covered period; and shall not include the compensation of an individual employee in excess of an annual salary of $100,000, as prorated for the covered period; taxes imposed or withheld under chapters 21, 22, or 24 of the Internal Revenue Code for the covered period; compensation for employees outside of the US; qualified sick leave wages for which credit is allowed under the Families First Coronavirus Response Act; or qualified family leave wages for which credit is allowed under the Families First Coronavirus Response Act.

Continue reading

What Can Dentists Do during the Covid-19 Pandemic?

dentist businesses during covid-19By: Chase Howard

Like most medical practices and businesses in Florida, dental practices have been deemed non-essential except for emergency type services. For good reason, non-life threatening care, surgeries and services are put on hold to help curb the spread of COVID-19, which has left providers with the question of what they can do to maintain and treat patients remotely.

Recently, the American Dental Association (ADA) provided helpful guidance on the difference between emergency and nonemergency care, as well as the use of teledentistry.

Teledentistry is the use of a telehealth system through a variety of different technologies to deliver virtual health services, including dentistry.

Telehealth includes live video (synchronous), store and forward (asynchronous), remote monitoring, and mobile health. Live video is a live, two-way transmission of audiovisual telecommunications. Store and forward is a recorded file of the patient’s health information. Remote monitoring allows a provider to track patient health data through the use of devices which transmit data to a portal which the provider can securely access. Mobile health is the use of personal devices to share health information and education.

The ADA has echoed local governments calls to alleviate the pressure on emergency services by having healthcare professionals postpone all elective services and non-emergency care. The ADA put forth guidance to help individuals and dentists determine what constitutes a dental emergency, which includes issues that are potentially life threatening and require immediate treatment. Immediate treatment would include stopping bleeding or treating severe pain, infections, or conditions. A more complete guide can be found here.Continue reading

Webinar | Adding DME to Your Chiropractic Practice

adding DME to your chiropractic practiceAttorney Mike Silverman of the Florida Healthcare Law Firm will be co-hosting with Board of Certification Credentialing Director Matt Gruskin for a special presentation exclusively focused on the the topic of adding durable medical equipment (DME) to a chiropractic office. As attendees may know, adding DME is a great way to impact a supplier’s revenue, but most importantly is a fantastic mechanism to provide more complete patient care and satisfaction.

During this “lunch n’ learn” Mike & Matt will break down the steps necessary for a chiropractic office to provide DME to its customers, be it cash paying, commercially insured, or Medicare patients alike.

April 16 @ 12:00 pm – 1:00 pm

Free

Webinar | Emergency Telemedicine Education: From Setup to Billing and COVID-19

emergency telehealth webinarJust the other day CMS issued new rules and temporary waivers to help combat the COVID pandemic. We are getting flooded with questions about telemedicine in particular and wanted to highlight some of the points of the March 31st update that relate to telehealth.

  • Hospitals may use and bill for telehealth services so that patients can be screened without presenting at a hospital. The telehealth screening will allow hospitals to determine the most appropriate site for care, thereby minimizing the patient’s risk of exposure to COVID-19.
  • Health care providers using telehealth will be able to bill for telehealth services at the same rate as in-person services of the same kind and level. Allowable telehealth services have also been expanded during the health care crisis.
  • Importantly, a patient’s home may now serve as the originating site for Medicare telehealth services. CMS is also allowing for required supervision of lower level clinicians to be accomplished through virtual technology if appropriate for a patient’s particular situation.
  • Further, providers, including practitioners, may be able to temporarily enroll in Medicare to be able to assist with the current health care crisis.

Even though CMS has created some flexibility during this incredibly uncertain time…something about telemedicine laws remaining tricky and not being a one size fits all suit. Attorney Susan St. John will give you all of the details on how telemedicine set up, billing questions and more! Join us for this free webinar.

April 14 @ 12:00 pm – 1:00 pm

Free

Webinar | Prepping Your Dental Practice for Sale

dental practice for saleChase Howard will present this live lunch n’ learn webinar for attendees interested in learning more about how to effectively prepare for the sale of their dental practice. He will cover issues like who and when to contact when considering a sale, proactive steps to lessen business disruption, when to tell your employees, and other important transition topics.

Preparing your dental practice for sale is quite possibly the biggest decision one can make! Understanding the legal landscape, the investment trends and options as well as what can optimize your business’ sale is essential. This webinar platform provides attendees to ask questions and chat directly with a highly qualified health law attorney.

April 22 @ 12:00 pm – 1:00 pm

Free

COVID-19 Temporary Waivers and New Rules Issued by CMS to Combat the Pandemic

covid-19 temporary waiver

covid-19 temporary waiverBy: Susan St. John

CMS has issued temporary waivers and new rules to help the American health care system address the increased need for health care services caused by COVID-19. Among the waivers, CMS is allowing hospitals to set up services in alternative sites to accommodate increased patient census. Hospitals may be allowed to use ASCs, inpatient rehab hospitals, hotels and dormitories for non-COVID-19 patients or patients not requiring critical inpatient services. Hospitals are also being encouraged to increase staffing, allowing hospitals to increase staff through hiring of local and non-local providers/practitioners as long as they are appropriately licensed in the same state as the hospital or another state. However, even though CMS has created flexibility for rendering services during this pandemic, use of alternative “hospital” sites and expansion of hiring staff must comport with a state’s emergency preparedness or pandemic response plan.Continue reading