Category Archives: Hospitals & Health Systems

April 27, 2020

HHS Updates Recently Issued Provider Relief Fund Terms and Conditions

By Kim Stanger

HHS has updated the Terms and Conditions and websites for two key portions of its Provider Relief Fund programs.

1. Provider Relief Funds. Over the weekend, HHS updated the Terms and Conditions and posted FAQs concerning the Provider Relief Fund, available here: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html. The new Terms and Conditions apply to the $50 billion General Distribution funds that have gone out and will go out over the next few weeks, and reaffirm reporting requirements as well as potential fraud and abuse liability for failing to comply. See https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/terms-conditions/index.html. HHS also opened the portal for those entities entitled to apply for additional General Distribution funds. https://covid19.linkhealth.com/docusign/#/step/1. The FAQs provide detailed information concerning eligibility, requirements, and information necessary to apply for additional funds. https://www.hhs.gov/sites/default/files/20200425-general-distribution-portal-faqs.pdf. Significantly, those who received the a portion of the $20 billion disbursement last week must still provide information confirming their patient revenues as well as attest to the updated Terms and Conditions relevant to that program. Continue reading

March 27, 2020

Health Provisions/Medicare & Medicare Extenders/OTC Drugs

By Karina Sargsian and Kim Stanger

The CARES Act adopts several measures to help stabilize the healthcare system, address health care issues directly and indirectly related to the current pandemic and ensure future preparedness. It also allocates $100 billion of direct funding to help hospitals keep their doors open. Many of the provisions are only tangentially related to the current pandemic, such as re-appropriations for a variety of health programs. Continue reading

November 25, 2019

CMS Issues Final Rule on Price Transparency by Healthcare Facilities

By Little V. WestKaitlyn Luck, and Lisa Carlson

On November 15, 2019, CMS issued a final rule pursuant to President Trump’s June 24, 2019, Executive Order to ensure price transparency by healthcare facilities. This price transparency rule will go into effect January 1, 2021, and will require hospitals operating within the United States to establish, update, and publicize all standard charges for all items and services provided by the hospital. Hospitals will also be required to display, in a consumer-friendly manner, standard charges for at least 300 shoppable services provided by the hospital. The stated purpose of this rule is to “increase market competition, and ultimately drive down the cost of healthcare services, making them more affordable for all patients.”

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July 15, 2019

New Patient Rights Rules for Idaho Hospitals

by Kim Stanger

The Idaho Department of Health and Welfare has implemented new patient rights rules for hospitals effective July 1, 2019.  (See IDAPA 16.03.14.220 to .350).  The rules were advanced by patient advocacy groups and, to a large degree, incorporate standards that parallel—but do not exactly mirror—existing law and/or Medicare conditions of participation for hospitals.  Because many of those regulatory conditions did not apply to critical access hospitals (“CAHs”), CAHs may need to implement new policies and procedures to satisfy the rules.  All Idaho hospitals as well as providers rendering services in hospitals should check their existing policies and practices against the new rules, including the following:

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August 8, 2018

Sports and Student Physicals: Legal Issues

By Kim Stanger

It’s that time of year when many healthcare providers offer free or discounted sports or student physicals as a community service or marketing ploy. If you participate in such programs, make sure you consider the legal issues, including the following:

  • Confirm that your malpractice insurance covers such services. Some states have statutes that protect practitioners when providing free medical services at such community events. (See, e.g., Idaho Code § 39-7701 et seq.). If you are relying on such a statute, make sure that you comply with the conditions associated with—and beware the limits to—such protection. For example, these statutes usually do not protect the provider against intentional or grossly negligent conduct. Make sure your malpractice insurance covers any gap.
  • If the student is an unemancipated minor, you likely need effective parental consent for the exam or treatment. Effective consent requires that you provide sufficient information concerning the risks, benefits, and scope of services to ensure the consent is truly informed.
  • Ensure that the student and/or their personal representative understand the limited scope of your services. You may want to have them acknowledge in writing that you are only providing the limited services associated with the program, and that you are not undertaking to provide ongoing or follow-up care unless you expressly agree otherwise.

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May 10, 2017

Admitting Privileges in Hospitals: New Idaho Law

by Kim Stanger

A new Idaho statute confirms that physician assistants and advanced practice nurses may admit patients to hospitals and other healthcare facilities if allowed by the facility’s bylaws.

Background. Historically, admitting privileges were usually reserved to physicians; however, such a limitation (whether real or imagined) seems to have become somewhat outdated given the expanding role of physician assistants and advanced practice nurses, whose licensure allows them to perform services traditionally performed by physicians. Many hospitals increasingly rely on midlevel practitioners to care for patients, especially in rural areas where physicians are in short supply or decline to participate in call coverage. The new statute resolves regulatory ambiguity concerning the authority of midlevels to admit patients. Continue reading

December 6, 2016

Liability for Non-Employees: Beware Apparent Authority

by Kim Stanger

As a general rule, hospitals and other healthcare providers are not liable for the acts of non-employed medical staff members, independent contractors or vendors; instead, each party is responsible for its own actions or those of its employees or agents who are acting within the scope of their employment or agency. However, courts are sometimes willing to hold a hospital or provider vicariously liable for the acts of non-employees under the doctrine of “apparent authority”.

Apparent Authority. In Jones v. Healthsouth Treasure Valley, for example, the Idaho Supreme Court held that a hospital might be liable for the acts of an independent contractor if: (1) the hospital’s conduct would lead a plaintiff to reasonably believe that another person acts on the hospital’s behalf (i.e., the hospital held out that other person as the hospital’s agent); and (2) the plaintiff reasonably believes that the putative agent’s services are rendered on behalf of the hospital (i.e., the plaintiff is justified in believing that the actor is acting as the agent of the hospital). (147 Idaho 109, 206 P.3d 473 (2009)). The Idaho Supreme Court recently reaffirmed the apparent authority theory in Navo v. Bingham Memorial Hospital, 160 Idaho 363, 373 P.3d 681 (2016). Continue reading

September 13, 2016

Idaho Board of Medicine Disavows the Corporate Practice of Medicine Doctrine

By Kim Stanger, Holland & Hart LLP

For decades, the Idaho Board of Medicine took the position that, with limited exceptions, the Idaho Medical Practice Act “prohibits unlicensed corporations and entities from hiring physicians as employees to provide medical services to patients.” Memo from J. Uranga to Idaho State Bd. of Medicine dated 2/26/07. This “corporate practice of medicine doctrine” had its Idaho foundation in a 1952 Idaho Supreme Court case which held that:

[n]o unlicensed person or entity may engage in the practice of the medical profession though licensed employees; nor may a licensed physician practice as an employee of an unlicensed person or entity. Such practices are contrary to public policy.

Worlton v. Davis, 73 Idaho 217, 221 (1952). The Board of Medicine warned that violations of the doctrine may result in disciplinary action against physicians and, more recently, physician assistants. Entities that improperly employed physicians or physician assistants risked the possibility of criminal action for the unauthorized practice of medicine.

Over the years, the corporate practice of medicine doctrine has been criticized as anachronistic and inconsistent with recent legislative action. See, e.g., M. Gustavson and N. Taylor, At Death’s Door—Idaho’s Corporate Practice of Medicine Doctrine, 47 Idaho L. Rev. 480 (2011). Continue reading

October 20, 2015

Nevada Supreme Court Upholds $350,000 Medical Malpractice Cap

by Brian Anderson, Holland & Hart LLP

In a unanimous decision on Friday, October 1, 2015, the Nevada Supreme Court (the Court) upheld as constitutional the state’s $350,000 statutory limitations on plaintiffs’ recovery of noneconomic damages in a medical malpractice or professional negligence suit.

In Tam v. Eighth Jud. Dist. Ct., 131 Nev. Adv. Op. 80 (Nev. Oct. 1, 2015), after the death of Charles Thomas Cornell, Sherry Cornell (individually, and as administrator of Mr. Cornell’s estate) filed a complaint against numerous defendants, including petitioner Stephen Tam, M.D., alleging medical malpractice. Dr. Tam filed a motion requesting in part that the Eighth Judicial District Court (district court) confirm that the Plaintiff’s noneconomic damages be capped pursuant to NRS 41A.035, which limits to $350,000 the recovery of a plaintiff’s noneconomic damages in a healthcare provider’s professional negligence action. The district court denied the motion, concluding that: (1) NRS 41A.035 is unconstitutional, as it violates a plaintiff’s constitutional right to trial by jury;(2) the statutory cap does not apply to the case as a whole, but a separate cap applies to each plaintiff for each of the defendants; and (3) the statutory cap does not apply to medical malpractice claims. Dr. Tam challenged the district court’s order, filing a petition for a writ of mandamus to compel the district court to vacate its order. The Court granted the petition in its entirety, holding that the district court erred in: (1) finding the statute unconstitutional; (2) finding the statutory cap applies per plaintiff and per defendant; and (3) finding the statute only applies to professional negligence and not to medical malpractice. Continue reading