The Office for Civil Rights (OCR) recently announced that it has entered into the 20th settlement under its Right of Access Initiative. The settlement with Children’s Hospital and Medical Center in Nebraska includes an $80,000 payment by the hospital for failing to provide a mother with timely access to her daughter’s medical records.

According to OCR, after the mother first requested the records, the hospital provided her with some of the records, but failed to provide her with missing records after repeated requests. Once OCR intervened, the hospital provided all of the records to the mother.

In addition to the monetary penalty of $80,000, the hospital entered into a Corrective Action Plan with OCR.

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On September 9, 2021 President Biden announced a COVID-19 Action Plan entitled “Path out of the Pandemic” (the “Plan”) which comprises a six-pronged national strategy aimed at combatting COVID-19. The Plan includes a number of important provisions related to health care, including implementation of COVID-19 vaccine requirements and an expansion of resources available for treatment of COVID-19. The Plan signals significant changes upcoming for health care organizations, their employees, and their patients.

The following summary addresses certain parts of the Plan with specific implications for health care, but please continue to check R+C blogs and legal updates for follow-up analysis of the specific guidance and rules that are released in furtherance of the Plan. Continue Reading Biden COVID-19 Action Plan Expands Vaccine Mandates, Testing, and Treatment to Combat Spread of Virus

On August 19, 2021, Connecticut Governor Ned Lamont issued Executive Order No. 13C (the “Order”) to expand access to COVID-19 vaccination information for patients and providers (and school nurses) as public health authorities continue to promote vaccination efforts, implement recommendations for vaccine booster shots, and as schools adopt COVID-19 control measures for returning students and staff. The Order modifies Connecticut law to allow the Commissioner of Public Health to disclose information reported to the Department of Public Health regarding a COVID-19 vaccine recipient’s immunization information– i.e., information in the state COVID-19 immunization registry – to:

  • a health care provider of a vaccine recipient or potential vaccine recipient;
  • each school nurse at a public or private school in any town, city or school district; and
  • local health directors and other public health authorities to support COVID-19 vaccination efforts within their jurisdictions.

The Order defines “health care provider” to include physicians, advanced practice registered nurses, and physician assistants licensed by the Department of Public Health, as well as any health care organization that is providing COVID-19 vaccines under a Center for Disease Control and Prevention COVID-19 Vaccination Program Provider Agreement or any officer, employee or agent thereof acting in the course and scope of his or her employment. The release of this COVID-19 immunization information must be for the purposes of reducing the spread of COVID-19 and increasing access, use, and the provision of COVID-19 vaccines. The Order also grants the Commissioner authority to issue policies and procedures necessary to administer the disclosure of COVID-19 immunization information in accordance with the Order, including the way in which such information will be disclosed to vaccine recipients.

According to a press release issued by Governor Lamont announcing the Order, the changes are intended to align access to vaccine information in Connecticut with approaches taken in at least 37 other states, including New Jersey, New York, and Rhode Island. The press release also states that the Order “will allow individuals to easily and securely access their own COVID-19 vaccine record” and suggests that the Order will remove current barriers for patients seeking to access their own COVID-19 vaccination record.

Notably, the Order takes effect immediately but will only remain in effect through September 30, 2021 unless it is earlier modified or terminated.

*This post was co-authored by Erin Howard, legal intern at Robinson+Cole. Erin is not yet admitted to practice law.

On June 7, 2021, Connecticut Governor Ned Lamont signed into law Public Act 21-26 “An Act Concerning Various Revisions to the Public Health Statutes” (the “Act”). This Act makes notable changes to laws affecting hospital and health system practices, including the following:

Hospitals Required to Give Patients Option to Contact Family or other Support Personnel Upon Admission

Existing law requires that. upon admitting a patient to a hospital, hospital personnel shall promptly ask the patient if he or she wants the hospital to notify his or her physician.  The Act expands this obligation for hospitals by also requiring them to ask if there is any family member, caregiver, or support person who should be notified about the admission. If the patient requests, the hospital personnel must then make reasonable efforts to contact the family member, caregiver, or support person as soon as practicable, but within 24 hours after the request. This requirement takes effect October 1, 2021.

Donation of Blood by 16-Year Olds

Under existing law, an individual seventeen years or older is deemed to have the capacity to consent to donate blood or any component thereof. The Act now allows any person sixteen years of age to consent to donate blood or any component thereof, with written authorization of a parent or guardian. This section became effective July 1, 2021.

Hospital Discharge Plans Can be Provided Electronically

Also effective July 1, 2021, The Act newly allows a hospital to electronically provide a discharge summary and any related materials to a patient upon discharge from the hospital, and to document acknowledgment of receipt of such materials electronically, as long as the patient agrees to electronic-only delivery.

*This post was co-authored by Erin Howard, legal intern at Robinson+Cole. Erin is not yet admitted to practice law.

In June 2021, the Centers for Medicare and Medicaid Services (CMS) issued a notable interpretation of the Physician Self-Referral Law (aka the Stark Law) in Advisory Opinion No. CMS-AO-2021-01 (Advisory Opinion) regarding whether a physician practice can furnish designated health services (DHS) through a wholly-owned subsidiary and still qualify as a group practice (as defined under the Physician Self-Referral Law) for purposes of compliance with various Physician Self-Referral Law exceptions. Continue Reading CMS Issues Advisory Opinion Clarifying Physician Self-Referral Law Group Practice Structure

On July 7, 2021, Connecticut Governor Ned Lamont signed into law Public Act 21-129 entitled “An Act Concerning Hospital Billing and Collection Efforts By Hospitals And Collection Agencies” (“the Act”). The Act expands the types of entities to which billing and collection restrictions apply, places further limitations on collection efforts by such entities, and makes several changes to Connecticut’s existing laws concerning facility fees. Continue Reading Connecticut Governor Signs Bill Limiting Hospital Billing and Collection Efforts and Revising Connecticut’s Facility Fee Laws

Below is an excerpt of a contributed article co-authored with Robinson+Cole Business Litigation Group partner Seth Orkand published in Medical Economics on July 27, 2021.

How a hodgepodge of federal and state telehealth waivers creates compliance concerns for providers practicing across state lines.

In response to the devastating COVID-19 pandemic in 2020, the federal government and state governments took a number of overlapping actions to promote telehealth as an alternative method for effectively delivering patient care while lowering risk of transmission – passing laws, updating regulations, issuing waivers and executive and agency orders, and releasing sub-regulatory guidance. Insurance companies and providers took corresponding steps to embrace telehealth, standing up new telehealth platforms and processes almost overnight. The result was a significant expansion of telehealth services, programs, and technologies that enabled patients to access critical care from the comfort of their homes, reduce the risk of transmission, and enable providers to reserve in-person care for higher acuity conditions.

These changes were crucial because regulatory and payment restrictions on telehealth limited its utility prior to the pandemic, except in certain situations and for specialized care for specific conditions. The COVID-19 expansion of telehealth resulted from a joint federal-state effort to waive, amend, and remove those restrictions. Importantly, inconsistencies in the approaches taken by states and the federal government, and inconsistent messaging from regulators, resulted in differing regulatory regimes for providers, particularly those who sought to provide care to patients across state lines, which was necessary as patients and providers scattered throughout the country in response to the pandemic. As a result, health care providers have raised questions regarding the permissibility of telehealth practice across state lines, and of potential exposure to audits for providers who have been reimbursed for telehealth services delivered to patients in states where providers may not be licensed. These questions – and the differences in approach taken between states – are becoming more acute as states terminate or allow state-level emergency declarations to expire, which in many cases end waivers that have enabled telehealth services during the pandemic. Read the article.

On July 6, 2021, Connecticut Governor Ned Lamont signed into law Public Act 21-113 titled “An Act Concerning Opioids” (PA 21-113), which establishes pilot programs to help serve persons with opioid use disorder in urban, suburban, and rural communities, and requires the Commissioner of Public Health to issue and increase awareness of chronic pain treatment guidelines. PA 21-113 became effective on July 1, 2021. Continue Reading Connecticut Legislature Passes Act to Help Address the Opioid Epidemic

On July 7, 2021 Connecticut Governor Ned Lamont signed into law Public Act 21-135 (the “Act”). The Act, among other things, makes a revision to the Department of Developmental Services (DDS) statutes allowing DDS regional or training school directors to consent to emergency care for individuals under DDS custody in certain situations.

Existing law allows a DDS regional or training school director to consent to emergency surgery for an individual under their custody or control living in a residential facility. The Act extends this authority to allow the DDS Commissioner or training school director to consent to any medical treatment or surgery when the individual’s attending physician determines that the treatment is of an emergency nature and there is insufficient time to obtain the written consent that would otherwise be required from the individual, the parent of a minor, or the individual’s legal representative. The Act also requires that the attending physician prepare a report describing the nature of the emergency which necessitated such medical treatment or surgical procedure and file a copy of such report in the patient’s record.

The Act became effective July 7, 2021.

This post was co-authored by Erin Howard, legal intern at Robinson+Cole. Erin is not yet admitted to practice law.

On June 23, 2021, Connecticut Governor Ned Lamont signed into law Public Act 21-2 “An Act Concerning Provisions Related To Revenue And Other Items To Implement The State Budget For The Biennium Ending June 30, 2023” (PA 21-2). PA 21-2 makes various changes to Connecticut law as part of implementing the Governor’s budget, including, in pertinent part, a change to statutory requirements that apply to contracts between health carriers (insurers) and participating health care providers. This provision of PA 21-2 takes effect October 1, 2021. Continue Reading Connecticut Budget Bill Includes Important Changes to Network Participation Contracts Between Health Care Providers and Insurers