Its Raining Regs COVID19 Legal Updates Megan Harkins

It’s Raining Regs COVID-19 Legal Updates

Megan Harkins Assistant General Counsel at Village. MD Compliance Guru Page 2 All information in this deck is confidential – property of Village. MD

Downpour of legal changes related to COVID-19 We have heard 670 federal announcements as of 5/1/2020 • National emergency declaration • State disaster declarations • Expedited treatment – diagnostic tests, vaccines, etc. • HIPAA enforcement discretion • Accelerated and Advanced Payment • Blanket waiver of Stark law • Cost sharing waiver • CARES Act Page 3 • Telehealth waivers • Quality Payment Program – relaxing reporting requirements • Medicare Provider Enrollment Relief • And many, many more! • FFCRA All information in this deck is confidential – property of Village. MD

We're Trying To Keep You Informed. . . 175 19 Page 4 from CMS 146 Were focused on PPE from DEA 34 51 Were focused on money 36 Were focused on telehealth were focused on reducing regulatory or administrative burdens (waivers, flexibilities, blanket waivers, etc. ) All information in this deck is confidential – property of Village. MD

Biggest Impact for Primary Care Page 5 Employer Duties Cash & Other Relief Telemedicine Treating COVID Focus on COVID Workforce waivers & expansion of physician supervision flexibility All information in this deck is confidential – property of Village. MD

Cash Relief for Physician Practices Accelerated and advanced payment • Up to 3 months • Repayment begins 120 days post-cash receipt • Apply via local MAC • 10. 25% interest rate for any payments not returned at the end of the recoupment period Page 6 PPP (Forgivable loan) • Up to 2. 5 x avg. monthly payroll • Under $1 M, turned around in 26 hours • Limits: can’t make material layoffs or reductions if you want loan forgiveness • Apply through SBA EIDL (Non forgivable loan) • Up to $2 M • Up to $10, 000 in three days • Limits: excludes from PPP eligibility; limited uses • Apply through the SBA Financial Relief Reimbursement portal • Medicare reimbursement increase (2%) • For uninsured individuals seeking care • Payment deferment o Payroll taxes o Existing SBA loan • Compensated at the Medicare rate • Tax credits o Employee retention o Net Operating Loss All information in this deck is confidential – property of Village. MD If you need help, talk to Village. MD

Workforce and COVID-19 You have the questions, we have the tools • Can you send someone home who is sick? • Do you pay them for time off? Caregiving • Can an employee stay home to care for a child or family member? Return to work Working sick Page 7 • What medical evidence (if any) should we require before someone can return to work? All information in this deck is confidential – property of Village. MD

Focus on COVID • Suspend certain paperwork requirements and reduced MIPS reporting • Suspend Medicare/Medicaid audits • Expand telemedicine and remote patient care services Page 8 All information in this deck is confidential – property of Village. MD

Telehealth – Here To Stay CMS has expanded telemedicine substantially with this COVID-19 pandemic. These requirements do continue to change and there are specific state laws that apply. Stay tuned for a future episode about telehealth content! Page 9 All information in this deck is confidential – property of Village. MD

Workforce waivers & expansion of physician supervision flexibility • Medicare physician supervision requirements • Scope of practice • Providing services out of state • Expedited provider enrollment • DEA reciprocity Page 10 All information in this deck is confidential – property of Village. MD

Each state is unique Village. MD States: • • • Page 11 Texas Arizona Illinois Indiana • • Georgia Michigan New Hampshire Kentucky Blanket waivers are available if states apply GA has approved Medicaid waiver All information in this deck is confidential – property of Village. MD

Treating COVID • FDA actions to expedite approvals for certain treatments • FDA are releasing warning letters about dangerous treatments • CDC guidelines continue to change with sterilization and PPE practices • Expansion of hospitals and workforce • Lightened restrictions on controlled substances prescriptions • New codes for COVID-19 billing • Lighten FDA restrictions for blood donors Page 12 All information in this deck is confidential – property of Village. MD

Here Comes The Sun Returning to Work Guidelines Wash your hands and disinfect surfaces Page 13 Encourage social distancing Have an interactive conversation with staff who may request an accommodation All information in this deck is confidential – property of Village. MD Wear protective gear (e. g. PPE, face mask, gloves, etc)

HOUSEKEEPING Terms of use Working Smarter podcasts are compliance and legal training for Village. MD employees, partners and affiliates. Written and audio content is property of Village. MD. Working Smarter material designed by Morgan Logan. Unauthorized use is prohibited in accordance with the Village. MD podcast terms of use. Available by request at wrubas@villagemd. com Questions? Concerns? Email: wrubas@villagemd. com Full content Like and subscribe to Village. MD Podcast channel so that you can receive notifications of new content. Page 14 All information in this deck is confidential – property of Village. MD