New Telehealth Quality Measures, CMS Pours More Resources into Nursing Homes, Different Hospital COVID-19 Reporting Requirements, and a Proposed Rule on Grandfathered Health Plans and Coverage Banner Image

Healthcare Law Blog

New Telehealth Quality Measures, CMS Pours More Resources into Nursing Homes, Different Hospital COVID-19 Reporting Requirements, and a Proposed Rule on Grandfathered Health Plans and Coverage

July 16, 2020

For more information about this blog post, please contact Khaled J. KleleRyan M. MageeLabinot Alexander Berlajolli, or Daniel J. Parziale.

Directs Additional Resources to Nursing Homes in COVID‑19 Hotspot Areas

The Centers for Medicare &
Medicaid Services (“CMS”) announced it is
providing additional resources to nursing homes in COVID-19 hotspot
areas. CMS plans to deploy Quality Improvement Organizations
(“QIOs”) to provide immediate assistance to nursing homes. QIOs are
contractors who work with healthcare providers to help improve the quality of
healthcare provided to Medicare Beneficiaries. To facilitate these
efforts, the agency is implementing an enhanced survey process to assess the
specific concerns of hotspot areas and leverage all available resources to the
facilities with known infection control issues.

Issues New Guidance on 39 New Telehealth Eligible Clinical Quality Measures

CMS recently issued new guidance
regarding the allowance of telehealth encounters for the eligible professional/eligible
clinician electronic clinical quality measures (“eCQMs”) used in CMS quality
reporting programs for the 2021 performance period. There are 39
telehealth eligible eCQMs for the 2021 performance period and they can be found

Alters COVID-19 Reporting Protocol

On July 10, 2020 the United
States Department of Health and Human Services (“HHS”) issued new guidance on COVID-19
reporting protocols for hospitals. On March 29, 2020, Vice President Mike
Pence requested daily reports on testing, capacity, utilization, and patient
flows be sent to the United States Center for Disease Control (“CDC”) on a
daily basis. According to the new guidance, “hospitals may be relieved
from reporting directly to the federal government if they receive a written
release from the state stating that the state will collect the data from the
hospitals and take over federal reporting responsibilities.” Moreover, the
guidance clarifies that prior to a hospital seeking certification from their
state, the state “must first receive written certification from their ASPR
Regional Administrator affirming that the state has an established, functioning
data reporting stream to the federal government that is delivering all of the
information below at the appropriate daily frequency.” Finally, the guidance
still requires that states collecting this data “must provide this data,
regardless of whether they are seeking immediate federal assistance.”

Rule on Grandfathered Health Plans and Grandfathered Group Health Insurance

85 FR 42782 – Proposed Rule
– The IRS, Department of Labor and HHS released a proposed rule regarding
grandfathered group health plans and grandfathered group health insurance
coverage. The proposed rule would amend the current rules to provide
greater flexibility for certain health plans in existence before the Patient
Protection and Affordable Care Act took effect. The changes would enable
eligible plans to continue offering affordable coverage while enhancing their
ability to respond to rising healthcare costs. Group health plans would be permitted
to increase cost-sharing requirements for enrolled individuals as long as they
do not exceed certain limits. Further, in some situations, the proposed rule
would allow plans to comply with minimum cost-sharing requirements for high
deductible health plans so enrolled individuals are eligible to contribute to
health savings accounts. These proposed regulations would not apply to or
otherwise change the current requirements applicable to grandfathered
individual health insurance coverage. In addition, the proposed rules would not
provide any opportunity for a plan or coverage that has lost its grandfather
status under existing rules to regain that status. Comments must be received by
no later than 5:00 pm on August 14, 2020.

Please visit Riker Danzig’s COVID-19 Resource Center to stay up to date on all related legal issues.

Get Our Latest Insights