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Matthew Shatzkes is a partner in the Corporate Practice Group in the New York office of Sheppard Mullin and is a member of the firm’s Healthcare Team.

Utah Bill Uses Telehealth to Address Mental Health

On March 2, 2021, Utah Governor, Spencer Cox, signed Senate Bill 41 (“SB41”) into law. The bill, sponsored by State Senator Luz Escamilla, allows coverage for mental health services delivered by telehealth – often referred to as “telemental health” services.  While we have seen many states move to create greater access to telehealth services in efforts to address the current public health crisis (the “Pandemic”), Utah is one of the first states to expand telehealth coverage to address the mental well-being of its citizens.  In a statement to State of Reform, Sen. Escamilla noted that “mental health is becoming a big crisis and in our state we’re seeing an increase in needs, and access has become very limited.”
Continue Reading The “State” of Telehealth: Utah

On February 4, 2021, the Department of Justice (“DOJ”), Office of Public Affairs, issued a Press Release (the “DOJ Press Release”) announcing that Kelly Wolfe, President of Regency, Inc., a medical billing company located in Florida, pleaded guilty to conspiracy to commit healthcare fraud through a “pernicious telefraud scheme”[1] involving fraudulent Medicare and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) claims for medically unnecessary durable medical equipment (“DME”) supplies.  As a result of Wolfe’s criminal plea, Wolfe could face up to 13 years in federal prison. 
Continue Reading OIG Warns Telehealth Industry: “With Great Power Comes Great Responsibility”

Virginia is now the second state, after California, to pass a comprehensive privacy law. The Consumer Data Protection Act (“CDPA”) will come into effect January 1, 2023 (the same time as the modification to California’s Consumer Privacy Act (“CCPA”), i.e., the California Privacy Rights Act (“CPRA”)). While CDPA has fairly broad exemptions for entities regulated by other laws, such as HIPAA, there is also a new “opt-in” requirement for collecting “sensitive data.”
Continue Reading What Virginia’s New Privacy Law Means for Organizations in the Healthcare Industry

West Virginia Bill Seeks to Regulate Parity and Out-of-State Providers

On February 10, 2021, members of the West Virginia Legislature introduced Senate Bill 1 (“SB1”) which seeks to regulate the use of telemedicine in the state. If passed, the proposed bill would require the Public Employees Insurance Agency, Medicaid and specified insurance plans to cover telehealth services at the same rate as in-person healthcare, starting July 1, 2021. The bill would also permit healthcare providers who are licensed in other states to provide telehealth services in West Virginia.
Continue Reading The “State” of Telehealth: West Virginia

Washington State Seeks to Make Audio-Only Telehealth Permanent

On February 5, 2021, Washington State Rep. Marcus Riccelli introduced House Bill 1196 (“HB-1196”) which seeks to set specific guidelines for use and coverage of audio-only telehealth platforms, such as the phone. HB-1196 would mandate coverage for audio-only telehealth beyond the public health emergency (the “Pandemic”) as long as the service met certain requirements. The bill was passed almost unanimously by the House on February 24, 2021 and is now before the state Senate.
Continue Reading The “State” of Telehealth: Washington

Oregon Telehealth Bill Proposes Parity for Telehealth Services

On January 11, 2021, Oregon Senator Lee Beyer and Rep. Rachel Prusak, introduced Senate Bill 11 (“SB11”)[1], which would permanently extend parity for telehealth services with in-clinic care services. Parity for telehealth services was originally proposed in response to Governor Kate Brown’s March 23, 2020 Executive Order 20-22 which ordered a temporary halt on nonurgent procedures to preserve personal protective gear for frontline workers. Telehealth services provided clinical providers with an opportunity to maintain revenue by allowing individuals to seek care from the safety of their own homes. In line with the move to telehealth services, emergency payment policies enacted by the Oregon Department of Consumer and Business Services and payers’ voluntary agreement allowed providers to receive the same rates for telemedicine services as they would for in-clinic services.
Continue Reading The “State” of Telehealth: Oregon

Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency.  Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth.  However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.
Continue Reading The Honeymoon Phase Is Over: OIG to Audit COVID-19 Part B Telehealth Services

Texas Governor Wants to Make Permanent Changes to Telemedicine Access

As part of his 2021 of the State address, Texas Governor, Greg Abbott, introduced his intention to permanently expand telemedicine services that were made available during the COVID-19 public health emergency (the “Pandemic”).
Continue Reading The “State” of Telehealth: Texas

New Hampshire Seeks to End Telehealth Parity and Audio-Only Phone Coverage

On January 13, 2021, New Hampshire lawmakers, Jess Edwards, Jason Osborne and John Hunt, introduced House Bill 602, which seeks to roll back certain provisions of the July 21, 2020 telehealth bill (“House Bill 1623”) signed into law by Governor Chris Sununu, during the height of the COVID-19 public health emergency (the “Pandemic”). House Bill 1623, amended the state’s definition of telemedicine to include new modalities, including audio-only phones, and requires Medicaid and private payers to reimburse for telehealth services on the same basis that it reimburses for in-person care. In sharp contrast, the newly proposed House Bill 602 would revise the state’s telehealth rules to eliminate payment parity and coverage for audio-only services.
Continue Reading “State” of Telehealth Series: New Hampshire

In response to the ongoing COVID-19 public health emergency (the “PHE”) first declared on March 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued blanket Section 1135 Waivers to expand, albeit on a temporary basis during the PHE, the range of healthcare professionals who can provide Medicare-covered telehealth services to include physical therapists, occupational therapists, speech language pathologists, and other non-physician practitioners.  (See also, CMS Fact Sheet, “Medicare Telemedicine Health Care Provider Fact Sheet” (March 17, 2020) and CMS’s “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” (December 1, 2020)).
Continue Reading The Other Shoe Drops: OIG To Audit COVID-19 Telehealth Home Health Services