COVID Vaccine Administration and Billing

COVID Vaccine Administration and Billing

By: Dean Viskovich

On November 13, 2020 Centers for Medicare and Medicaid Services (CMS) announced that all Americans will have access to the COVID-19 vaccine at no cost.  CMS has clearly communicated to private insurers, Medicaid programs and Medicare that it is their responsibility to cover the vaccine at no charge to beneficiaries.  CMS states that Operation Warp Speed ensures that States, provider’s and health plans have the information and direction they need to ensure broad vaccine access and coverages for all.  As a condition of receiving free COVID-19 vaccines from the federal government, providers will be prohibited from charging consumers for administration of the vaccine.

Beneficiaries with Medicare will not pay anything for the COVID-19 vaccine and their coinsurance/copayment and deductible amounts will be waived.  In 2021, for Medicare Advantage beneficiaries, Medicare will pay directly for the vaccine and its administration for those enrolled in MA plans.  MA plans are not responsible for reimbursing providers to administer the vaccine.  MA beneficiaries do not pay for the vaccine and copayment/coinsurance and deductibles are waived.Continue reading

Can Your Florida Medical Business Pass the Legal Test?

florida medical license lawyer

florida medical license lawyerIf you own or operate a florida medical business, contact Florida Healthcare Law Firm to make sure you are legally compliant, up to date with telehealth regulations and ready for your next audit.

If you are the owner or chief operating officer of a florida medical business, then you are likely dealing with a lot more than health care on a daily basis. You’re probably facing an avalanche of ever-changing state and federal policies. Trying to interpret each one is like juggling three balls in the air and waiting for one to drop. But you don’t have to be a master juggler. You’re not expected to understand the nuance of every piece of legislation that comes your way. With the expert attorneys at Florida Healthcare Law Firm, you can concentrate on your practice, while we navigate the landscape of healthcare policy. From regulatory compliance to payor issues, telemedicine, operations, start-ups, technology and ZPIC audits for fraud, we will coach you, prepare you, counsel you and, above all, educate you so you better understand the implications of every future professional decision you make. We even offer free webinars on hot topics such as diagnostic imaging and radiology compliance, lessons learned from 2020 that can make 2021 easier and how to protect your pharmacy from risky prescriptions. From A to Z, we’ve got you covered.

But if you’re interested in something specific, our boutique firm will cater to your needs. For example, when it comes to finding a florida medical license lawyer, our team is unmatched. If you’re like most physicians, the documentation that allows you to practice is one of your most valuable possessions. And you work hard to maintain its integrity. But sadly, one error, one unhappy patient or one miscommunication could be catastrophic and could even cause you to lose your career. If this happens, don’t waste a second in calling the best representation you can find. You can’t count on the board siding with you. You can’t count on dismissal of your case based on what you consider a frivolous complaint. You cannot risk having your credentials revoked. Our team with 150 years of collective experience focuses solely on doctors and their needs. We know your business so let us take care of saving it for you. We’ll partner with you and will work until we achieve success—our guarantee. Be proactive and call Florida Healthcare Law Firm for a complimentary consultation.

When Does a Gift Become a Kickback?

gift or kickback

There’s a fine line between gifts and kickbacks within the healthcare setting. Read about the differences and how to properly plan your healthcare marketing in your business.

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Pharmacists Authority To Give Vaccinations Expanded By HHS

pharmacists giving childhood vaccines

pharmacists giving childhood vaccinesBy: Zach Simpson

On August 19, an amendment to the Public Readiness and Emergency Preparedness Act was announced by HHS which allows pharmacists in every state to now administer childhood vaccinations to children ages 3 and older, subject to several requirements,

  • The vaccine must be approved or licensed by the Food and Drug Administration (FDA).
  • The vaccination must be ordered and administered according to the CDC’s Advisory Committee on Immunization Practices (ACIP) immunization schedules.
  • The licensed pharmacist must complete a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE). This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of vaccines, and the recognition and treatment of emergency reactions to vaccines.

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CMS to Resume Healthcare Provider Audits

cms audit

cms auditBy: Karina P. Gonzalez

CMS has announced that it will resume Medicare Fee-For-Service (FFS) medical reviews August 3, 2020 regardless of the status of the COVID-19 public health emergency. These audits have been suspended since March 30 as a result of the crisis and applied to prepayment reviews and post-payment reviews conducted by Medicare Administrative Contractors (MAC).Continue reading

Florida State Surgeon General’s Emergency Order 20-011 Continues to Allow Out-of-State Practitioners to Offer Telehealth Services to Persons in Florida

telemedicine extension

telemedicine extensionBy: Susan St. John

On June 30, 2020, State Surgeon General, Scott A. Rivkees, M.D., issued Emergency Order (“EO”) 20-011, which further extends EO 20-002 until the expiration of the Governor’s Executive Order No. 20-52, or any extensions thereof. Thus, EO 20-011 continues to allow out-of-state MDs, DOs, APRNs and PAs, to offer telehealth services to persons in Florida.

EO 20-011 continues to allow Florida licensed controlled substance prescribers (MDs, DOs, APRNs, PAs) to issue renewal prescriptions of controlled substances for non-malignant pain for existing patients. Additionally, EO 20-011 extends a qualified physician’s ability to recertify an existing qualified and certified patient’s continued use of medical marijuana using telehealth services. These further extensions are also tied to the expiration of Executive Order 20-52 and any extension thereof.Continue reading

The 3 Knocks Coming to your Healthcare Business’ Door Post-Pandemic: The Lawyers, The Regulators; and The Auditors

Healthcare Business Door Post Pandemic

florida healthcare law firm audits after covidBy: Steven Boyne

When COVID-19 passes and the world begins to return to normal, you can be guaranteed that many of your old “friends” will come to visit you. To minimize future liability, pain and time, you should be preparing today for tomorrow’s visitors:

The Lawyers. Lawyers come in many flavors, and can bring good or bad news. Depending on your initial reaction to the pandemic, and your subsequent actions as the panic started to die down you may see three types of lawyers: (1) Those that represent past or present employees who have lost their job or contracted COVID-19; (2) Those that represent patients who claim malpractice based on the care that you did or did not deliver, and also those patients who assert that they contracted COVID-19 at your office; and finally (3) Those that represent creditors or debtors of your practice. The actions you should take today are many and varied and beyond the scope of this overview, however, you should be asking the following questions of yourself: (i) did you file a claim for business interruption despite the fact that your insurance broker said you were wasting your time? (ii) does your malpractice carrier cover you for liability outside of the normal scope of providing care? (iii) are your documenting your actions throughout the pandemic to demonstrate that you were acting reasonably at a time when you did not have all the facts? (iv) did you look at your business insurance policies for coverage for employee claims, or workers comp claims, or OSHA claims? (v) did you research what other similarly situated companies are doing, as you will most likely be held to the same standards? (vi) did you follow guidance from State and Federal entities? and (vii) did you provide notice during the pandemic to debtors or other parties who have breached their obligations?Continue reading

Florida State Surgeon General’s Emergency Order 20-009 Continues to Allow Out-of-State Practitioners to Offer Telehealth Services to Persons in Florida

Telehealth Services to Persons in Florida

By: Susan St. John

State Surgeon General, Scott A. Rivkees, M.D., issued Emergency Order (“EO”) 20-009, which extends EO 20-002 and continues to allow out-of-state MDs, DOs, APRNs and PAs, to provide telehealth services to persons in Florida. EO 20-009 is set to expire June 30, 2020, unless otherwise extended.

Further, EO 20-009 continues to allow Florida licensed controlled substance prescribers (MDs, DOs, APRNs, PAs) to issue renewal prescriptions of controlled substances for non-malignant pain for existing patients. Additionally, EO 20-009 extends until June 30, 2020, a qualified physician’s ability to recertify an existing qualified and certified patient’s continued use of medical marijuana by using telehealth services.Continue reading