Showing posts with label WV. Show all posts
Showing posts with label WV. Show all posts

Tuesday, April 07, 2020

COVID-19 Pandemic - West Virginia and Federal Health Care and Legal Resources UPDATED

Prepared and updated by Bob Coffield, Flaherty Sensabaugh Bonasso PLLC
LAST UPDATED: 4/7/2020

We all are working to adapt to the volatile and fluid nature of the changes brought on by the COVID-19 pandemic. I hope this post finds you well, at your home and social distancing. Mountaineers are always free (montani semper liberi), but today and going forward please follow the "stay at home" order issued by the State of West Virginia. Let's bend and flatten this curve West Virginians along with the help of all humans around our globe.

It remains difficult to grasp and stay up to date on the fluid nature of the changing information relevant to our health care and business clients. The legal and regulatory landscape is in constant flux and a lot of questions are arising from our clients. As our health care law team works remotely to stay connected, share information, and attempts to analyze the most recent changes from the various state and federal agencies which regulate and oversee health care providers and the industry, we have pulled together this "resource" page post. We are regularly checking these various aggregation points for new or updated information that are specifically related to West Virginia. We thought it would be valuable to have an access point where not only we can go, but the general public can go, to access the latest information. 

We will be adding and updating these resources as we go forward. If you know of any resource that we have not included, please leave a comment or send us an email. We will assess the information and consider adding it to the resource materials.

COVID-19 Data Resources and Real Time Tracking of the COVID-19 Crisis:
  • The COVID Tracking Project - Most Recent Data (by state). The COVID Tracking Project collects information from 50 US states, the District of Columbia, and 5 other US territories to provide the most comprehensive testing data we can collect for the novel coronavirus, SARS-CoV-2. We attempt to report positive and negative results, pending tests, and total people tested for each state or district currently reporting that data.
State of West Virginia Health Care Regulatory Agencies and Departments (including a short description of the scope of each agency/department along with a list of current COVID resources):
  • Office of Health Facility Licensure and Certification (OHFLAC): OHFLAC’s primary functions are processing licensure application and investigating complaints filed against its regulated health care facilities. OHFLAC supervises eight programs: Administration; Behavioral Health Program; Chronic Pain Management Clinic Program; Life Safety Program; Medicare/Hospital Program; Nurse Aide Program; Nursing Home Program; and Assisted Living Program.
    • 3/12/2020 announcement in response to COVID-19, including reporting requirements for all West Virginia providers to report "any postive COVID-19 illness in patients/residents/clients and employees to the local health department and OHFLAC". The notification requirements and information that must be reported are listed on this announcement.
  • Office of the West Virginia Attorney General: The Office of the Attorney General is responsible for prosecuting and defending legal actions on behalf of the State, and for ensuring that the rights of the State and its citizens are protected in matters before the circuit courts of this State, the West Virginia Supreme Court of Appeals, and all federal courts. The Attorney General is entrusted with enforcing the laws of the State as they relate to consumer protection, unfair trade practices, civil rights, and other important areas. 
    • No current information/updates.
  • West Virginia Board of Occupational Therapy: The West Virginia Board of Occupational Therapy regulates and licenses persons providing occupational therapy services to the general public in the State of West Virginia. The Board's purposes are to protect consumers and promote quality of occupational therapy services, and to assure the highest degree of professional care and conduct on the part of occupational therapist and occupational therapist assistants. 
    • West Virginia Board of Physical Therapy: The WVBOPT is a state regulatory board created by the WV Legislature to regulate the practice of physical therapy and athletic training in order to protect the public from the unauthorized, unqualified and unregulated practice of physical therapy. The WVBOPT is a part of the Executive Branch of the Government which enforces laws. 
    • West Virginia Registered Nursing Board: The WV RN Board promotes and protects public health, safety, and welfare through the regulation of registered professional nurses, advance practice registered nurses and dialysis technicians. The WV RN Board also oversees the prescriptive authority privileges through collaborative practice agreements.
      • COVID-19 Information. Per this summary, the West Virginia RN Board by vote, has suspended some rules to expedite licensure. These rule suspensions are TEMPORARY in nature and all suspended requirements will have to be fulfilled after the emergency order is lifted.
        • Bullet Points for Board Voted Suspended Rules On 3/20/2020:
          • A Criminal Background Check (CBC) will still be required. However, if the facility where the applicant would go is closed and there isn’t one within a 50 mile radius then the applicant does NOT have to get the CBC. The applicant would have get the CBC as soon as other fingerprinting resources are available or within 30 days of the lifting of the State of Emergency, whichever comes first.
          • The temporary permit (TP) is extended for more than 90 days. Therefore, the applicant would be able to have a temporary permit for more than 90 days. This applies to both exam applicants and endorsement applicants.
          • Verifications do not have to be requested by applicants through NURSYS. The Board will utilize NURSYS and individual state websites.
          • For limited prescriptive authority, the applicant does not have to provide documentation of pharmacotherapy in the clinical practice.
          • Reinstatement applicants will not have to provide continuing education.
        • Bullet Points from the Governor’s Signed Executive Order on 3/23/2020 (but see Executive Order 12-20 issued 3/26/2020, which rescinded the suspension of certain requirements):
          • If a person is licensed in another state as a RN or APRN a WV license is NOT required to practice in WV as long as disciplinary action hasn’t been taken or there is none pending.
          • There is no renewal of licenses.
          • CRNAs can administer anesthesia without supervision. Suspension Rescinded by Governor 3/26/2020
          • APRNs with prescriptive authority do not need a collaborative physician. Suspension Rescinded by Governor 3/26/2020 
          • No limitation on prescriptive writing privileges for APRNs with prescriptive authority as to prescriptive formulary limitations, prescriptive refill and supply limitations. Suspension Rescinded by Governor 3/26/2020
          • Continuing education not required for APRNs. Suspension Rescinded by Governor 3/26/2020
          • Disciplinary timelines for hearings are waived and may be conducted by telephone at the discretion of the agency.
    • West Virginia State Board of Examiners for Licensed Practical Nurses: The WV LPN Board is a legally constituted agency of State government established by the West Virginia Legislature. The Board promotes and protects the public health, safety and welfare through licensure of practical nurses. 
      • Notice: The West Virginia LPN Board is instituting policies of social distancing to make our workplace as safe as possible. Staff who are able to perform their duties from home are working remotely. For a quicker response please use the message center in the nurse portal.
    • West Virginia State Tax Department: The State Tax Department’s primary mission is to collect and accurately assess taxes due to the State of West Virginia in support of State services and programs.
      • Coronavirus 2019 (COVID 19) Response
      • 3/25/2020 letter by Senate President Carmichael and House Speaker Hanshaw among other West Virginia Legislators requesting Governor Justice to issue an Executive Order extending the deadline for filing state income tax returns in West Virginia from April 15 to July 15. (via @BradMcElhinny tweet).
      • In his press conference held at 3:00 PM, March 25, Governor Jim Justice stated, “I have instructed State Tax Commissioner Dale Steager to extend the West Virginia state tax filing and payment deadline to July 15, 2020, to align with the Federal tax filing deadline.” The Administrative Order will be posted on the State Tax Department’s website at tax.wv.gov by end of day tomorrow, March 26.
    West Virginia Hospitals and Health Care Systems Information: 
    • Charleston Area Medical Center (CAMC): 
    Federal Legislation and Information: 
    • CMS Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (Interim Final Rule with comment period), issued 3/26/2020 and applicable beginning on 3/1/2020. This interim final rule with comment period (IFC) gives individuals and entities that provide services to Medicare beneficiaries needed flexibilities to respond effectively to the serious public health threats posed by the spread of the 2019 Novel Coronavirus (COVID-19). Recognizing the urgency of this situation, and understanding that some pre-existing Medicare payment rules may inhibit innovative uses of technology and capacity that might otherwise be effective in the efforts to mitigate the impact of the pandemic on Medicare beneficiaries and the American public, we are changing Medicare payment rules during the Public Health Emergency (PHE) for the COVID-19 pandemic so that physicians and other practitioners, home health and hospice providers, inpatient rehabilitation facilities, rural health clinics (RHCs), and federally qualified health centers (FQHCs) are allowed broad flexibilities to furnish services using remote communications technology to avoid exposure risks to health care providers, patients, and the community. We are also altering the applicable payment policies to provide specimen collection fees for independent laboratories collecting specimens from beneficiaries who are homebound or inpatients (not in a hospital) for COVID-19 testing. We are also expanding, on an interim basis, the list of destinations for which Medicare covers ambulance transports under Medicare Part B. In addition, we are making programmatic changes to the Medicare Diabetes Prevention Program (MDPP) and the Comprehensive Care for Joint Replacement (CJR) Model in light of the PHE, and program-specific requirements for the Quality Payment Program to avoid inadvertently creating incentives to place cost considerations above patient safety. This IFC will modify the calculation of the 2021 and 2022 Part C and D Star Ratings to address the expected disruption to data collection and measure scores posed by the COVID-19 pandemic and also to avoid inadvertently creating incentives to place cost considerations above patient safety. This rule also amends the Medicaid home health regulations to allow other licensed practitioners to order home health services, for the period of this PHE for the COVID-19 pandemic in accordance with state scope of practice laws. We are also modifying our under arrangements policy during the PHE for the COVID-19 pandemic so that hospitals are allowed broader flexibilities to furnish inpatient services, including routine services outside the hospital.
    • KFF Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19. This page aggregates tracking information on approved Medicaid emergency authorities to address the COVID-19 Coronavirus emergency. We currently include details on Section 1135 waivers and 1915 (c) Waiver Appendix K strategies, but will update soon to add additional emergency authorities.
    Other Guidance, Resources and Information: 
    Posted by Bob Coffield at 12:47 PM 0 comments
    Labels: , , , , , ,

    COVID-19 Emergency Response and Information by the Supreme Court of West Virginia, West Virginia State Bar and Other Legal Agencies UPDATED 4/27/2020

    Written by Bob Coffield, Flaherty Sensabaugh Bonasso PLLC

    As a result of the ongoing COVID-19 pandemic, the Supreme Court of West Virginia, the West Virginia State Bar and other state agencies have taken various actions and issued orders in response to the ongoing COVID-19 crisis. Below are website resources, orders and summary of some of the actions taken in response. This list is not comprehensive and is likely subject to change in the coming days and months. Please advise me of any additional information or resources in the comments. Thanks to the West Virginia State Bar Blast for pushing out some of this information. I recommend that lawyers and law firms providing legal services in West Virginia regularly check the websites of both the Supreme Court and the West Virginia Bar for the latest updated information.
    • Supreme Court of West Virginia - Pandemic Response Documents. The following documents are being issued to govern operations by courts throughout the State of West Virginia in order to protect the health and well-being of court employees, litigants, witnesses, jurors, attorneys, and the general public. 
      • Temporary Order Regarding Civil Litigation and Rules of Civil Procedure in Circuit Court, Docket No. 20-Rules-04, April 24, 2020. This Temporary Order, "temporarily amend[s] certain rules governing the conduct of civil litigation under the West Virginia Rules of Civil Procedure. Access to the courts requires that parties have the ability to conduct proceedings in civil cases, including hearings, depositions and meditations, as long as such proceedings are conducted remotely and consistent with the consent requirements and authority of the judicial officer to determine the reasonableness of a party's refusal to consent, as contained in the Second Amended Order." Lawyers currently handling litigation matters in West Virginia should consult this Temporary Order. The Temporary Order contains significant details on holdings hearings, motions, written discovery, depositions, etc. 
      • Administrative Order re: Judicial Emergency Declared, Second Amended Order, April 22, 2020. This Second Amended Order extends the March 22, 2020 Administrative Order and adjusts the emergency order for deadlines set to expire between March 23, 2020 and May 15, 2020, and extended through May 18, 2020, for all 55 counties in West Virginia. The Second Amended Order further provides other direction regarding limited emergency proceedings and affirmatively states that circuit court judges, family court judges, and magistrates may conduct hearings, proceedings, or bench trials via telephone or video conferencing in non-emergency matters upon mutual consent of the parties. 
      • Administrative Order Re: Judicial Emergency Declared, March 22, 2020. This Administrative Order declares a judicial emergency in all 55 counties in West Virginia from March 23, 2020 through April 10, 2020. Pursuant to West Virginia Code 2-2-2(a), all proceedings and court deadlines, except emergency proceedings, directed to take place or any act required to be done on any day falling within this period of judicial emergency, are stayed. Deadlines in court rules, statutes, ordinances, administrative rules, scheduling orders, or otherwise that are set to expire between March 23, 2020 and April 10, 2020, are extended to April 11, 2020. Statutes of limitations and statues of repose that would expire during such period are extended to April 11, 2020. Proceedings previously scheduled between these dates are continued generally until a later date determined by the presiding judicial officer. The Court may extend this order in the event the public health crisis continues. 
      • Administrative Order, Supreme Court of Appeals of West Virginia, March 16, 2020. This Administrative Order applies to all courts of West Virginia from March 16, 2020 through April 10, 2020, and requires that all civil and criminal trials, and jury orientations scheduled during this time shall be continued generally, except where a criminal defendant's speedy trial rights may preclude continuation. The Administrative Order outlines emergency matters, including domestic violence petitions, child abuse and neglect petitions, mental hygiene petitions. Further, it provides that all hearings shall either be postponed or held by telephonic or video technology. Judicial office or clerk's offices around the state shall remain accessible by telephone and email to the extent possible if closed to the public. 
      • COVID-19 Planning Document, Supreme Court of Appeals of West Virginia, March 12, 2020. This document provides direction from the Supreme Court of Appeals of West Virginia to all court systems, court affiliates, and court personnel throughout West Virginia, The Courts and the judicial system shall remain open and function as normally as possible absent specific direction from the Supreme Court of Appeals of West Virginia.
    • West Virginia State Bar - WV State Bar COVID-19 Response Plan (Updated March 20, 2020). This provides lawyers, law firms and judicial officers/staff various resource materials related to the pandemic preparedness., including vendors for teleconference/video conferencing platforms, virtual work policies/guides, virtual client services, virtual meeting tips, etc. 
    • West Virginia State Bar - Temporary Waiver of Online Continuing Legal Education Credit Limit, issued March 12, 2020. Click here for full Order In re: Temporary Waiver of Online CLE Credit Limitation, No.20-Rules-02. The Supreme Court of Appeals of West Virginia granted a request from the Mandatory Continuing Legal Education Commission for a temporary waiver of current CLE rules and regulations which limit the CLE credits for online and in-house credits to 12 credits, or half of the mandatory continuing legal education requirements. Attorneys will now be able to earn all or any portion of the required 24 CLE credit minimum through video, audio, correspondence, telephone seminars, computer-based training courses and in-house instruction, so long as the courses otherwise satisfy the requirements of the CLE rules and regulations and are approved for CLE credit in West Virginia. The temporary waiver is limited to the 2018-2020 reporting period ending June 30, 2020. 
    • West Virginia Division of Corrections and Rehabilitation COVID-19 Policy. The West Virginia Division of Corrections and Rehabilitation has suspended all non-lawyer visitation at all West Virginia correctional facilities.  Attorneys will still be able to visit their client in person, but will be subject to a screening process (questions and observation) to determine if they have symptoms of the Coronavirus.  Attorneys that do not want to consult or visit in person may meet with their client via video conferencing.  The attorney will need to make arrangement with the correctional facility.
    • Social Security Administration COVID-19 Policy. The Social Security Committee Chairperson has advised the State Bar that in an effort to stop the spread of Coronavirus/ COVID - 19, the Social Security Administration, Office of Hearings Operations, Charleston, WV closed to the public on March 17, 2020 until further notice.  We will be reaching out proactively to our patrons to discuss options for continuing holding scheduled hearings. We will be offering telephone hearings whenever possible. We will also provide video hearings if the representative has a Representative Video Unit and we are able to continue with the hearing via video in one of our local offices.
    Posted by Bob Coffield at 9:57 AM 0 comments
    Labels: , , , , , , , ,

    Thursday, March 26, 2020

    COVID: Office for Civil Rights Issues Guidance on How Covered Entities May Disclose PHI About an Individual Infected/Exposed to COVID-19

    Written by Bob Coffield, Flahety Sensabaugh Bonasso PLLC

    On March 24, 2020, the Office for Civil Rights (OCR), U.S Department of Health and Human Services issued the following guidance document related to the ongoing COVID crisis, COVID-19 and HIPAA: Disclosures to law enforcement, paramedics,other first responders and public health authorities.

    The OCR guidance indicates that covered entities (hospitals, physicians, long term care facilities, home health agencies, and other providers) may disclose protected health information (PHI) about an individual who has been infected with or exposed to COVID-19 to law enforcement, paramedics, other first responders, and public health authorities in compliance with the Health Insurance Portability and Accountability Act of 1996 under the Privacy Rule  (HIPAA). The PHI can be disclosed by the covered entity without first obtaining the individual's HIPAA authorization. 

    The guidance explains the circumstances under which a covered entity may disclose PHI such as the name or other identifying information about individuals, without their HIPAA authorization, and provides examples including:
    • When needed to provide treatment;
    • When required by law;
    • When first responders may be at risk for an infection; and
    • When disclosure is necessary to prevent or lessen a serious and imminent threat.
    This guidance clarifies the regulatory permissions that covered entities may use to disclose PHI to first responders and others so they can take extra precautions or use personal protective equipment. The guidance also includes a reminder that generally, covered entities must make reasonable efforts to limit the PHI used or disclosed to that which is the "minimum necessary" to accomplish the purpose for the disclosure. 

    Examples outlined in the guidance include the following: 
    • HIPAA permits a covered skilled nursing facility to disclose PHI about an individual who has COVID-19 to emergency medical transport personnel who will provide treatment while transporting the individual to a hospital’s emergency department. 45 CFR 164.502(a)(1)(ii); 45 CFR 164.506(c)(2).
    • HIPAA permits a covered entity, such as a hospital, to disclose PHI about an individual who tests positive for COVID-19 in accordance with a state law requiring the reporting of confirmed or suspected cases of infectious disease to public health officials. 45 CFR 164.512(a). 
    • HIPAA permits a covered entity to disclose PHI to a public health authority (such as the Centers for Disease Control and Prevention (CDC), or state, tribal, local, and territorial public health departments) that is authorized by law to collect or receive PHI for the purpose of preventing or controlling disease, injury, or disability, including for public health surveillance, public health investigations, and public health interventions. 45 CFR 164.512(b)(1)(i); see also 45 CFR 164.501 (providing the definition of “public health authority”).
    • HIPAA permits a covered county health department, in accordance with a state law, to disclose PHI to a police officer or other person who may come into contact with a person who tested positive for COVID-19, for purposes of preventing or controlling the spread of COVID-19. 45 CFR 164.512(b)(1)(iv).
    • HIPAA permits a covered entity, consistent with applicable law and standards of ethical conduct, to disclose PHI about individuals who have tested positive for COVID-19 to fire department personnel, child welfare workers, mental health crisis services personnel, or others charged with protecting the health or safety of the public if the covered entity believes in good faith that the disclosure of the information is necessary to prevent or minimize the threat of imminent exposure to such personnel in the discharge of their duties. 45 CFR 164.512(j)(1).
    • HIPAA permits a covered entity, such as a physician, located at a prison medical facility to share an inmate’s positive COVID-19 test results with correctional guards at the facility for the health and safety of all people at the facility. 45 CFR 164.512(k)(5).
    • A covered entity, such as a hospital, may provide a list of the names and addresses of all individuals it knows to have tested positive, or received treatment, for COVID-19 to an EMS dispatch for use on a per-call basis. The EMS dispatch (even if it is a covered entity) would be allowed to use information on the list to inform EMS personnel who are responding to any particular emergency call so that they can take extra precautions or use personal protective equipment (PPE). Under this example, a 911 call center that is a covered entity should only disclose the minimum amount of information that the officer needs to take appropriate precautions to minimize the risk of exposure. Depending on the circumstances, the minimum necessary PHI may include, for example, an individual’s name and the result of the screening.
    For more information on HIPAA and COVID-19, see OCR's February 2020 Bulletin, Office for Civil Rights, U.S. Department of Health and Human Services BULLETIN: HIPAA Privacy and Novel Coronavirus.

    UPDATE (3/30/2020): 

    Following is additional HIPAA privacy related flexibility and guidance issued by the Office for Civil Rights (OCR):
    Posted by Bob Coffield at 4:48 PM 0 comments
    Labels: , , , , , , , , , , , , , ,

    Monday, March 23, 2020

    West Virginia Governor Issues "Stay at Home Order" Effective Tuesday, March 24 at 8:00 pm

    Today the Governor of West Virginia announced a "Stay at Home Order" effective Tuesday, March 24 at 8:00 p.m. The Order does not have a duration listed but instead states that the Order will be in effect until terminated. Here is a summary FAQ issued by WVDHHR on "Staying at Home in West Virginia".

    The State of West Virginia Executive Department issued Executive Order No. 9-20, March 23, 2020, provides the detailed requirements of the "Stay at Home Order" and specifically lists those essential businesses and operations that can continue along with those non-essential businesses and operations that must temporarily cease operation. The Order states,

    1. Stay at home or your place of residence. To preserve public health and safety, and to ensure the healthcare system in West Virginia is capable of serving all citizens in need, especially those at high risk and vulnerable to COVID-19, all individuals within the State of West Virginia are under a general stay-at-home order and are directed to stay at home or their place of residence unless performing an essential activity. An activity is essential if the purpose of the activity is one of the following:

     a. Obtaining food, medicine, and other similar goods necessary for the individual or a family member of the individual.

     b. Obtaining non-elective medical care and treatment and other similar vital services for an individual or a family member of the individual.

     c. Going to and from an individual's workplace if such workplace and/or work is included in the definition of Essential Businesses and Operations as outlined in Section 3, below.

     d. Going to and from the home of a family member.

     e. Going to and from the home of another individual who, under the terms of a parenting plan or similar agreement, is entitled to visitation with or the care of a child.

     f. Going to and from an individual's place of worship.

     g. Engaging in outdoor activity, provided that individuals at all times and as much as reasonably possible maintain social distancing of six feet from one another and abide by a 1 0-person limitation on gathering size.

    Further, the Order outlines the following prohibited activities stating,

    "All places of public amusement, whether indoors or outdoors, including but not limited to locations with amusement rides, carnivals, zoos, museums, arcades, fairs, pool halls, bingo halls, malls (except where stores in a mall that have a direct outdoor entrance and exit that provide essential services and products under the terms of this Order), children's play centers, playgrounds, bowling alleys, movie and other theaters, concert and music halls, adult entertainment venues, racetracks, social clubs, and other similar businesses shall be closed."

    The Order continues by stating that,

    "All public and private gatherings of any number of people occurring outside a single household or living unit are prohibited, except for the limited purposes permitted by this Order. Any gathering of more than 1 0 people is prohibited unless exempted by this Order. Nothing in this Order prohibits the gathering of members of a household or residence."




    Posted by Bob Coffield at 2:21 PM 0 comments
    Labels: , , , , , , , ,

    COVID: Resources for West Virginia Businesses in Response to COVID-19 are Coming

    As part of Washington's efforts to minimize the economic disruption of COVID-19 to the nation's 30 million small businesses, the United States Small Business Administration ("SBA") is offering companies low-interest federal disaster loans for working capital through its Economic Injury Disaster Loan Program (EIDL). Small businesses in each of the fifty (50) states are eligible to apply. Applications may be submitted online or via mail.

    The SBA's EIDL Program offers up to $2 million in assistance per applicant that can provide vital support to small businesses in these trying times. The interest rate for qualifying non-profit businesses is 2.75%, and 3.75% for other small businesses.

    EIDL Program loans offer long-term repayment structures, up to 30 years, to keep payments affordable. The repayment terms are determined on a case-by-case basis and by taking into account each borrower's ability to repay.

    These are unprecedented times. Flaherty Sensabaugh Bonasso PLLC stands ready to assist you in your interactions with the United States Small Business Administration and to partner with you as you navigate these previously uncharted waters.

    Written by Bryan Price and Meghan Capps
    Posted by Meghan Capps at 12:45 PM 0 comments
    Labels: , , , , , , , ,

    COVID: West Virginia Board of Medicine and West Virginia Board of Osteopathic Medicine Responding to Address COVID-19 Crisis

    West Virginia Board of Medicine and West Virginia Board of Osteopathic Medicine Responding to Address COVID-19 Crisis

    Written by Luke Schmitt, Flaherty Sensabaugh Bonasso PLLC

    In response to the COVID-19 pandemic and in anticipation of the challenges to come, the West Virginia Board of Medicine (the “Board”) this week has taken specific measures to prepare and to assist healthcare providers during this unprecedented time. The Board issued a COVID-19 Information Update on March 20, 2020.

    First, the Board has announced that it recognizes the need to facilitate the influx of available health care practitioners into West Virginia and is taking efforts to try to expedite the process. The Board has announced that it is working to streamline the licensure approval process for COVID-19 providers and to maximize practice authorizations for physician assistants. However, the Board has not yet released specific details regarding its anticipated changes.

    In addition, the Board in its March 20, 2020, update encouraged the use of telemedicine technologies, to provide flexibility for licensed health care professionals to respond to this emergency and expected patient volume surges. Specifically, the Board has stated that physicians who are evaluating and/or triaging COVID-19 patients are providing emergency care that falls within a statutory exception to the requirement for a face-to-face (in person or video) initial encounter to establish a physician/patient relationship. These providers may, consistent with the standard of care, conduct such evaluations through an audio-only encounter. The Board cautioned, however, that all non-COVID-19 telemedicine practice must continue to comply with the requirements prohibiting the establishment of a physician/patient relationship via audio-only communication.

    Finally, the Board has stated that physician assistants with authorized Practice Agreements and/or active Practice Notifications may practice via telemedicine in collaboration with physicians even if the Practice Agreement and/or Practice Notification does not specifically identify telemedicine as an authorized practice modality. The Board further stated that physician assistants who are likewise evaluating and/or triaging COVID-19 patients may similarly conduct initial patient encounters through audio-only measures even though the establishment of a physician/patient ordinarily must occur via a face-to-face (in person or by video) initial encounter. Again, regular practice requirements continue to govern in situations not involving the treatment of COVID-19 patients.

    Following is the complete language posted by the Board regarding its recommendations on telemedicine services in West Virginia: 

    Telemedicine:  (New 3-18-2020)
     In an effort to ensure maximum flexibility for our licensees and to surge the response to this emergency,  the Board encourages the use of telemedicine technologies, consistent with the standard of care, where appropriate.  
    Physician Telemedicine Practice for COVID-19 Emergency 
    For physicians who are evaluating and/or triaging COVID-19 patients, this emergency care falls within a statutory exception to the requirement for a face-to-face (in person or via video) initial encounter to establish a physician/patient relationship and may, consistent with the standard of care, occur through an audio-only encounter.  All non-COVID-19 telemedicine practice must continue to comport with the requirement that a physician-patient relationship may not be established via audio-only.    
    Physician Assistant Telemedicine Practice for COVID-19 Emergency and Non-COVID-19 Practice 
    Physician assistants with authorized Practice Agreements and/or active Practice Notifications may practice via telemedicine, where appropriate and in collaboration with physicians, even if the PA’s Practice Agreement and/or Practice Notification does not specifically identify telemedicine as an authorized practice modality.   For physician assistants who are evaluating and/or triaging COVID-19 patients, this emergency care falls within a statutory exception to the requirement for a face-to-face (in person or via video) initial encounter to establish a practitioner/patient relationship and may, consistent with the standard of care, occur through an audio-only encounter.  All non-COVID-19 telemedicine practice must continue to comport with the requirement that a practitioner/patient relationship may not be established via audio-only.

    Likewise, the West Virginia Board of Osteopathic Medicine has indicated that it is in the process of reviewing its licensing and renewal requirements and its authority to make changes to those requirements in emergencies. While specific measures have not been announced, the Board has stated it will initiate every possible action to ensure that qualified individuals can efficiently obtain a license so that they can assist in responding to this unfolding health care challenge.


    Posted by Bob Coffield at 11:16 AM 0 comments
    Labels: , , , , , , , , ,

    Sunday, March 22, 2020

    COVID: The Health Care Law Blog Restart

    These unprecedented and uncertain times have all of us worried, seeking data/information, thinking in new ways as a result of our world being turned upside down in the past month due to the ongoing COVID-19 crisis. The law is largely built around precedent and written law/regulations. However, no time during my legal career have I see so much change and fluid movement in the law as I saw this past week.

    As we stay home and shelter with our families and communities, I thought it was time to restart my blogging at the Health Care Law Blog as a way to share health care and legal information and content relevant that may be helpful to my health care clients, other health care providers, hospitals, nursing homes, physicians/physician practices, home health agencies and other providers. My last post on this blog was in 2012 - but it is time to dust off the blogging keyboard again in light of these worldwide events that impact us all from every direction. I started the Health Care Law Blog back in 2004, the infant hears of blogging and social media. At that time, there were only a handful of bloggers who connected nationally/globally. It was such an eye opening experience as a young lawyers sitting in little old wild and wonderful West Virginia - through this platform I was immediately connected with health care industry, health care lawyers and other technology interested lawyers around the world. Many of those individuals I still follow today via my Twitter feed at @BobCoffield and other social media platforms. In fact, much of my "trusted content" on the developing COVID crisis comes from these same health care blogging resources who I have trusted over the years. 

    So with these opening comments, this health care regulatory, transactional and technology lawyer who practices out of Charleston, West Virginia at Flaherty Sensabaugh Bonasso PLLC is starting up the posts today. In the coming days, I plan to share my own thoughts and health care/legal related content along with content prepared by other health care lawyers in our firm's health care practice group, including, Caleb Knight, Shereen Compton McDaniel, Amy McLaughlin, Luke Schmitt, and others at our firm. This past week a few of us were brainstorming how we can help our clients, our communities, our state of West Virginia, our country and our globe during these difficult times. I think we all are struggling with what role we can and should play. Maybe through efforts to write, document, share content and commentary we can find some balance to what are likely difficult days and months to come for us and so many. 

    Stay home, stay safe.
    Posted by Bob Coffield at 10:40 PM 0 comments
    Labels: , , , , , ,

    Saturday, March 10, 2012

    OHFLAC Announces New Independent Informal Dispute Resolution Procedure for West Virginia Nursing Homes

    The latest West Virginia Health Care Association e-News Update announced that the Office of Health Facility Licensure and Certification (OHFLAC) has put into place a new Independent Informal Dispute Resolution (IIDR) review of disputed deficiencies for all nursing homes in West Virginia. The new IIDR procedure goes into effect immediately and three out of state vendors experienced in IDRs were selected to be the third party reviewers. The current Informal Dispute Resolution (IDR) will remain as an alternative option.

    According to the e-News Update, the new procedure will be detailed in a letter to providers when OHFLAC returns the Statement of Deficiencies to the provider after a survey. The letter will contain instructions on how to request an IIDR. OHFLAC is proposing to use the following language in the letters:
    INFORMAL DISPUTE RESOLUTION:
    In accordance with 42 CFR 488.331, you have an opportunity to question cited deficiencies through an informal dispute resolution process. To request an informal dispute resolution, please submit in writing the specific deficiencies being disputed and an explanation of why you are disputing those deficiencies to:

                                        Informal Dispute Resolution Review Committee
                                        Office of Health Facility Licensure and Certification
                                        408 Leon Sullivan Way
                                        Charleston, WV 25301-1713
    You may also send your request via email to DHHR.OHFLAC.@wv.gov. 
    This request must be sent during the same ten (10) calendar days you have for submitting a Plan of Correction (POC) for the cited deficiencies and must be contained on a document separate from the CMS-2567L, which contains the POC. 
    You may choose between an informal dispute resolution (IDR) and an independent informal dispute resolution (IIDR).  You must clearly indicate your choice in the attention line of your request and the subject line of your email. An IDR will be completed by OHFLAC staff not associated with the referenced survey event.
    Per West Virginia State Code §16-5C-12a, an IIDR will be completed by an independent review organization.  If an independent informal dispute resolution process is selected, the matter will be assigned to one of three independent review organizations accredited by the Utilization Review Accreditation Commission.  The facility may be subject to certain costs such as:
    •     The cost of a face-to-face conference if one is requested; and
    •     The cost charged by the independent review organization, should the facility not be successful in its dispute.
    Please call us at 304-346-4575 if you have any questions.
    The new IIDR procedure will allow nursing homes an alternative option to the standard IDR process when questions arise during the survey process and related POC requirement. The new procedure will allow a nursing home provider to challenge the particular survey finding through an alternative/independent process. Whether this new alternative procedure will be valuable to nursing home providers is yet to be seen.
    Posted by Bob Coffield at 3:55 PM 0 comments
    Labels: , , , , , , , ,

    Tuesday, January 03, 2012

    WVHCA: 2012 CON Capital Expenditure Minimum

    The West Virginia Health Care Authority has announced the 2012 certificate of need capital expenditure minimum threshold of $2,916,104. The new threshold is effective beginning January 1, 2012. The threshold is used as a part of the analysis by health care providers who must determine whether or not a certificate of need is required for a proposed project or health care acquisition. 

    Pursuant to W.Va. Code 16-2D-2(h) and (s), the Authority is required to adjust the expenditure minimum annually and publish an update of the amount on or before December 31 of each year. The expenditure minimum adjustment isbased on the DRI inflation index published in the Global Insight DRI/WEFA Health Care Cost Review. The DRI inflation index as of December 31, 2011 is 2.9%.
    Posted by Bob Coffield at 10:31 AM 0 comments
    Labels: , , , ,

    Sunday, May 22, 2011

    FSB Welcomes Tom Clark

    A warm welcome to J. Thomas "Tom" Clark who recently joined Flaherty Sensabaugh Bonasso PLLC as Senior Counsel. Tom is a welcomed addition to our corporate practice group and will help to expand the level of representation that we provide our health care, oil and gas, coal and banking industry clients.

    Tom comes to FSB with over 10 years of experience in handling business organization and commercial transactions. Tom received his undergraduate degree from Virginia Tech in 1993 and his J.D. from the University of Pittsburgh in 1997.
    Posted by Bob Coffield at 12:52 PM 0 comments
    Labels: , ,

    Monday, January 31, 2011

    WVDHHR Transfers OHFLAC Staff and Operations to OIG

    According to the West Virginia Department of Health and Human Resources (DHHR), the West Virginia Office of Health Facility Licensure and Certification (OHFLAC) will be transferred to the West Virginia Office of Inspector General (OIG) effective February 1, 2010. OHFLAC oversees the state and federal licensure and certification process in West Virginia for hospitals, critical access hospitals, behavioral health facilities, home health agencies, hospice agencies, ESRD services, and other health care services.

    All personnel and positions currently assigned to OHFLAC will be administratively transferred. DHHR has states that this action is to further enhance the integrity of the regulatory unit of the Department of Health and Human Resources.
    Posted by Bob Coffield at 2:40 PM 0 comments
    Labels: , , , ,

    Sunday, December 12, 2010

    West Virginia Connect

    Today's Charleston Gazette features an article on a new health care demonstration project, West Virginia Connect, funded by a $36 million federal Health Resources and Services Administration (HRSA) grant.

    The article indicates that the funding will be for eight West Virginia primary care clinics to provide preventative care services to eligible health consumers for a flat $35 per month. The services will include unlimited doctor visits, immunizations and screenings, chronic disease management, and minor surgical procedures.

    To be eligible to particpate a person must have a job, be between 19 and 64, and make less than $43,320 for a single person or $88,200 for a family of four. In return, participants have to let the state fold their medical data - blood pressure, blood sugar, etc. - into an anonymous 10,000-person database the state plans to use to make more informed choices as health-care reform unfolds.

    The article indicates that the primary care centers involved say the project is intended to:
    • generate useful information about uninsured West Virginians and cost-effective ways to treat chronic diseases;
    • demonstrate lowered emergency room usage, hospital stays, and times when people don't show up for appointments;
    • develop an electronic patient tracking system other centers can use;create a catalogue of best practices that help people take better care of their own health;
    • help the health system get ready for 2014, when hundreds of thousands will be newly insured through federal reform.
    This is the first I have heard about this demonstration project. Other than this Grantee Project Abstract at HRSA website, I was unable to find any additional information or links about the demonstration project online. The article indicates that the project is currently governed by a steering committee of the DHHR secretary, insurance commissioner, and director of the GO HELP office.
    Posted by Bob Coffield at 9:01 AM 0 comments
    Labels: , , , ,

    Sunday, December 05, 2010

    West Virginia PEIA: Innovative Steps to Improve Long Term Health of West Virginia

    This past week the West Virginia Public Employees Insurance Agency (PEIA) announced a creative and proactive health initiative to improve the health of West Virginians and move toward keeping future health care costs down for state and public school employees and ultimately for West Virginia taxpayer. Charleston Gazette's Phil Kabler reports on the initiative in "PEIA insurees can offset premiums increase."

    The Improve Your Score initiative is a part of PEIA's Pathways to Wellness. PEIA announced that state and public school employees will have no health care premium increase this year if they comply with two requirements.The two requirements:
    • Undergo a four-step wellness screening to measure waist circumference, total cholesterol, blood pressure, and blood glucose. Completion of the screening provides a $10-a-month premium discount.
    • Submit an affidavit verifying they have filed an advanced directive for end-of-life care, sometimes called a "living will." That provides an additional $4-a-month discount.
    Wonderful to see West Virginia, often more known nationally for unhealthy news, taking a proactive approach to improving West Virginians health by promoting a wellness activity and encouraging end of life care planning. Both initiatives will help to curb the long term impact on our state's health care cost problems and help West Virginia's become more active in understanding and managing their (un)healthy problems.

    Posted by Bob Coffield at 9:46 AM 0 comments
    Labels: , , , , ,

    Thursday, December 02, 2010

    WVHIN: Public Comment Period on Proposed Privacy and Security Policies

    The West Virginia Health Information Network (WVHIN), West Virginia's health information exchange, has issued proposed privacy and security policies and is seeking public comments on the proposed policies from December 3, 2010 through January 3, 2011. The WVHIN is a public/private partnership created in 2006 under W.Va. Code 16-29G-1 et seq. and is charged with building a secure electronic health information system for the exchange of patient data among physicians, hospitals, diagnostic laboratories, other care providers, and other stakeholders.

    The proposed privacy and security policies that are available for review and comment are as follows:
    Pursuant to a press release from the WVHIN on the proposed privacy and security policies:
    “WVHIN has been developing our core privacy and security policies that will guide us in our initial health information exchange implementation and pilot for 2011. We expect to have changes to the policies as a result of learning how to improve our operations through testing in the pilot period.“

    “The policies have been developed over the past few months by the WVHIN Privacy and Security Committee and legal counsel, and are based upon an established WVHIN Privacy Framework and national best practices recommendations in Health Information Exchange (HIE). The committee is made up of stakeholder organizations including provider groups, state government, and consumer groups. The committee followed a cycle of reviewing and vetting the policies that have resulted in our drafts.”

    “We have established a public comment period for the draft policies and would like to invite any member of the public to comments on these policies. Thus, we would like to request your assistance in forwarding this e-mail to any parties you may feel would like to comment on the policies. We welcome all feedback”, according to Business Development Manager Samantha Stamper.
    Written comments on the proposed privacy and security policies may be submitted to Samantha Stamper, Business Development Manager by January 3, 2011 at sstamper@wvhin.org.
    Posted by Bob Coffield at 9:58 AM 0 comments
    Labels: , , , , ,

    Thursday, November 25, 2010

    Thanksgiving 2010: Will You Engage With Grace?

    Will You Engage with Grace this Thanksgiving weekend? I hope so.

    For the third year running I am participating in the Thanksgiving holiday Engage with Grace Blog Rally. A viral effort to communicate the importance of having a conversation with your family and loved ones around end of life care wishes. Would you prefer to die in a hospital, or at home? Can your family correctly describe how you would want to be treated in the case of a terminal illness or sudden traumatic accident? Does your family know where you keep your living will and advanced directive?

    At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. They’re not easy questions, but they are important. The key is having the conversation before it’s too late. Throughout the year I continue to promote the Engage with Grace effort (and so can you) by using the One Slide (see the slide below) at the end of my power point presentations.

    So in the spirit of the upcoming Thanksgiving weekend, take time after your dinner, turn off the TV, and take time with your family and friends to engage in the Engage with Grace conversation. 

    Thanks to Alexandra Drane, Paul Levy, and many other health care bloggers and professionals for continuing to inspire and share the Engage with Grace message. Learn more about Engage with Grace and the One Slide Project at http://www.engagewithgrace.org.


    Some other resources you may want to read and explore:
    •  My 2008 Engage with Grace Blog post where I shared how Alexandra Drane's talk at the 2008 Health 2.0 Conference personally touched me because of my experience as a young 12 year old boy who lost his mother to cancer who was allowed to die at home surrounded by her husband and family.


    Posted by Bob Coffield at 9:39 AM 0 comments
    Labels: , ,
    Subscribe to: Posts (Atom)