Recent Adopted Statutes in New Jersey
With the approval of S2273, the School Employees’ Health Benefits Program (“SEHBP”) is required to offer, starting January 1, 2020, only three plans for medical and prescription benefits coverage: (1) New Jersey Educators Health Plan; (2) the SEHBP NJ Direct 10 plan; and (3) SEHBP NJ Direct 15 plan. Starting July 1, 2021, the SEHBP must provide a fourth plan called the Garden State Health Plan, which shall offer the same level of medical and prescription drug benefits provided by the New Jersey Educators Health Plan, except that the benefits under the Garden State Health Plan shall be available only from providers located in the State of New Jersey.
CMS Releases Updated COVID-19 Coverage FAQs
CMS has released updated FAQs regarding COVID-19 coverage issues under the Families First Coronavirus Response Act (“FFCRA”) and the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). Under FFCRA, insurers are required to cover COVID‑19 tests without patient cost-sharing.
Guidance on Contacting Patients For Plasma Donations During COVID-19
The United States Department of Health and Human Services, Office of Civil Rights (“OCR”) issued guidance regarding a health care provider’s ability to utilize a patient’s protected health information (“PHI”) to contact patients and encourage them to donate blood or plasma to help other patients suffering from COVID-19.
HHS Says Health Care Providers Will Not Have to Submit Report on How They Spent COVID-19 Relief Grants by July 10
Many providers have received funds pursuant to the Provider Relief Fund and executed the terms and conditions, which require providers to issue reports to the Department of Health and Human Services (“HHS”). However, HHS has recently announced in its FAQ, under Reporting Requirements, that recipients do not need to submit a separate quarterly report to HHS or the Pandemic Response Accountability Committee, as initially required.
Telemedicine
As we have mentioned in several of our past Updates, the federal and New Jersey governments have greatly expanded telemedicine because of COVID-19. Due to the perceived success of that expansion, the question is will the expansion, or parts of it, become permanent?
New Jersey and the Federal Government continue to revise statutes and regulations to address COVID-19. Our updates continue to focus on these revisions. For example, New Jersey is currently considering a law that delays, for nine months, the assessment that Ambulatory Surgery Centers must pay by June 15. Any Center, however, should not wait until June 15 to determine if the law passes. Call the Department of Health and ask for an extension to pay the assessment.
Although everyone’s attention has been focused on COVID-19, other aspects of health care continue to move forward. This update focuses on non-COVID-19 issues like five recent federal proposed payment rules, the recent Medicare Advantage Rate Announcement, and critical federal litigation.
Skilled Nursing Homes
The Centers for Medicare & Medicaid Services ("CMS") recently announced a new independent Commission that will conduct a comprehensive assessment of the nursing home response to COVID-19.
CMS Makes a Second Set of Sweeping Regulatory Waivers
On April 30, 2020, the Centers for Medicare & Medicaid Services ("CMS") issued a press release announcing another round of sweeping regulatory changes giving physicians, hospitals and other healthcare organizations greater flexibility in responding to COVID-19. These new changes build on the broad changes CMS issued in March 2020 as outlined in our previous Update.
$20 Billion in Grant Money
In our previous update, we noted that CMS issued $30 billion out of the $100 billion in grant money under the CARES Act (the “Provider Relief Fund”). As of April 24, 2020, CMS issued the $30 billion, and providers were not required to engage in any activity or application to get those funds, with the exception of attesting to the terms and conditions within thirty (30) days of receiving the funds through the Provider Attestation Portal.
