The HFMA MA-RI Chapter would like to thank all of those who made April 9th Telehealth & Hot Topics in Compliance Virtual Roundtable a success! Thank you to our more than 40 participants who joined us for our first virtual roundtable in 2021.
A special thank you to our speakers and moderator, Kyle Faget, Partner, Foley & Lardner, LLP, Garrett Gillespie, VP, Deputy General Counsel & Corporate Compliance Officer, BMC HealthNet Plan, Dr. Rebecca Mishuris, Chief Medical Information Officer, Boston Medical Center, Donna Schneider, VP, Corporate Compliance and Internal Audit, Lifespan, Larry Vernaglia, Partner, Foley & Lardner, and Dhara Satija, Senior Manager, Deloitte & Touche LLP for sharing their insights. We hope you enjoyed the discussion and look forward to having more in the near future.
The Compliance Hot Topics panel featured Garrett Gillespie, Donna Schneider, and Larry Vernaglia. The panelists discussed a wide variety of current compliance topics as a result of the pandemic and the change in administration in Washington.
- Before the pandemic, rural providers were the innovators in using telehealth in order to increase access to care in remote areas as a result of Medicare reimbursement rules.
- As a result of the pandemic, and the less restrictive reimbursement rules, the providers in more urban areas have caught up in using telehealth.
- The success of telehealth visits and its endorsement by both patients and providers most likely will result in payers maintaining coverage for telehealth visits once the public health emergency ends, although there may be some new restrictions adopted.
- The legal implications of a missed diagnosis during a telehealth visit really are not higher than during an in-person visit. The ultimate question comes down to whether the provider met the applicable standard of care.
- Before the pandemic the biggest concern for compliance officers probably was a data breach. In the last year, the primary concerns now are spread over many areas, including data breaches, the Cures and CARES Acts, billing under the new pandemic rules, Provider Relief Fund accounting and repayment, and HIPAA.
- The new Stark and anti-kickback rules have not been fully digested yet by most compliance officers. The new rules should be viewed as opportunities for providers instead of the rules adding to the many ways that a compliance officer can say “no” to proposals by staff.
- Compliance officers should keep careful track of all of the numerous waivers of regulatory requirements that were put into place during the public health emergency and how their organization has changed operations to take advantage of the waivers. This is important because once the pandemic is over and some of the waivers are withdrawn or changed, the organization must know what it must change again to be in compliance.
- Regulators follow the money. With the hundreds of billions of dollars that were distributed during the pandemic, one can focus on the biggest dollar areas to anticipate where the enforcement agencies will focus their activities.
- The change in administration in Washington is not expected to have a major shift in compliance enforcement. All regulators, regardless of political party, aim to control fraud, waste, and abuse. The career enforcers in agencies generally perform their job without regard to who is in power. That said, enforcement priorities may change but overall compliance officers should continue to focus as before.