"Ambulance officers across the country have been directed to only transport family members with patients in exceptional circumstances. Coronavirus: New ambulance rules don't allow family members to travel Study: Temperature and Humidity May Indicate COVID-19 Transmission Risk, Evusheld No Longer Authorized to Prevent COVID. Our longstanding guidance makes clear that "[w]henever a laboratory offers or gives to a source of referrals anything of value not paid for at fair market value, the inference may be made that the thing of value is offered to induce the referral of business." They also recently started delivering groceries, medical supplies, and necessary goods to medically vulnerable or transportation-disadvantaged recipients on behalf of nonprofits, government agencies, and health care organizations. With ride-sharing, theres a lot of unknowns, so you always need to take your precautions: wearing a mask that covers your nose and mouth, keeping a hand sanitizer with you, maintaining distance, and opening the window.. . If a patient received a positive test result, the patient would be directed to the provider of his or her choice and would not be directed to the FQHC or any other specific provider. ", 1The Secretary of the Department of Health and Human Services (HHS) determined, through a January 31, 2020, determination, pursuant to section 319 of the Public Health Service Act, that a public health emergency exists and has existed since January 27, 2020. We recognize that the donation of face masks under these circumstances presents a lower risk of fraud and abuse because it operates to protect the health and safety of the donor physician group and its treating clinicians who furnish services to the nursing home's residents during the public health emergency and who may work closely with the nursing home's staff. Nevertheless, OIG believes that a hospital's suspension of rental charges and accrual of interest for a FQHCLA presents a sufficiently low risk of fraud and abuse so long as the following conditions are met: (i) the arrangement suspending rental charges and accrual of interest is set out in a written document or documents, signed by the parties, that describes all material terms of the arrangement (which could be in the form of amendments to the underlying lease and line-of-credit agreements); (ii) the suspension of rent and accrual of interest is not conditioned on the volume or value of Federal health care program business generated between the hospital and the FQHCLA; (iii) the arrangement does not require the FQHCLA (or its affiliated health care professionals) to refer patients to a particular individual or entity or restrict the FQHCLA (or its affiliated health care professionals) from referring patients to any individual or entity; (iv) the suspension of rent and accrual of interest is only offered to the FQHCLA when necessary as a result of the COVID-19 outbreak; and (v) the suspension of rent and accrual of interest is effective only during the period subject to the COVID-19 Declaration. FQHCLAs deliver comprehensive primary care services to some of the country's most vulnerable individuals and families in areas where economic, geographic, or cultural barriers may limit access to affordable health care services. Sitting in the back of the car and opening the window farthest away from you may also improve air circulation and reduce exposure to aerosol droplets. Generally, the service has yielded positive results; studies found patients using rideshare-based NEMT had fewer missed primary care appointments, a lower average wait time, a higher rate of on-time pickup compared to those using other types of NEMT, and lower costs. In light of these EMS protocols, on May 5, 2021, pursuant to section 1135(b)(9) of the Social Security Act, the Secretary of Health and Human Services waived certain statutory requirements relating to Medicare payments for ground ambulance services furnished in response to a 911 call (or the equivalent in areas without a 911 call system) in cases in which an individual would have been transported to a destination permitted under Medicare regulations but such transport did not occur as a result of communitywide EMS protocols established due to the public health emergency (the Waiver). The informal feedback furnished on this site does not bind or obligate HHS, the U.S. Department of Justice, or any other agency. The clinical laboratory would bill payors, including Federal health care programs, for the laboratory tests, and it would pay the retail pharmacy a fair market value fee for the costs described above associated with running the collection sites. Typically, one family member or friend can ride to the hospital with the patient. 200 Independence Avenue, S.W. All ride-along participants must be 18 years of age or older. 1001.952(bb), for free or at reduced cost to obtain medically necessary items or services furnished by the eligible entity; (ii) provided only when necessary as a result of the COVID-19 outbreak and during the period subject to the COVID-19 Declaration; and (iii) not air, luxury, or ambulance-level transportation. The eye protection should be put back on when you stop driving and are still with the person with COVID-19. According to the facts presented, a clinical laboratory would provide free COVID-19 antibody testing to patients, including Federal health care program beneficiaries, who contemporaneously undergo other medically necessary blood tests performed by the laboratory. Every day you know EMS workers make life and death decisions, and it's in consultation with the hospital physicians emergency room physicians that will make this decision out in the field," said Hahn, "They're gonna make every effort that's reasonable based on you know what the case is all the decisions are based, you know, based on sound clinical judgment.. We understand that Federal health care program beneficiaries with cancer, who are receiving chemotherapy or radiation treatment, sometimes qualify for free or discounted housing at a nonprofit lodging facility near treatment sites while receiving treatment. How fast should ambulances go? - Slate Magazine 1320a-7a(a)(5). This way they can be properly secured with a seat belt. California Consumer Limit the Use of My Sensitive Personal Information, California Consumer Do Not Sell or Share My Personal Information. Riding in a car with someone outside of your home carries a risk of COVID-19 infection for yourself and others. OIG's longstanding guidance makes clear that, depending on the facts and circumstances, the provision of free goods or services to an actual or potential referral source of Federal health care program business may implicate the Federal anti-kickback statute. In particular, we believe such transportation assistance would present low risk so long as the transportation assistance is: (i) provided by an "eligible entity" to an "established patient," as those terms are defined under 42 C.F.R. If, after such analysis, the parties remain concerned about OIG pursuing administrative enforcement authority in connection with remuneration related to such referrals or arrangement, we invite the parties to submit questions to OIGComplianceSuggestions@oig.hhs.gov. The provision of valuable technology and services to Federal health care program beneficiaries for free or at a reduced cost likely implicates the Federal anti-kickback statute and Beneficiary Inducements CMP; in normal circumstances, offering or giving Federal health care program beneficiaries such items or services would be suspect under both laws. OIG has longstanding and continuing concerns regarding the provision of cash or cash equivalents to Federal health care program beneficiaries. That can be a sign of stroke or other serious illness. Christopher Whaley is a policy researcher at RAND and a professor at the Pardee RAND Graduate School. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Sections II(B)(12)-(17) of the blanket waivers of the physician self-referral law protect "referrals," as defined under section 1877(g) of the Act, rather than "remuneration," and reflect differences in the statutory proscriptions of the physician self-referral law when compared to the Federal anti-kickback statute. authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically Can a hospital provide access to its existing HIPAA-compliant, web-based telehealth platform for free to independent physicians on its medical staff to furnish medically necessary telehealth services during the time period subject to the COVID-19 Declaration. In light of the unique circumstances of the current public health emergency, the Secretary has offered regulatory flexibilities to health care entities similar to those requested here via Blanket Waivers of Section 1877(g) of the Social Security Act (the Act), issued March 30, 2020 (the Blanket Waivers). For example, we understand that some essential staff at SNFs and other long-term-care providers may be unable to report to work due to a lack of childcare, and we received a question about whether a hospice vendor that is already providing services to some patients at a SNF could furnish certain basic care needsnot to exceed the scope of the hospice's or the hospice staff's licensesfor free to patients who are not the hospice's clients to help mitigate any staffing shortages. Can an oncology group practice provide free in-kind local transportation to and from an established patient's home to an alternate practice location to receive medically necessary oncology care during the time period subject to the COVID-19 Declaration? We recognize that this scenario involves potential direct or indirect financial relationships between donors, providers, and patients and that there are different fraud and abuse risks with respect to each relationship. Patients and physicians would be able to access COVID-19 antibody testing results through the laboratory's patient portal, and the results from the antibody testing program also would be reported to the Centers for Disease Control and Prevention and State public health agencies to further support COVID-19 surveillance and response efforts. David Tan, M.D., president of the National Association of EMS Physicians, explains the precautions being taken by EMTs to keep non-COVID patients safe and help them get the care they need. The Organization would contract with various health care providers (HCPs), including physicians, physician group practices, and health systems, to provide these administrative services. HCPs also would bill third-party payors, including Federal health care programs, for vaccine administration services. The pharmacy would direct and operate all aspects of the vaccination clinic, including obtaining patient consents; administering COVID-19 vaccinations to individuals, some of whom may be Federal health care program beneficiaries; observing patients after vaccination and responding to any adverse reactions; and providing all items and services related to vaccine administration (e.g., staff and equipment). During the time period subject to the COVID-19 Declaration, can a clinical laboratory that bills Federal health care programs for laboratory tests to diagnose COVID-19 pay a retail pharmacy a fee for certain costs that the retail pharmacy incurs related to testing collection sites? The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. See U.S. Department of Health and Human Services, Public Health Emergency Declaration Q&As, available at https://www.phe.gov/Preparedness/legal/Pages/phe-qa.aspx#faq7. Pursuant to the Waiver, ground ambulance services under such circumstances will be paid at the usual base rate based on the level of service that was provided-Basic Life Support (BLS) emergency or Advanced Life Support, level 1 (ALS1) emergency-that would have been paid if the patient had in fact been transported to the nearest appropriate facility able to treat the patient's condition and other means of transportation were contraindicated, without payment for mileage. People are sick, losing jobs, postponing important life events, projects, losing chunks of their retirement, and living in a constant state of fear. Under certain circumstances, such as the Federal Communications Commission distributing grants to certain providers to fund Telecommunications Technologies, the remuneration (i.e., the grant funds) from the "donor" (i.e., the Federal Government) to the provider would not implicate the Federal fraud and abuse laws. Similarly, depending on the facts and circumstances, providing free goods or services to Federal health care program beneficiaries may implicate the Beneficiary Inducements CMP. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. (Photo/Getty Images) That's because this. At least three states removed regulatory barriers to allow rideshares to provide NEMT in the last few weeks, some using the 1135 waivers (PDF) under the Stafford Act to exercise greater flexibility. CMS adapts treat-in-place reimbursement during COVID-19 - EMS1 In addition, independent physicians who use the hospital's telehealth platform for free (i) receive no remuneration for use of the platform from the hospital (other than free access to the platform); (ii) must be responsible for appropriately maintaining any required records for patients who receive services using the platform; and (iii) independently bill and receive reimbursement from payors for professional services furnished via the platform. You also should call 911 if you have trouble seeing and . Can a home health agency's (HHA) staff members furnish free blood draws-provided that such blood draws are within the scope of the staff's licenses-to assisted living facility residents who are Federal health care program beneficiaries and are not patients of the HHA? Under the facts described herein, the provision of free COVID-19 diagnostic testing to Federal health care program beneficiaries presents a sufficiently low risk of fraud and abuse under the Federal anti-kickback statute and Beneficiary Inducements CMP because, as described, the program includes the following safeguards: (1) free COVID-19 testing is offered to all patients who request it, regardless of the patient's insurance coverage or lack thereof; (2) beneficiaries who received positive test results would not be referred to the FQHC or to any other specific provider; (3) the FQHC would not offer special discounts or any other free or discounted items or services to beneficiaries who received free COVID-19 testing; (4) no payor, including the beneficiary, a commercial insurance company, or a Federal health care program, would be billed for or pay any costs in connection with the COVID-19 testing services; and (5) the COVID-19 tests are cleared or approved by the Food and Drug Administration (FDA), are subject to an FDA-issued Emergency Use Authorization, or are covered by the Medicare program. U.S. Department of Health & Human Services Why does the "OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emergency" not incorporate sections II(B)(12)-(18) of the blanket waivers of the physician self-referral law as issued by the Secretary? Making ridesharing a workable option in the current crisis requires local and state government cooperation, TNC capacity, clarity around the rideshare driver's role, and protection for the driver. Is It Really Time to Take Off Your Mask on Public Transit? Finally, the Organization's provision of administrative services to HCPs would not operate in conjunction with any other arrangement or agreement between and among the Organization, the HCPs, any Federal health care program beneficiary who receives vaccinations from one of the sites, or any other person or entity in a position to refer or arrange for the referral of items or services reimbursable by a Federal health care program. In contrast, if the pharmacy were to bill Federal health care programs foror otherwise were to receive Federal or State funding (e.g., through the Coronavirus Aid, Relief, and Economic Security Act) to cover the costs associated withthe items and activities for which the clinical laboratory would reimburse the pharmacy, such remuneration could constitute a problematic double payment and could evidence unlawful intent under the Federal anti-kickback statute. Patients need to be advised that if they have confirmed or suspected COVID-19 and are seeking help or are experiencing a medical emergency, rideshares are not the right transportation option. In addition, we recognize that this scenario also involves potential direct or indirect financial relationships between the non-governmental donor entity providing funding, the FQHC, and Federal health care program beneficiaries, and there are different potential fraud and abuse risks with respect to those relationships. The HCPs would oversee administration of the COVID-19 vaccine and provide certain clinical staffing to administer the vaccine at the sites. Not only is it dangerous to drive yourself to a hospital when you're experiencing these symptoms, but it will also take extra time that can prevent you from getting the care you need as soon as you need it. OIG's longstanding guidance makes clear that, depending on the facts and circumstances, the provision of free space to an actual or potential referral source likely implicates the Federal anti-kickback statute and would not satisfy the requirements of the space rental safe harbor, 42 C.F.R. We recognize that this scenario also involves potential direct or indirect financial relationships between the private foundation, the FQHC, and the Federal health care program beneficiary receiving the grant funding, and that there are different fraud and abuse risks with respect to each relationship. And if you have a confirmed case of COVID-19 . Analysis: Half of Emergency Ambulance Rides Lead to Out-of - KFF Get the best experience and stay connected to your community with our Spectrum News app. Verywell Health's content is for informational and educational purposes only. However, we believe that there are scenarios in which an HHA and an assisted living facility could work together to fill critical gaps caused by the COVID-19 outbreak to provide necessary health care services to vulnerable beneficiaries residing in an assisted living facility. A lot of the spread is from places where we dont necessarily know where the transmission took place, he says. According to the facts presented in the question submitted, an oncology practice wishes to offer free or discounted lodging to certain financially needy patients who would have qualified for free or discounted lodging at a nonprofit lodging facility that is now closed as a result of the COVID-19 public health emergency. Lyft and Uber have issued guidance to their drivers around safe operations, including disinfecting the in-vehicle environment and not driving when ill. In earlier FAQs, we have recognized that FQHCs deliver care to some of the nation's most vulnerable individuals and families, which can include Federal health care program beneficiaries. Ambulances are being told not to transport trauma patients - victims of heart attacks, gunshot wounds, car crashes - to the hospital if they can't be resuscitated in the field. Cars dont have the same air filtration system as airplanes, which may be slightly safer because of their HVAC ventilation. Beyond current services, TNCs deliver customer-purchased groceries and goods. The "OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emergency" does not incorporate sections II(B)(12)-(18) of the blanket waivers of the physician self-referral law as issued by the Secretary. Non-Emergency Medical Transportation (NEMT), transportation to medical appointments, pharmacies, lab visits, and other types of routine care for the transportation-disadvantaged, aims to reduce this barrier. For example, under some State plans certain providers and suppliers assume responsibility for storing COVID-19 vaccines in cold or ultracold storage and redistributing (which includes, in certain instances, transporting) vaccines to other providers and suppliers, some of which may be actual or potential referral sources. Mathai says that currently, this study does not apply to other modes of public transportation. %PDF-1.5 % In addition, individuals would be screened for eligibility after being referred to the FQHC for case management services, but the offer or provision of gift cards would not be conditioned on the individual's past or anticipated future use of the FQHC's services reimbursable in whole or in part by Federal health care programs. On the fence about calling an Uber to get to an appointment? We believe the proposed arrangement offers the possibility of substantial public health benefits through the identification of additional potential convalescent plasma donors and valuable public health information and data and would pose a sufficiently low risk of fraud and abuse, provided the proposed arrangement includes the following safeguards: (1) the physicians ordering the laboratory tests, including the free COVID-19 antibody tests, would not receive any payments or anything else of value from the clinical laboratory in connection with the free antibody testing program; (2) the patients receiving the laboratory tests would not receive any payments or anything of value, other than the free COVID-19 antibody test, from the clinical laboratory in connection with the free antibody testing program; (3) the tests would be offered only to patients receiving other medically necessary blood tests as part of a medically necessary exam or treatment; (4) no payor, including the patient, a commercial insurance company, or a Federal health care program, would be billed for or pay any costs in connection with the COVID-19 antibody tests; and (5) the antibody tests are cleared or approved by the U.S. Food and Drug Administration (FDA) or are subject to an FDA-issued Emergency Use Authorization.

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