Category Archives: Idaho Healthcare Law

August 25, 2020

Idaho COVID-Related Civil Liability Immunity – Special Session Legislation

By William Myers III

When Gov. Little called the Legislature into Special Session on August 24th, he did so with a proclamation that attached draft legislation establishing immunity from liability when a person or company makes “good faith efforts” to undertake activities safely during the coronavirus emergency.

The draft legislation must be introduced and passed in the House and Senate and that has not happened as of this writing. However, a review of the draft bill attached to the Governor’s proclamation gives an idea where the legislation may go. Continue reading →

March 11, 2020

Update on Corporate Practice of Medicine Under Idaho Law

By Gabriel (Gabe) Hamilton

Republished with permission, this article originally appeared in the online edition of Idaho State Bar’s The Advocate on March 11, 2020.

In 2016, the Idaho Board of Medicine abandoned its position that Idaho law prohibits physicians from being employed by non-physicians. The Board’s new position removes obstacles to non-physician investments in medical practices and other transactions that previously were prohibited by the Board’s enforcement of an antiquated rule known as the corporate practice of medicine doctrine (“COPM”). Continue reading →

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:

Continue reading →

June 24, 2019

Mental Holds in Idaho

By Kim Stanger

In Idaho, a competent patient generally has the right to consent to or refuse their own healthcare. By statute,

Any person who comprehends the need for, the nature of and the significant risks ordinarily inherent in any contemplated health care is competent to consent thereto on his or her own behalf. Any healthcare provider may provide such health care and services in reliance upon such consent if the consenting person appears to possess such requisite comprehension at the time of giving the consent. Continue reading →

October 10, 2018

Producing Records of Other Providers

by Kim Stanger

There is a common misunderstanding that healthcare providers may not or should not produce medical records that were created by another healthcare provider.

Under HIPAA, patients have a right to access all records that a provider maintains in a designated record set, i.e., documents the provider uses to make decisions about a patient’s healthcare or payment for healthcare. (45 CFR 164.524). This would generally include records the provider obtains or receives from other providers relating to the patient’s care. Thus, providers generally must produce such records in response to the patient’s request; failure to do so would violate HIPAA. The OCR published the following FAQ relevant to this issue:

A provider might have a patient’s medical record that contains older portions of a medical record that were created by another previous provider. Will the HIPAA Privacy Rule permit a provider who is a covered entity to disclose a complete medical record even though portions of the record were created by other providers?

Answer: Yes, the Privacy Rule permits a provider who is a covered entity to disclose a complete medical record including portions that were created by another provider, assuming that the disclosure is for a purpose permitted by the Privacy Rule, such as treatment. Continue reading →

October 5, 2018

Idaho Fraud and Abuse Statutes: Requirements, Penalties and Repayments

By Kim Stanger

Most Idaho healthcare providers are—or should be—aware of federal fraud and abuse laws, including the False Claims Act, Anti-Kickback Statute, Ethics in Patient Referrals Act (“Stark”), and the Civil Monetary Penalties Law, but they may not realize that Idaho has its own fraud and abuse laws that also apply. Violations may result in criminal, civil, and administrative penalties in addition to the obligation to repay amounts received in violation of the rules and provider agreement.

1. Idaho Anti-Kickback Statute. It is illegal for a health care provider to engage in the following misconduct:

(1)(a) Knowing that the payment is for the referral of a claimant to a service provider, either to accept payment from a [healthcare] provider or, being a [healthcare] provider, to pay another; or

(b) To provide or claim or represent to have provided services to a claimant, knowing the claimant was referred in violation of paragraph (a); [or]

(2) [E]ngage in a regular practice of waiving, rebating, giving, paying, or offering to waive, rebate, give or pay all or part of a claimant’s deductible or claim for casualty, disability insurance, worker’s compensation insurance, health insurance or property insurance.

(Idaho Code § 41-348). The statute applies to referrals for “health care services”, which are defined as “a service provided to a claimant for treatment of physical or mental illness or injury arising in whole or substantial part from trauma.” (Id. at § 41-348(2)). Violations may result in civil monetary penalties of up to $5,000. (Id. at §§ 41-348(4) and 41-347(1)). Significantly, the Idaho statute is broader than its federal counterpart: it applies to services payable by private payers as well as government programs. Continue reading →