By Kim Stanger
As discussed in our November 28 client alert, the No Surprise Billing Rules (NSBR) require that convening providers contact co-providers and include co-provider fees in the convening provider’s good faith estimate to uninsured (self-pay) patients. Continue reading
By Kim Stanger
At this time of year, healthcare providers may want to give gifts to patients, referring providers, or other sources of business, but such gifts may violate federal and state fraud and abuse laws and result in civil or criminal fines for both the giver and receiver. Continue reading
By Kim Stanger
For nearly three years, federal and state agencies have waived or relaxed regulatory requirements and expanded reimbursement for services due to the COVID-19 public health emergency (PHE), but the signs indicate that the party is nearly over. Many states have already ended their emergency exceptions, and the federal PHE appears to be coming to an end. The current 90-day PHE extension issued by the Health and Human Services (HHS) will expire January 11, 2023. (See here.) The Biden Administration has informally promised that it would notify stakeholders at least 60 days in advance of ending the PHE; consequently, there is a good chance that the PHE will be extended an additional 90 days into April 2023, but no formal announcement has issued yet. In the meantime, HHS has warned providers that most of the PHE waivers will end upon termination of the PHE and that providers should prepare now for a return to normal standards. (See CMS, “Creating a Roadmap for the End of the COVID-19 Public Health Emergency” (8/18/22), available here.) Continue reading
By Kim Stanger
Update: On December 2, 2022, HHS issued new guidance extending the January 1, 2023 compliance deadline for co-provider requirements until further rulemaking. For more information, click here. The new guidance affects the remaining content below.
Since January 1, 2022, the No Surprise Billing Rules (NSBR) have required virtually all healthcare providers to give a good faith estimate of anticipated charges to uninsured (self-pay) patients.1 Unless the Department of Health and Human Services (HHS) changes its rules, beginning January 1, 2023, the good faith estimate provided to patients will need to include the anticipated charges from co-providers or co-facilities in addition to the convening provider’s own charges. Continue reading
The U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) entered into a Voluntary Resolution Agreement (“Agreement”) with CHI St. Vincent Hot Springs (“CHI”) to ensure there are effective communication accommodations in a healthcare setting for patients who are deaf or hard of hearing. The Agreement resolves a complaint filed with OCR by an individual (“Complainant”) alleging that CHI discriminated against her based on her disabilities (deafness and Usher Syndrome) when CHI failed to provide Complainant with appropriate auxiliary aids during her September 1, 2019, Emergency Department visit. Complainant alleged that this instance violated Section 504 of the Rehabilitation Act of 1973 (“Section 504”) and Section 1557 of the Affordable Care Act of 2010 (“Section 1557”). Continue reading
By Kim Stanger
Idaho healthcare facilities and providers may struggle to understand or stay on top of the requirements of the Idaho Patient Act (“IPA”), which limits providers’ ability to pursue collection actions unless certain conditions are satisfied. To learn more about the IPA (including recent changes), see our article here.
In addition, we provide the attached Flow Chart summarizing the relevant requirements and timelines for IPA compliance. We hope that it will help our clients and friends navigate the IPA rules more easily.
By Kim Stanger
Idaho’s total abortion ban is now in effect. Effective August 25, 2022, anyone who performs an abortion of a clinically diagnosable pregnancy is guilty of a felony unless the abortion is necessary to save the life of the pregnant woman or in the case of rape or incest.1 On August 24, 2022, the United States District Court of Idaho confirmed another important exception (at least for the time being): the Court entered a preliminary injunction blocking enforcement of the total abortion ban in cases in which the Emergency Medical Transport and Active Labor Act (“EMTALA”) would require hospital-affiliated providers to perform an abortion to protect the health of the mother.2 Given these developments, we have updated our answers to common questions concerning Idaho’s abortion laws. Continue reading
By Kim Stanger
Idaho’s total abortion ban took effect August 25, 2022. Under the statute, abortion of a clinically diagnoseable pregnancy is illegal unless necessary to save the life of the mother or in the case of rape or incest. (Idaho Code 18-622). On August 24, 2022, the Federal District Court of Idaho issued a preliminary injunction prohibiting enforcement of the total abortion ban to the extent it conflicts with the Emergency Treatment and Active Labor Act (“EMTALA”). (Memorandum Decision and Order, United States v. State of Idaho, Case No. 1:22-cv-00329-BLW, available here). The net effect is that, when EMTALA applies, a physician may perform an abortion if necessary to preserve the health of the pregnant woman, not just to save her life. With that said, it is important to understand the limited scope of the EMTALA exception. Continue reading
By Kim Stanger
The turmoil over Idaho abortion laws continues. On August 12, 2022, the Idaho Supreme Court ruled that Idaho’s total abortion ban will take effect August 25, 2022. It also lifted the stay on Idaho’s Texas-style statute that allows certain family members to sue persons who perform abortions after a fetal heartbeat is detected. Planned Parenthood’s lawsuit challenging the laws will continue, but in the meantime, the laws will take effect. The Idaho Supreme Court has set a hearing on the merits of the lawsuit for September 29, 2022.
On the federal front, the Department of Justice sued Idaho, claiming that the total abortion ban is preempted by the Emergency Medical Treatment and Labor Act (“EMTALA”) for those women seeking emergency care at hospitals. The hearing on the DOJ’s motion for a preliminary injunction is set for August 22, 2022. Continue reading
By Kim Stanger
On Tuesday, July 26, the United States Supreme Court formally issued its judgment in Dobbs v. Jackson Women’s Health Organization; accordingly, Idaho’s complete abortion ban is triggered and set to take effect on August 25, 2022, unless stayed by the Idaho Supreme Court. The statute prohibits all abortions of a clinically diagnoseable pregnancy except (i) as necessary to save the life of the mother, or (ii) in the case of rape or incest provided that the rape or incest is reported to law enforcement and a copy of the report is given to the physician before the abortion. (Idaho Code 18-622). Violations may result in criminal penalties of at least $5,000, from 2 to 5 years in prison, and suspension or revocation of the physician’s license. Continue reading