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

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.

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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

Noncompete Agreement Tips and Mistakes to Avoid After COVID-19

noncompete agreement tips and mistakes to avoid during covid-19

noncompete agreement tips and mistakes to avoid during covid-19By: Jeff Cohen

COVID is proving to be so burdensome on employers that we are seeing lay-offs and furloughs all over the country. As the virus curve bends back in a positive direction and physician and patient concerns for safety wane, patients will stream back to office. But what happens to the laid off (or furloughed) employees and contractors with non-competes? Will they come back or will they have moved on, possibly in a way that violates their noncompetes? And will a court think a noncompete has been violated when an employee or contractor was let go and there is no specific provision in their written contract that allows the employer to immediately let someone go without notice due to this type of situation? How will the COVID based lay-offs and furlough affect noncompetes? The short answer is we don’t yet know, but widespread lay-offs and furloughs may result in a flood of cases being filed because (1) many have been let go, (2) there likely isn’t a provision in their contract with the employer that specifically authorizes that sort of termination, and (3) a contract’s “breach” (e.g. no contract based allowance for the prompt termination) is traditionally a defense to an action to enforce a noncompete.

The COVID Issue

Though there is an exception for unusual specialties or where there is essentially a community need, noncompetition covenants are generally enforceable in Florida with respect to doctors and other healthcare professionals. Many people think doctors in particular can’t be restricted from practicing medicine under any circumstances. That is just not true.

Getting to the bone of the issue, noncompetes are enforceable in Florida if:Continue reading

Webinar | How can you transform your business to be prepared for future situations like COVID-19?

prepare your business to be fully remote online during a crisis like covid-19

prepare your business to be fully remote online during a crisis like covid-19Join Florida Healthcare Law Firm Attorney Chase Howard on our free webinar titled “How can you transform your business to be prepared for future situations like COVID-19?”

Faced with the reality of remote operation, we’ll talk about how your business prepare to thrive in a similar scenario in the future.

  • What to do with remote staff when it comes to contracts, operations and patient privacy.
  • How do Federal regulations impact telework.
  • Could expanded telehealth laws ease the transition to remote care in a future crisis.

Presenter: Chase Howard, Esq. is an Attorney at the Florida Healthcare Law Firm and has focused his legal practice on health law, medical malpractice defense, business law, and contracts. He deploys crucial skills gained through hands-on business experience in the medical tech world to service clientele such as medical spas, medical practices, medical technology businesses, healthcare business entities, physicians, chiropractors, and dentists. Chase’s experience working in University of Miami Health System’s Risk Management Department provided him with a strong understanding of legal compliance in the healthcare world as well as experience in liability assessment, prevention and defense. With his multi-specialty background, Chase’s practice focuses on all aspects of transactional Health Law, MedSpa Start-up and consulting, general business law, and MedTech.

Webinar to prepare for future situations like covid-19

Florida Medicaid Waiver in Response to COVID-19 National Emergency

florida medicaid waiver for covid-19 corona virus

florida medicaid waiver for covid-19 corona virusBy David J. Davidson

On March 16, 2020, Florida became the first state to receive a Medicaid waiver from CMS in response to the COVID-19 national emergency. These provider enrollment emergency relief efforts also apply to the Children’s Health Insurance Program (CHIP), as applicable. With this waiver, Florida Medicaid, and Medicaid providers, will have greater flexibility in treating covered patients. Pursuant to the Florida waiver:

 

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A Telehealth Break for Medicare Patients and Providers

new medicare laws for telehealth related to corona virus

new medicare laws for telehealth related to corona virusBy: David J. Davidson

Up until now, Medicare has been fairly structured in how telehealth services are reimbursed. Medicare would pay for telehealth services only if certain, very narrow criteria were met. These rules covered the patient, the patient’s location, the provider, the types of services rendered, the telehealth equipment used and the way the services are coded. Those rules can now be relaxed under recent federal legislation.

On March 6, 2020, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 into law. That law relaxes the current Medicare criteria, in order to expand the use of telehealth as a resource against COVID-19. Pursuant to this law, the Secretary of HHS has the authority to waive the “site” requirements for telehealth services provided to Medicare beneficiaries who are located in an identified “Emergency Area” during an “Emergency Period.” Since the whole country is currently is experiencing a public health emergency, as declared by both the President and the Secretary of HHS, the Emergency Period and Emergency Area requirements are met on a nation-wide basis.

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