The Biden Administration’s Potential Impact on Health Care

Congress and the Biden Administration are grappling with an economic stimulus bill that will touch many segments of American life, including health care, if it passes in the Senate. This has many clients wondering what impact the Biden Administration will have on the healthcare sector from a regulatory perspective. Early indications point to a focus on four issues that continue to resound: the Affordable Care Act (“ACA”), COVID-19-related regulatory relief, lowering prescription drug prices and restricting the occurrence of surprise billing.

The ACA

To strengthen the ACA ...

Can a Healthcare Provider Require Employees to Take a COVID-19 Vaccine?

As pandemic restrictions begin to lift and the prospect of employees returning to the workplace becomes a reality, many employers are wondering, whether they can or should make the COVID-19 vaccine a mandatory requirement as a condition of employment or continued employment. The short answer is, per recent EEOC guidance, employers can require employees to be vaccinated, subject to certain exceptions, requirements and caveats discussed below. However, a critical issue is whether employers should mandate COVID-19 vaccinations. First, many states like California have not ...

New Disclosure Requirements for Those that Contract with ERISA Group Health Plans

Included within the 5539 pages of statutory changes in the Consolidated Appropriations Act, 2021 (the COVID-19 relief bill signed into law at the end of December 2020) are important new “transparency” laws that affect third party administrators and other providers who contract with ERISA-regulated group health plans for certain brokerage and consulting services.

Section 202

Section 202 of the new law requires “covered service providers” who enter into contracts or arrangements with ERISA-regulated group health plans to disclose direct and indirect compensation ...

Cities Consider Creating Their Own Public Health Departments

In response to public health restrictions ordered by county health departments and the resulting disruption of local business, a number of California cities are exploring whether or not to create their own health departments. While city health departments were common in California during the 1800s and early 1900s, most cities deferred this governmental function to the better-equipped county level. A number of California statutes empower city governments to create their own health departments.

There are four California cities that have historically maintained their own ...

California Nurse Practitioners Eligible for Greater Practice Independence in 2021

On September 29, 2020, California Governor Gavin Newsom signed Assembly Bill 890 into law, launching significant changes to the scope of practice for Nurse Practitioners (“NPs”) over the next few years.

Changes to Scope of Practice Effective in 2021

Effective January 1, 2021, NPs who meet certain education and training requirements will be able to perform certain functions without standardized procedures in specified healthcare settings where one or more physicians practice with the NP, such as a clinic, acute care hospital, state hospital, medical group practice and other ...

Posted in COVID-19
Healthcare Providers’ Crisis Care Guidelines in Light of Recent OCR and CDPH Guidance

Faced with an ongoing public health emergency that threatens to overload healthcare systems, many states, including California, have developed or revisited their crisis care guidelines to address a potential COVID-19 patient surge. Many of these provide a framework, guided by ethical principles and a commitment to treating patients with equity, for hospitals, county health departments and healthcare providers to plan for the potential allocation of critical care resources (such as ventilators) should they become scarce.

The California Department of Public Health ...

DOJ Broadly Applies New Kickback Law Beyond Its Original Opioid-Related Purpose

On October 24, 2018, Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”), two sections of which constitute the Eliminating Kickbacks in Recovery Act of 2018 (“EKRA”). EKRA was codified at 18 U.S.C. § 220.

Similar to the Anti-Kickback Statute, EKRA was enacted to address abusive payment arrangements but intended for the context of opioid epidemic treatment and recovery efforts. Specifically, EKRA prohibits the knowing and willful (1) solicitation or receipt of ...

Department of Consumer Affairs Waives Physician Assistant Supervision Requirements to Make More Providers Available for COVID Surge

California Governor Gavin Newsom’s March 30th Executive Order authorized the Department of Consumer Affairs to issue waivers of certain laws and regulations pertaining to healthcare licensees. On April 14th, the Department of Consumer Affairs issued Waiver Order 20-04, waiving certain key restrictions on physician assistants’ (“PAs’”) supervision.

The waiver order “only applies if” a PA moves to a hospital or practice setting “to assist with the COVID-19 response”; or, if no supervising physician is available to supervise the PA pursuant to a practice ...

Paycheck Protection Program and Health Care Enhancement Act

On April 21, 2020, the United States Senate passed the Paycheck Protection Program and Health Care Enhancement Act (the Act). The House is expected to pass the Act and send it to the President on April 23, 2020. Broadly speaking, the Act amends the CARES Act to provide additional funding for the Paycheck Protection Program, hospitals and providers, and includes funding for coronavirus testing.

The Act provides an additional $75 billion on top of the $100 billion appropriated in the CARES Act for the Public Health and Social Services Emergency Fund of the Department of Health and Human ...

CMS Expands the Accelerated and Advance Payment Program in Response to COVID-19

On March 28, 2020, the Centers for Medicare & Medicaid Services (“CMS”) announced that the agency would provide relief to Medicare providers and suppliers by expanding the Accelerated and Advance Payment Program for the duration of the COVID-19 public health emergency.  According to CMS’ guidance, to qualify for accelerated or advance payments, the provider or supplier must:

  • Have billed Medicare for claims within the prior 180 days
  • Not be in bankruptcy
  • Not be under active medical review or program integrity investigation
  • Not have any outstanding delinquent Medicare ...

Our Health Law Ticker is a one-stop resource for everything new and noteworthy in healthcare law. We cover recent developments in healthcare legislation, healthcare reform, Medicare/Medicaid, managed care, litigation, regulatory compliance, HIPAA, privacy, peer review, medical staffs and general business operations for healthcare companies and licensed healthcare professionals.

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