can you ride in an ambulance with someone during covid
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. doi:10.1126/sciadv.abe0166. TNCs can do more than just provide NEMT during the current crisis. Providing free testing to individuals who are not Federal health care program beneficiaries would be unlikely to implicate the Federal anti-kickback statute or Beneficiary Inducements CMP. To sign up for updates or to access your subscriber preferences, please enter your contact information below. Section II(B)(18) of the blanket waivers protects a compensation arrangement that is neither set forth in writing nor signed by the parties but otherwise fully complies with an applicable physician self-referral law exception. That can be a sign of stroke or other serious illness. We also acknowledge that OIG's longstanding guidance makes clear that, depending on the facts and circumstances, providing free or discounted goods or services to an actual or potential referral source may violate the Federal anti-kickback statute. 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. 185 0 obj <>stream Subscribe to the weekly Policy Currents newsletter to receive updates on the issues that matter most. Helping Coastal Communities Plan for Climate Change, Measuring Wellbeing to Help Communities Thrive, Assessing and Articulating the Wider Benefits of Research, >Non-Emergency Medical Transportation in the Time of COVID-19, confirmed or suspected COVID-19 and are seeking help or are experiencing a medical emergency, medically vulnerable or transportation-disadvantaged recipients, In Pittsburgh: Feeding the Needy, and Protecting Workers on the Front Lines of the Pandemic, Protecting Household Employers and Workers During the COVID-19 Pandemic, What Autonomous Vehicles Could Mean for American Workers. 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? When she came home, a letter arrived: The air ambulance company said she owed $52,112 for the trip. Get the best experience and stay connected to your community with our Spectrum News app. 5Note that "[a public health emergency] declaration lasts until the Secretary declares that the [public health emergency] no longer exists or upon the expiration of the 90-day period beginning on the date the Secretary declared a [public health emergency] exists, whichever occurs first. If you are experiencing any severe symptoms call triple zero (000) for an ambulance and tell the ambulance staff that you have COVID-19. Can a Federally Qualified Health Center (FQHC), including an entity that receives grant funds or designation under section 330 of the Public Health Service Act, conduct free COVID-19 diagnostic testing that has been cleared or approved by the Food and Drug Administration (FDA), is subject to an FDA-issued Emergency Use Authorization, or is covered by the Medicare program, including for Federal health care program beneficiaries, at community health fairs and via mobile testing in underserved communities impacted by COVID-19? 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. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We recognize that sufficient access to personal protective equipment is crucial to protect patients and frontline health care workers during the coronavirus disease 2019 (COVID-19) public health emergency. ", 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. According to the FQHC, other than the free use of space, no remuneration would be exchanged between the parties. The HCPs would oversee administration of the COVID-19 vaccine and provide certain clinical staffing to administer the vaccine at the sites. Call 911 if you suddenly have blurry vision, double vision, or loss of vision. Parties must separately assess any fraud and abuse risks that may arise with respect to any direct or indirect financial relationships between the donor and the provider or patient. o PPE worn during transport should be thrown out by placing it directly into a plastic garbage bag, Finally, making rideshare-based NEMT a workable option requires a firm understanding of what rideshare drivers and TNCs can and cannot do. The FQHC intends to advertise the availability of free testing. By Jocelyn Solis-Moreira It is incumbent on the parties to determine a fair market value payment for the actual and necessary items and services furnished by the retail pharmacy; we express no opinion regarding the fair market value for such items and services. The .gov means its official. In the unique circumstances resulting from the COVID-19 outbreak, we believe that these facts likely would present a low risk of fraud and abuse under the Federal anti-kickback statute and the Beneficiary Inducements CMP provided the free blood draw services being offered by an HHAthrough its staff membersto Federal health care program beneficiaries who are not patients of the HHA and reside in an assisted living facility are: (1) within the scope of practice of the HHA's staff; (2) limited to the period subject to the COVID-19 Declaration; and (3) not contingent upon referrals for any items or services that may be reimbursable in whole or in part by a Federal health care program, either during or after the COVID-19 Declaration period. Transportation problems are often cited as a barrier to receiving care and medical compliance. However, under other circumstances, arrangements between the donor and the provider, or indirect financial relationships between the donor and the patient, could implicateand present risk underthe Federal fraud and abuse laws. Federal government websites often end in .gov or .mil. Narrator: Simultaneously, the paramedics are checking the patient's overall condition, looking at their airway, breathing, and circulation. 8. We recognize that many physicians who prescribe extended courses of treatment such as chemotherapy, dialysis, radiation therapy, cardio/pulmonary rehabilitation treatment, or behavioral health services to beneficiaries may desire to provide transportation assistance to mitigate the effects of office closures caused by the COVID-19 outbreak or increased risk of exposure to COVID-19 for patients who use public transportation to access care. Similarly, we received a question about a SNF or other long-term-care provider filling patient-care needs as a result of staffing shortages with, for example, community dentists or podiatrists who otherwise are not practicing at full capacity during the current public health emergency and are willing to offer their services for free or at a reduced rate to the SNF's patients on a temporary basis. 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 may violate the Federal anti-kickback statute; similarly, depending on the facts and circumstances, the provision of free goods or services to Federal health care program beneficiaries may implicate the Beneficiary Inducements CMP. The arrangement would implicate the Federal anti-kickback statute because the clinical laboratory would pay remuneration to a referral source (i.e., the retail pharmacy). Upon arrival for your ride-along shift, you will be required to sign a liability waiver and agree to a routine wants and warrants check by the on-duty watch commander. OIG's longstanding guidance makes clear that, depending on the facts and circumstances, providing free or discounted goods or services to an actual or potential referral source may violate the Federal anti-kickback statute. 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. However, given the unique circumstances of the COVID-19 public health emergency, we believe that the provision of free or reduced-cost masks would pose a low risk of fraud and abuse under the Federal anti-kickback statute provided that (1) the decision to furnish masks for free or at a reduced cost is directly connected to addressing the impact of the COVID-19 outbreak (e.g., the nursing home needs masks due to COVID-19 supply chain disruptions); (2) the masks are furnished only during the time period subject to the COVID-19 Declaration; (3) the provision of free or reduced-cost masks is not marketed by the physician group; and (4) the provision of the masks is not made contingent on the nursing home's referrals to the physician group of any specified item or service, or any specified volume or value of past or anticipated referrals of items or services that may be reimbursable, in whole or in part, by a Federal health care program. Routine waivers of cost-sharing obligations implicate the Federal anti-kickback statute and the civil monetary penalty provision prohibiting inducements to beneficiaries and may result in overutilization or inappropriate utilization of items and services reimbursable by Federal health care programs. Drivers receive no formal medical training. The mask is there to protect others from other respiratory droplets or anything that is coming out. The AAA, PWW and other ambulance industry partners have also requested that CMS relax the ambulance medical necessity rules during the public health emergency. Mathai explains car air ventilation flows from the back to the front window. COVID can worsen quickly at home. Thank you. Changes are already occurring in isolated circumstances. An FQHC has received funding from a non-governmental donor to be used to provide free COVID-19 diagnostic testing to vulnerable populations that may have difficulty accessing testing due to low income, lack of transportation, or other barriers. However, there are exceptions to this rule such as when the patient is unconscious, a minor, intoxicated or mentally incompetent. We recognize, however, that beneficiary obligations that arise as a result of billing by ambulance providers or suppliers under the Waiver could result in the perception of "surprise billing," particularly with respect to retroactive billing for services that were provided prior to the issuance of the Waiver. During the COVID-19 public health emergency, some patients who receive care from FQHCs may be experiencing additional financial hardships. Theres a risk of the coronavirus on surfaces, but a majority of transmissions are not from it.. In the facts presented, the FQHC would provide the free use of space for the pharmacy to operate a vaccination clinic. A new study finds that rolling your windows down is more effective than car ventilation for improving air circulation and reducing airborne transmission of the coronavirus. I am an eligible provider who received a distribution through the CARES Act Provider Relief Fund. Second, the TNC must have the logistical capabilities to provide NEMT to transportation-vulnerable Medicare and Medicaid recipients. 4 /16. Can the FQHC furnish cash-equivalent gift cards, in specified amounts, to address social determinants of health for financially needy individuals, including Federal health care program beneficiaries who meet certain criteria? In the limited context of the COVID-19 outbreak and in light of certain flexibilities in coverage for various telehealth and other virtual services payable by Federal health care programs, we believe the provision of a cell phone, service or data plan, or both (individually or collectively, "Telecommunications Technologies") by a mental health or substance use disorder provider to a patient likely presents a sufficiently low risk of fraud and abuse so long as the arrangement includes the following safeguards: (i) the provider determines in good faith that the patient is in financial need in advance of providing the Telecommunications Technologies; (ii) the provider determines in good faith that the patient requires Telecommunications Technologies to access medically necessary services related to his or her mental health or substance use disorder treatment; (iii) all services furnished using the Telecommunications Technologies are medically necessary, which lowers the risk of overutilization or inappropriate utilization; (iv) the provider uses the third party's funding solely for Telecommunications Technologies; (v) the provider does not market the Telecommunications Technologies (e.g., offer or provide free phones to generate business); (vi) the provider offers the Telecommunications Technologies only to "established patients" as that term is defined under 42 C.F.R. 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). Although drivers can bring a transportation-vulnerable individual to a pharmacy anywhere across the country, they don't have scaled capabilities to pick up the prescription and deliver it to the individual's home. Just like it's illegal to hold onto children and infants in your personal vehicle while it's traveling, the same holds suit in the back of an ambulance. 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. RAND is nonprofit, nonpartisan, and committed to the public interest. We also acknowledge that it may be possible for parties to structure the provision of free or reduced-cost lodging to meet the Promotes Access to Care exception to the Beneficiary Inducements CMP (see, e.g., OIG Advisory Opinion 17-01), but we are unable to make this determination without all the relevant facts, and we further note that there is no parallel safe harbor for protection under the Federal anti-kickback statute. However, under the facts presented to us, the COVID-19 relief grant was specifically designated for emergency cash assistance to individuals and, in the limited context of the COVID-19 public health emergency and with the combination of safeguards presented below, distributing the grant funds to individuals including Federal health care program beneficiaries in the form of cash-equivalent gift cards would be sufficiently low risk. 49 views, 2 likes, 1 loves, 3 comments, 1 shares, Facebook Watch Videos from Hope Center Covenant Church: Sunday Celebration, April 09, 2023 Join us. For parties analyzing referrals by physicians for designated health services to entities under sections II(B)(12)-(17) of the blanket waivers under the Federal anti-kickback statute, we advise parties to consider whether such referrals would result in remuneration that implicates the Federal anti-kickback statute. endstream endobj startxref 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. Some states were unable to allow TNCs to provide NEMT because of historical barriers, driver requirements, or other obstacles. Can mental health and substance use disorder providers accept donations from public entities (i.e., local, State, or Federal government entities), private charitable foundations, or health plans to fund cell phones, service or data plans, or both for patients who are financially needy or who do not own their own cell phone for the purpose of furnishing medically necessary services while in-person care is disrupted during the COVID-19 outbreak? Jocelyn Solis-Moreira is a journalist specializing in health and science news. 442 U.S.C. According to the facts presented, an oncology group practice has temporarily closed a particular office due to actual or potential patient and staff exposure to COVID-19. In the case of the COVID-19 public health emergency, the Secretary has issued subsequent 90-day renewals of the original January 31, 2020, public health emergency determination.
