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Are You Ready for It? Section 1557’s Upcoming Deadlines
/in ACABy Allison (Ally) Kjellander
The Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) published its final rules implementing the anti-discrimination provisions under Section 1557 of the Affordable Care Act (“Final Rule”) on May 6, 2024. The Final Rule applies to all health programs or activities that receive, directly or indirectly, federal financial assistance (“FFA”),1 and to all health programs or activities administered by HHS or by a Title I entity. Entities falling within one of these three categories are called “covered entities.”2 This Final Rule mimics many of the requirements from the Obama Administration’s 2016 Section 1557 Rule (“2016 Rule”).3 The Final Rule continues to prohibit discrimination on the basis of race, color, national origin, sex, age, or disability, but there are several new twists. And while many requirements under the Final Rule became effective on July 5, 2024, various provisions have staggered effectives dates. Specifically, covered entities need to be ready for the following upcoming deadlines:4 Read more
OCR Provides Guidance to the Healthcare Industry to Combat Ransomware Attacks
/in HIPAABy Allison (Ally) Kjellander
In the spirit of National Cybersecurity Awareness Month, the Office of Civil Rights (“OCR”) released a new video on October 17, 2024, to promote awareness on ransomware trends in the healthcare industry and how HIPAA subject entities can combat ransomware. OCR’s video covers breach and ransomware trend analysis, reviews OCR’s ransomware guidance and materials, analyzes ransomware attack chains, and discusses how compliance with the HIPAA Security Rule can combat ransomware. Read more
CMS Updates EMTALA Signage for Hospitals
/in EMTALABy Jay DeVoy
On August 13, 2024, the Centers for Medicare and Medicaid Services (CMS) and its Center for Clinical Standards and Quality / Quality, Safety & Oversight Group issued its memorandum QSO-24-17-EMTALA (the “Memorandum”), providing updated model signage for hospital emergency departments to use to help comply with the Emergency Medical Treatment and Labor Act (EMTALA).
EMTALA is a federal law that requires hospitals with emergency departments to screen incoming patients for emergency medical conditions and, if necessary, stabilize patients regardless of their ability to pay for treatment.1 Generally, emergency departments must screen patients who present for emergency treatment to determine whether an emergency medical condition exists and, if so, must provide further examination and treatment until the patient’s emergency medical condition is stabilized or until the patient may be transferred to another facility (such as when a higher level of care is required).2 EMTALA has received much attention in recent years, especially as it relates to the use of abortion procedures as a method of stabilizing emergency care and in relation to the laws of certain states that enacted partial or total abortion bans in the wake of the US Supreme Court’s Dobbs decision. Read more
Idaho’s New Crisis Hold Law
/in Idaho Healthcare LawBy Kim Stanger
Idaho’s new crisis hold statute takes effect October 1, 2024, and allows hospitals to temporarily detain “persons with a neurocognitive disorder who are in acute crisis due to an unidentified underlying medical condition [so they] can get the care they need and return home once the underlying medical condition is resolved.” (I.C. § 56-21011). The new statute was intended to help fill a gap created by recent amendments to Idaho’s mental hold statute. Although the new law does not provide a long-term solution for such patients, it is a step in the right direction.
MENTAL v. CRISIS HOLDS. As a general rule, hospitals must have informed consent from a competent patient or, if the patient lacks capacity to consent, from the patients’ legally authorized surrogate decision-maker2 to detain a patient and/or render necessary care. (I.C. §§ 39-4503 and -4504). If the patient or the patient’s surrogate decision-maker consents to care, there is generally no need for a mental or crisis hold: the hospital may provide care based on the patient’s or personal representative’s consent. In some cases, however, it may be necessary to initiate a mental or crisis hold to detain the patient because the patient objects to needed care, lacks capacity to consent, or consent cannot be obtained from a surrogate decision-maker. Initiating a hold may also help ensure a payer source for the care rendered. Read more
FMV for Provider Contracts: Regulatory Standards
/in Anti-Kickback, StarkBy Kim Stanger
As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. In this health law update, we summarize Stark and Anti-Kickback Statute considerations.
I. STARK (PHYSICIANS AND PHYSICIAN FAMILY MEMBERS).
The federal Ethics in Patient Referrals Act (aka Stark) prohibits physicians1 from referring certain designated health services (DHS)2 payable by Medicare or Medicaid to entities with which the physician or a family member of the physician has a financial relationship unless the arrangement is structured to fit within a statutory exception or regulatory safe harbor.3 Violations may result in significant penalties.4 Read more