Ombudsman Defends Nursing Home Decisions During Pandemic
Michigan’s Long-Term Care Ombudsman, Salli Pung, says she believes the “best decisions” were made about the placement of COVID-19 patients in nursing homes given the information and resources that were available at the time.

“If we had the opportunity to create nursing homes that were isolated simply for residents with COVID-19, we would all pick that,” Pung told the House Joint Select Committee on the COVID-19 Pandemic Sept. 15. “We would want that for them because that would be the safest, but I don’t know that we had that opportunity to do that and staff it and meet residents’ needs because staffing is critical at this time. There are not people beating down the doors to work in nursing homes, unfortunately.”

She also had reservations about the field hospitals that the state set up, like the one established in the TCF Center in Detroit.

“I was concerned that it wouldn’t meet the residents’ needs for safety and access to services and supports that they needed. Things as simple as utilizing the restroom might have been really challenging in that type of a setting. But at the same time, I, of course, had concerns that we wouldn’t want to be introducing COVID-19 into [Read More]

By JESSICA BUSCH
Minimally invasive cosmetic medical services are on the rise and in high demand. With their recent popularity, many licensed cosmetologists and estheticians are looking to offer these cosmetic medical services to their existing customers. Midlevel medical providers, such as registered nurses, advanced practice nurses, or physician assistants often desire to leverage their medical experience to start cosmetic medical businesses of their own. These businesses can yield significant profits and present an enticing investment opportunity for licensed physicians.

However, there are numerous legal pitfalls associated with offering cosmetic medical services that must be considered and avoided. Most significantly, cosmetology and medical spa businesses (collectively referred to herein as “medical spas”) are often unaware that they are illegally engaging in the unauthorized practice of medicine. Without the proper legal structure, partnering physicians also expose themselves to potential civil and criminal liability and put their medical licenses at risk.

What are Cosmetic Medical Services?

The term “cosmetic medical services” is intended to refer to a subset of medical-grade skin care and aesthetic services that constitute the practice of medicine and may only be performed by, or under the supervision of, a licensed physician. Cosmetic medical services generally are not medically necessary and can be minimally invasive, which often [Read More]

Michigan hospitals have lost a combined $1.1 billion during the recent pandemic, and that’s even after factoring in $2.1 billion in emergency federal aid, according to a Michigan Health and Hospital Association report released July 30.

The loss of patients, canceled and delayed medical procedures, staffing changes and the need to buy additional personal protective equipment has cost the hospitals a combined $2.7 billion, according to the report. The addition cost of treating COVID-19 patients has added $440 million in emergency expenses for a total of $3.2 billion in combined financial losses.

MHA noted that MidMichigan Health lost 24 percent of its impatient volume between March and June compared to the same time period in 2019.

This comes at a time when hospitals muscle through nearly $2.6 billion in uncompensated care they typically expect during normal circumstances.

“Responding to the COVID-19 pandemic has come at a steep price,” said MHA CEO Brian Peters. “Now more than ever, support is needed for the hospitals and health care providers that have been serving on the front lines of the pandemic.”

Back in April, the financial losses for the states’ 134 hospitals was at $600 million.

Meanwhile, nursing homes also are on the financial ropes due to the COVID-19 pandemic, according to the American [Read More]

By LIZ SZABO
With millions of lives on the line, researchers have been working at an unprecedented pace to develop a COVID-19 vaccine.

But that speed — and some widely touted breakthroughs — belie the enormous complexity and potential risks involved. Researchers have an incomplete understanding of the coronavirus and are using technology that’s largely unproven.

Among many worries: A handful of studies on COVID-19 survivors suggest that antibodies — key immune system proteins that fight infection — begin to disappear within months. That’s led scientists to worry that the protection provided by vaccines could fade quickly as well. Some even question whether vaccines will really end the pandemic. If vaccines produce limited protection against infection, experts note, people will need to continue wearing masks and social distancing even after vaccines roll out.

Yet in an interview with Kaiser Health News, the country’s top infectious disease expert, Dr. Anthony Fauci, said he’s “cautiously optimistic” that researchers will overcome such obstacles.

“We know the body can make an adequate response against this virus” after two shots of a vaccine being tested, Fauci said. “There’s no reason to believe that we won’t be able to develop a vaccine against it.”

Because early-stage trials began just a few months ago, doctors don’t know how [Read More]

By EWA MATUSZEWSKI
“I have often depended on the kindness of strangers.” Thus, wrote Tennessee Williams in his famous Streetcar Named Desire. We, too, looked to the kindness of strangers in the early days of the pandemic, particularly for personal protection equipment. It was an all-in, humanitarian effort to keep our colleagues and patients safe. Because there were more stringent demands for the wearing of PPE for longer durations, and for more frequent changing of PPE than in our halcyon pre-pandemic days, the need to quickly source PPE for immediate use was paramount.

I wrote in a previous column of the need for keeping a 30-day inventory of PPE. I want to reiterate that, but also stress that depending on strangers to step in and restock PPE inventory as the pandemic continues is a foolish and fraught strategy. Poor planning on your part does not constitute a crisis on my part. A colleague shared this adage with me years ago, and it’s a perfect fit for this situation. If you need more stable channels for reliable PPE supplies, look to your physician organization for referrals, talk to your existing office and cleaning suppliers or consider joining an association that offers PPE resources as a member benefit. I [Read More]

By ROLF LOWE
In July of 2020 the Wisconsin Supreme Court issued an opinion addressing the scope of the Wisconsin Department of Health Services authority to recoup payments to Medicaid service providers. Plaintiffs Kathleen Papa and Professional Homecare Providers (PHP) challenged WDHS’s recordkeeping policies, which included identifying things such as paperwork mistakes, that resulted in significant overpayment obligations from the state’s independent private duty nurses. In seeking an overpayment WDHS didn’t challenge whether the nurses provided a Medicaid patient with a covered service or that the payment for the claim was inappropriate or inaccurate, but instead based its right to seek recoupment of Medicaid funds because of inadequate documentation. The policy at issue covering the documentation requirements was affectionately identified by the Court as the “Perfection Policy.”

While the Court reviewed several issues on appeal, some of them procedural, the substantive issue decided in PHP’s favor was whether the Perfection Policy exceeds WDHS’s recoupment authority. In one of its previous filings in a lower court PHP provided an affidavit from one of the nurses that characterizes the scrutiny of the Perfection Policy reiterated by the Court in its opinion, stating that WDHS’s Office of Inspector General’s recoupment efforts were based on “noncorrelation between the medication record, the [Read More]

By ROSE WILLIS
In the world of health information technology, “information blocking” generally refers to actions that discourage the interoperability of electronic health information except when necessary to comply with law (e.g. HIPAA). The concept applies to a range of problematic activities from charging patients unreasonable fees for copies of their electronic medical record to a software system’s inability to transfer records to a healthcare provider’s new electronic medical record system. Ultimately, information blocking hinders the desired full interoperability and exchange of electronic healthcare information (EHI).

The Federal Department of Health and Human Services, Office of the National Coordinator for Health Information Technology (ONC) released a Final Rule on May 1, 2020 (the Final Rule), which implements the information blocking provision of the 21st Century Cures Act, enacted in 2016. The information blocking provision applies to health care providers, health IT (HIT) developers and health information exchanges/networks (HIEs).
The Final Rule defines information blocking broadly as any practice that is likely to interfere with, prevent or materially discourage access, exchange or use of EHI when the actor knows it is likely to do so. Under this definition, information blocking is an “intent based” action that can take many forms, such as:

• A healthcare provider charging an unreasonable fee [Read More]

A Run On Tests For Senators After One Member Positive For COVID

Word that Sen. Tom Barrett (R-Charlotte) tested positive for COVID-19 on July 31 has led to a run on tests in the upper chamber.

Five days earlier, Barrett was with Sen. Adam Hollier (D-Detroit), on a district exchange program that included a student-less Pershing High School as part of their Motown visit. Hollier then visited Barrett’s district. Barrett says they both wore masks the entire time.

Hollier, whose wife is pregnant, tested negative for the virus Aug 3.

Others who have reportedly been tested include Sen. Jeremy Moss (D-Southfield), Sen. Betty Jean Alexander (D-Detroit) and Sen. Erika Geiss (D-Taylor).

Sen. Peter Lulido (R-Shelby Twp.), at the urging of his wife, was slated for a test Aug. 4. During last week’s Judiciary and Public Safety Committee hearing on July 30, Lucido sat two seats away from Barrett.

“Sen. Curt VanderWall (R-Ludington) sat between us and that’s a pretty big buffer to have,” Lucido joked.

VanderWall said he had already been tested Aug. 3 and he expected to have the results back Aug. 4.

Sen. Ruth Johnson (R-Holly) had just got off the phone with her doctor when MIRS called. She will be tested as soon as possible. Several senators who were in [Read More]

By SUSAN ADELMAN, MD
Anyone who follows the supposed official numbers of people dying of coronavirus will find inexplicable discrepancies in the numbers from country to country. For example, the data for June 6 on the Worldometers website record 111,636 deaths in the United States and 4,634 in China, the country in which the virus originated. China? A country of 1.4 billion people? Really? India, a country with 1.3 billion people, reports only 6,933 deaths, as contrasted with Belgium, a country of 11.5 million people, which had 9,580 deaths. Seriously?

What about Germany, population 83.7 million, with 8,766 deaths, as contrasted with Spain, population 46.7 million, with 27,135 deaths, or Italy, population 60 million, with 33,846 deaths? How can this be? How do they count these deaths? Do they have political agendas?

Of course the website’s data collection methods could be faulty, and some have accused it of numerous discrepancies, but other websites have similar numbers. The key question is whether these are a potpourri of deaths from coronavirus, deaths among people who also have coronavirus, deaths of people who are assumed to have coronavirus, or even whether the deaths were of people proven by accurate tests actually to have coronavirus. We will come back to the various [Read More]

Those days are gone forever. I should just let them go…
—Don Henley

By PAUL NATINSKY
Irrevocable changes are here and more are to come. COVID-19 will change small things as well as large.

We might finally be seeing the end of currency. Bills and coins are some of the dirtiest things we encounter in the course of our daily lives. Gone for good, likely, is the handshake, possibly the casual greeting kiss or hug. I vote for the bow to replace these conventions—elegant and regal, safe and sanitary.

Big things will change, too. Social distancing and reduced capacities for indoor businesses, restaurants, bars, concert halls and movie theaters are likely to stick in some form. The same is true for public transportation and ride services. Masks? The nonsensical controversy there looks like it too, will continue for years, not months.

Distance learning for schools and remote working for businesses—already established by some institutions, pre-COVID, likely will continue to develop.

As scientists struggle to learn more about the virus amid a hostile political environment, solid answers on how to slow its spread and treat its ravages remain elusive.
Much hope is being pinned on finding a vaccine. If one is developed, would enough people vaccinate to slow or stop the virus? Would anti-vaxxers [Read More]

By EWA MATUSZEWSKI
This column was not supposed to be about COVID-19—yet it must be. Not only because the virus continues to thrive in various parts of the country as I write this on the cusp of the 4th of July holiday weekend, but because in many ways the hard part has just begun.

I do not mean to minimize the extreme sickness and loss of life during the pandemic’s peak. That was a tremendously frightening and heartrending time not only in our nation but globally, and healthcare professionals at all levels used heroic measures to tame a fearsome, unknown enemy that was – and is – the virus. Their work continues, while ours has begun in fits and starts.

By “ours,” I refer to those of us in the healthcare community who are not treating patients in the hospital or rehabilitation facilities. I also refer to leaders beyond healthcare – business owners, managers and supervisors who must convey through their actions the seriousness of the virus and its easy spread. The standard has been set, with an array of health and safety protocols such as screening questions for potential COVID-19 symptoms or exposure, temperature screening, masks, physical distancing, hand washing, and reduced capacity. Some mandated, some strongly [Read More]

By ROLF LOWE
The COVID 19 pandemic has had a significant impact on health care providers of all sizes and practice areas. While non-essential services came to a halt during the early part of the pandemic creating a sudden income loss, the loss of insurance coverage for existing and potential patients due to a job loss, reduction in income or reduction in hours worked could have a lingering effect on patient visits for routine care and serious health conditions. Fortunately, the Health Insurance Marketplace created by the Affordable Care Act and the Medicaid program allow individuals who have lost their health insurance to find low or no cost options for health care coverage.

Providers typically verify insurance coverage when a patient shows up in the office for a scheduled visit. In the wake of the COVID 19 pandemic that practice needs to evolve. Providers need to be proactive and reach out to patients and inform them of potential alternatives for health care coverage in the event they do lose coverage. While there were significant job losses resulting in a loss of health care coverage early on in the pandemic, many employers took advantage of the Payroll Protection Program in the CARES Act to keep staff on [Read More]

By ALEXANDRA CRANDALL
The COVID-19 National Emergency has now been effective in the United States for three months. During this time, guidance from federal agencies has been dynamic as the government adapts to the “new normal.”

But even as the global health crisis halts nonessential travel and disrupts visa issuance to many foreign nationals, federal agencies have published additional guidance and announced special consideration for medical professionals. To be sure, these carve-outs are critical, as 17 percent of medical professionals—and 28 percent of all physicians—in the United States were born outside of the United States.

Medical Professionals Present in the United States:

USCIS has implemented a temporary policy change for former J-1 medical graduate physicians who (1) were granted a waiver of the two-year foreign residence requirement; and (2) currently practice in the United States as H-1B nonimmigrant physicians based on interest from a government agency.

Typically, in order to maintain their waiver, these former J-1 medical graduate physicians must work full-time (40 hours a week) and administer healthcare to a population in a “shortage area” (as defined by the U.S. Department of Health and Human Services). In a policy memo dated May 11, 2020, USCIS provided the following “flexibilities” for these medical graduates who “are assisting in the [Read More]

Gov Mulls How To Enforce Mask-Wearing
Gov. Gretchen Whitmer said July 9 she is reviewing the state’s current mask-wearing requirements to consider “whether or not we need to take this a step further to strengthen compliance.”

The governor led off her COVID-19 update press event with a picture from the Diamond Lake sandbar party from the over the weekend and said she wanted to make it “very clear” the law still requires people to wear masks in enclosed places of accommodation.

“Make the mask. Make the mask with a political statement saying ‘I hate masks’ if you want. But just wear it,” the governor said toward the end of the press conference.

Whitmer said “we do actually have penalties under the law,” but it comes down to enforcement, which she said comes at the local level. She said “we have the ability for a misdemeanor and a fine” but she said she is considering what’s going to be the “most helpful to encourage compliance.”

She added that “the last thing I want to do is be doling out lots of penalties.”

Meanwhile, Chief Medical Executive Dr. Joneigh Khaldun said statewide COVID-19 data trends “is not looking so good” and while Michigan is not in the “extreme situation we were in this [Read More]

(This story courtesy of MIRS, a Lansing-based news and information service.)

House Judiciary Committee members had some hard questions May 19 about legislation that would give immunity to hospitals, nursing homes, and health care providers from civil suits related to the COVID-19 pandemic.

In the end, the bill designed to tie up a loose end caused by the Legislature not extending the governor’s original emergency declaration didn’t move out of committee.

“If this bill passes, if it actually gets signed in its current form, which is incredibly unlikely, then plaintiffs would be unable to bring a suit or a theory saying that there was a failure to exercise appropriate care under the circumstances?” Rep. Brian Elder (D-Bay City) asked of Amy Barkholz of the Michigan Health and Hospital Association. She testified in support of SB 0899, sponsored by Sen. Michael MacDonald (R-Sterling Heights).

Elder contended that under current law, “a regime of Michigan tort reform, it is already incredibly difficult to bring medical malpractice cases.” In court, the judge would have to consider the circumstances, which would necessarily include the fact that the state is under a pandemic.

“You are saying that a person, if they can find a lawyer, if they can actually get all of the experts [Read More]

By CARMEN HEREDIA & ANNA ALMENDRALA
As a contact tracer, Teresa Ayala-Castillo is sometimes asked whether herbal teas and Vicks VapoRub can treat COVID-19. These therapies aren’t exactly official health guidance, but Ayala-Castillo isn’t fazed. She listens and then suggests other ideas — like getting rest and drinking plenty of fluids.

“I don’t want to call them old wives’ tales, but these remedies are things that I’m 100 percent familiar with because my mom used them on me,” said Ayala-Castillo, a bilingual first-generation Ecuadorian American who works for the city of Long Beach, California.

Health departments across the United States are working at a furious pace to staff their armies of contact tracers to control the spread of the coronavirus that causes COVID-19. Experts estimate local and state health departments will have to add 100,000 to 300,000 people to get the economy back on track.

As they build these forces, many states and localities are trying hard to hire from the racial and ethnic minority communities hit hardest by the virus. They’re anticipating a need for skilled, culturally competent tracers who can convert suspicious or hesitant contacts into enthusiastic, willing participants in the drive to stamp out the virus.

Virus-tracking activities vary by state. Most states have created plans to [Read More]

By EWA MATUSZEWSKI
The emergence of a best practices playbook for physician practices following the pandemic is likely as close as any primary care physician practice has come to having a strategic plan. Of course, a playbook or return-to-work strategy is not a strategic plan. It is focused on health and safety for patients, practice teams, vendors and anyone who sets foot in a physician’s office. But if you haven’t considered adopting a broader strategic plan as an offshoot of a playbook, it’s advisable to do so now.

Learn from other industries. I was in the trenches with PCPs as they struggled with financial issues, staff layoffs, insufficient personal protection equipment and other COVID-19 induced threats to a practice’s viability. Prior to the recent availability of guidance from national and state medical agencies and professional medical associations, which came far too late in my opinion, I turned to social media as part of my information gathering process to create our own back-to-work manual. That’s where I “met” Gary Johnson, Chief Manufacturing and Labor Affairs Officer at Ford Motor Company.

I don’t know Mr. Johnson, but I requested permission via LinkedIn to utilize the Ford Motor Company COVID-19 Playbook. He gave me permission and I incorporated some of the [Read More]

By KAITLIN NUCCI
On May 21, Gov. Gretchen Whitmer issued Executive Order No. 2020-96 in response to the steady drop in confirmed daily cases of COVID-19. This new order has lifted the postponement of non-essential medical and dental procedures as of May 28 at 11:59 PM. Upon the resurgence of these medical and/or dental services, outpatient healthcare facilities will be subject to the workplace safety rules as provided in Executive Order 2020-97. These restrictions aim to continue the downward trend in daily confirmed cases, while acknowledging that COVID-19 remains a danger in the state of Michigan.

Executive Order 2020-97 enacts safeguards that facilities must use in providing non-essential services. These facilities will be required to post signs at entrances that instruct patients to wear some sort of face covering while inside. Patients will be required to wear this face covering while inside the facility, except as necessary for identification purposes or to conduct an examination or procedure, and facilities must provide face coverings and hand sanitizer at the patient entrances. Of course, employees will be required to properly use their personal protective equipment pursuant to CDC and OSHA guidelines.

A facility’s waiting area capacity must be limited to the number of people who can be present while [Read More]

By MARK E. WILSON
Over the past few months the State of Michigan along with the world has been stricken by a pandemic not seen for the last 100 plus years. Throughout the last few months the learning curve has been steep while the best medical and scientific minds have struggled to learn everything possible about the disease.

In Michigan at the end of May there had been nearly 58,000 cases and more than 5500 deaths due to Covid-19. It is likely we will find out that even more people have had the virus but never knew it. The shelter in place, social distancing, masking and closing of the economy were widely accepted as the only anecdotes available in the early days. The impact on those anecdotes will likely result in the State unemployment numbers being in the millions. Throughout the pandemic, reliance on the science and the data became the lynch pins for actions taken to save lives. And while every expert does not believe it is over, imagine the stress on the State’s citizens, economy and its health care system if the vast majority of the symptoms were not “mild.”

As more and more becomes known on how to limit exposure, protect people and eventually [Read More]

(This feature presented in cooperation with MIRS, a Lansing-based news and information service)

Statewide COVID-19 Testing At Center Of Recovery Plan
Michigan should implement statewide COVID-19 testing system to ensure people coming back into the workforce are not spreading the coronavirus, Business Leaders for Michigan advocated June 1 as part of their economic recovery plan.

The group is suggesting repurposing existing state and federal money and streamlining the government approval process to assist employers in getting their displaced workers back on the job safely.

In laying out the business roundtable’s three-part plan, BLM President & CEO Doug Rothwell also is advocating for the Department of Transportation and county road commissions to put a priority on starting “shovel ready” projects.

They want a streamlined permitting process, money put back into the Pure Michigan tourism program, and helping Michigan Business Connect with suppliers as their global supply chains adjust.

The Business Leaders also want a review of the state’s tax structure and the state Department of Licensing and Regulatory Affairs to accelerate certificate programs for in-demand positions.

At the front of all these proposals, Rothwell said, is putting a priority on protecting public health as part of its COVID-19 plan.

“The shutdown of operations across industries is unprecedented,” Rothwell said. “There was no playbook [Read More]

(This story presented as part of a cooperative effort between Healthcare Michigan and MIRS, a Lansing-based news and information service.)

Detroit reported that the city’s COVID-19 related deaths continues to decline, with nine additional deaths reported May 1, bringing the city’s total to 1,045.
Mayor Mike Duggan said in his daily press briefing that the number of deaths at nursing homes, however, continues to grow. By May 1, 233 nursing home residents and three staff had died after testing positive for COVID-19, he said.

“The numbers are coming down extremely fast,” he said. “What we’re doing is continuing to work … Before this is over, we’re going to find a quarter to a third of all the deaths in the city occurred at the nursing homes and senior living facilities.”

Duggan said the numbers are low, in part, because “we did not get a bunch of old death certificates” from the state. He prefers to measure the city’s progress by using the weekly numbers, saying the city had 197 COVID-19-related deaths weeks four weeks ago compared to 81 this week.

To date, the city has 9,192 positive COVID-19 cases, city health officer Denise Fair said.

The Mayor also announced that more than 400 city employees were scheduled to return to [Read More]

By JULIE ROVNER
The United States is in the midst of both a public health crisis and a health care crisis. Yet most people are not aware these are two distinct things. Further, the response for each is going to be crucial.

If you are not a health professional of some stripe, you might not realize that the nation’s public health system operates in large part separately from the system that provides most people’s medical care.

Dr. Joshua Sharfstein, a former deputy commissioner for the Food and Drug Administration and now vice dean at the school of public health at Johns Hopkins in Baltimore, distinguishes the health care system from the public health system as “the difference between taking care of patients with COVID and preventing people from getting COVID in the first place.”

In general, the health care system cares for patients individually, while public health is about caring for an entire population. Public health includes many things a population takes for granted, like clean air, clean water, effective sanitation, food that is safe to eat, as well as injury prevention, vaccines and other methods of ensuring the control of contagious and environmental diseases.

In fact, it is public health, not advances in medical care, that has accounted for [Read More]

By EWA MATUSZEWSKI
Will healthcare be forever changed in a post-COVID-19 world? Hopefully yes and hopefully no. We must of course hang on to what is good about our healthcare system. Primary care physicians and nurse practitioners affirming the care model of the patient-centered medical home. Fearless leaders such as Dr. Kimberly Farrow, CEO of Central City Integrated Health, and Dr. Anthony Clarke of Health Centers of Detroit, who toiled away in the heart of the city, the epicenter of Michigan’s pandemic, to treat, comfort, educate and encourage our state’s neediest patients. In the meantime, minutes and hours away, family medicine physicians, internal medicine docs, pediatricians and other Michigan providers also cared for their patients, some introducing makeshift telehealth, others treating, if not COVID-19 symptoms, then the anxiety and depression they spawned. And that will be a healthcare change.

There will be a new COVID-19 post-traumatic stress disorder experienced by healthcare workers, first responders and grocery store clerks. Primary care providers and behavioral health specialists must be prepared. These same professionals must plan to support and care for each other, as well as colleagues who engaged in the war against COVID-19 with varying degrees of battlefield exposure. From the front lines to federally qualified health centers to [Read More]

(EDITOR’S NOTE: The opinions expressed below are those of the author and not necessarily those of Healthcare Michigan or its publisher.)

By SUSAN ADELMAN, MD
One nation in the developed world stands out for its exceptional approach to the coronavirus pandemic – Sweden. While most Americans were locked down, we looked with jealousy at pictures of Swedes walking on the streets, seemingly unconcerned, living normal lives. How could they do that, and has it worked?

First, it is a myth that the Swedes have had no restrictions, but their rules certainly have been more relaxed than those in most of Europe or in the United States. While their schools remained open for younger children, colleges and universities went online. Businesses and hair salons are open, but people are advised to work from home where possible. Home care and nonessential travel were banned, and so were gatherings of more than 50 people. Restaurants remained open but not bars. Restaurants had to maintain 1.5 meters of separation between tables. Almost all games are closed or must be played without an audience. Concerts and large social activities are closed. Social distancing is voluntary, but the Swedes dutifully stay away from each other. Sweden’s borders are closed to non-EU residents. Internal travel [Read More]

By KIMBERLY RUPPEL
In this new normal we are experiencing as a result of the COVID-19 pandemic, social distancing and telehealth go hand in hand. Telehealth includes a range of technology, for example, the use of real-time video interaction, “store and forward” technology, remote patient monitoring or online chat groups.

Telehealth is particularly well suited for initial screening of patients and providing quicker and safer access to providers now, and also once we are safely beyond the current health crisis. As a result, this is a critical time for healthcare providers to encourage their patients to make use of this valuable tool and to implement or improve processes and systems already in place. More often, older patients are reluctant to give up the familiar in-person encounter.

Yet, that is exactly the population that may benefit the most from the efficiency and convenience of avoiding travel time or sitting in a waiting room possibly subjecting themselves to exposure to unknown health risks from other patients.

Both federal and state guidelines on this topic are rapidly evolving, many of which are intended to be temporary and only apply while the current state of public health emergency remains in effect. The CARES Act provides a number of important temporary waivers of [Read More]