COVID-19’s greatest impact has been on the health care sector. In addition to the obvious and unprecedented emergency response, there are profound direct and indirect impacts on health care entities, their staff, and the individuals they serve. Whether it is a service cancellation, the absence or unavailability of preferred staff, or the significant disruption to service recipients’ daily routines, health care providers and patients are being forced to adapt and respond in ways that were unfathomable to many of us just a few “short” weeks ago.
Given the uncertainty of how long this will last or the magnitude of the afflicted, providers will have no option but to continue to showcase extraordinary adaptability and the perseverance necessary to meet the ongoing needs of their patients.
To address the crisis, Congress passed and President Trump signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act (HR 784), providing immense levels of public spending in an effort to assist individuals and employers during the COVID-19 health crisis, including:
- Access to low-interest business loans for small- and mid-size businesses for payroll and operations expenses and, under certain conditions for small businesses, loan forgiveness
- $100 billion in appropriations to prevent, prepare for, and respond to COVID-19 domestically and internationally and to reimburse, through grants or other mechanisms, eligible health care providers for health care-related expenses and lost revenues that are attributable to COVID-19
- Increased benefits under unemployment insurance
- Add-on Medicare payments for hospital inpatient COVID-19 patients
- Authorization for the Department of Health and Human Services secretary to make available appropriate, accelerated Medicare payments to hospitals
The CARES Act also includes a number of provisions to ease regulatory burdens or barriers to care, including:
For Community-Based Providers
- Increased utilization of telehealth services for certain health care providers, including for federally qualified health centers and rural clinics, home health and hospice for certain care, monitoring, and care planning. Similar to many recent Medicaid pronouncements, this encourages remote monitoring and check-ins while promoting social distancing.
- Authorizing nurse practitioners, physician assistants, and clinical nurse specialists to establish and review plans of care, certify the need for care, and conduct required face-to-face encounters with home care patients
- Provision of home and community-based services in acute care hospitals
For Acute and Sub-Acute Providers
- Relaxing minimum care requirements for post-acute care placements
- Suspending sequestration adjustments on Medicare payments
For All Providers
- Enacting limitations on liability for volunteer health care workers
This array of unprecedented measures designed to facilitate ongoing operations is demonstrative of the unique times and challenges currently faced by health care providers across the state and nation. However, it is important to note that many forms of the “relief” outlined above require providers to immediately focus their time and attention to avail themselves of the assistance or develop new processes and compliance protections to meet the evolving regulatory requirements. Providers must keep in mind that these changes don’t excuse them from appropriately providing and adequately documenting the care and services to support payment.
While government and private payors have suspended audit and collection activities during this crisis, providers should be prepared for these activities to resume—and be potentially expanded—once the current pandemic subsides.
Barclay Damon stands ready to help providers navigate these challenging times by offering advice and counsel on submitting financial and regulatory applications and drafting, modifying, and implementing compliance-related processes.
If you have any questions regarding the content of this alert, please contact Bob Hussar, partner, at rhussar@barclaydamon.com or another member of the firm’s Health Care & Human Services Practice Area.
We have a specific team of Barclay Damon attorneys who are actively working on assessing regulatory, legislative, and other governmental updates related to COVID-19 and who are prepared to assist clients. You can reach our COVID-19 Response Team at COVID-19ResponseTeam@barclaydamon.com.