By Kim Stanger and Allison (Ally) Kjellander
HHS has issued helpful FAQs that answer common questions concerning the No Surprise Billing Rules and self-pay patients, available here. The FAQs confirm the following: Continue reading
By Kim Stanger and Allison (Ally) Kjellander
HHS has issued helpful FAQs that answer common questions concerning the No Surprise Billing Rules and self-pay patients, available here. The FAQs confirm the following: Continue reading
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
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
By Little V. West, Kaitlyn 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.”
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:
Continue readingBy 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:
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
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
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
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