Coronavirus (COVID-19) Guidance and Business Preparedness

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In Virginia and beyond, legal questions and concerns surrounding the COVID-19 virus are at the forefront today. Hancock Daniel has created a COVID-19 Task Force to counsel businesses and individuals and help them navigate the regulatory and legal issues around the topic.

The firm’s COVID-19 Task Force is here to assist with any questions or issues you may have related to the pandemic.  Please see our Advisories page for current updates on COVID-19.  The following members of the task force are available to answer your questions in their respective areas of expertise:

EMTALA/Conditions of Participation/Section 1135 Waivers- Mary Malone

Licensure/Certification/Bed Surge- Emily Towey

Safety and Security/Emergency Preparedness- Page Gravely

Contracts and Performance Issues- Mike Newby

Commercial Transactions: Jim Daniel

Employment/Human Resources and Medical Staff- Kim Daniel

HIPAA Privacy and Security- Bill Hall

FDA- Liz Whalley Buono

Insurance Coverage- John Mumford

Legislative/Executive Agency Developments- Scott Johnson, Ben Traynham

PUBLIC HEALTH RESOURCES:
AMA resource page for physicians
CDC information page
JAMA Coronavirus Resource Center
New England Journal of Medicine update page
NIH information page
National Library of Medicine Coronavirus page
World Health Organization Situation Updates

EXECUTIVE ORDERS, STATE HEALTH DEPARTMENTS and VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS RESOURCES:
New York State Department of Health’s Coronavirus page
North Carolina Department of Health and Human Services Coronavirus page
South Carolina Department of Health and Environmental Control Coronavirus page
Tennessee Department of Health’s Coronavirus page
Virginia Department of Health’s Coronavirus page
VDA Overview of Order of Public Health Emergency No. 2 March 25, 2020
Out-of-State Licensed Provider Reporting Form
State Health Commissioner Guidance on COVID-19 Information Sharing Between Long-term Care Facilities (LTCF) and Skilled Nursing Facilities (SNF) Memorandum, April 22, 2020
Press Release April 24, 2020: Governor Northam Unveils Blueprint for Easing Public Health Restrictions
Virginia Temporary waivers for Regulations Governing the Practice of Nursing
Virginia Temporary waivers for Regulations Governing Nurse Practitioners
Virginia Temporary waivers for Regulations Governing Medication Aides
Virginia Temporary waivers for Regulations Governing Nursing Education Programs
Virginia Temporary waivers for Regulations for Nurse Aide Education Programs
Virginia Temporary Waiver for Nursing Reinstatement or Reactivation
Virginia Temporary Waiver for Medicine Reinstatement or Reactivation
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-ONE: DECLARATION OF A STATE OF EMERGENCY DUE TO NOVEL CORONAVIRUS (COVID-19), March 12, 2020
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-TWO: INCREASES IN HOSPITAL BED CAPACITY IN RESPONSE TO NOVEL CORONAVIRUS (COVID-19), March 20, 2020
Virginia Order of the Governor and State Health Commissioner Declaration of Public Health Emergency, Order of Public Health Emergency One, March 20, 2020
Virginia Order of the Governor and State Health Commissioner, Order of Public Health Emergency Two, March 25, 2020
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-THREE (AMENDED): EXTENSION OF TEMPORARY RESTRICTIONS ON RESTAURANTS, RECREATIONAL, ENTERTAINMENT, GATHERINGS, NON-ESSENTIAL RETAIL BUSINESSES, AND CLOSURE OF K-12 SCHOOLS DUE TO NOVEL CORONAVIRUS (COVID-19)
VIRGINIA EXECUTIVE ORDER NUMBER 54: DELEGATION OF AUTHORITY TO THE COMMISSIONER OF THE VIRGINIA EMPLOYMENT COMMIISSIONER OF THE VIRGINIA EMPLOYMENT COMMISSION TO REQUEST TITLE XII ADVANCES TO SUPPORT VIRGINIA WORKERS, March 28, 2020
VIRGINIA EXECUTIVE ORDER NUMBER 55: TEMPORARY STAY AT HOME ORDER DUE TO NOVEL CORONAVIRUS (COVID-19) (2020), March 30, 2020
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-SIX (AMENDED): POSTPONING JUNE 9, 2020 PRIMARY ELECTION TO JUNE 23, 2020 DUE TO NOVEL CORONAVIRUS (COVID-19), April 24, 2020
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-SEVEN (AMENDED): LICENSING OF HEALTH CARE PROFESSIONALS IN RESPONSE TO NOVEL CORONAVIRUS (COVID-19), April 23, 2020
VIRIGNIA EXECUTIVE ORDER NUMBER FIFTY-EIGHT: ACCESS TO MEDICAID-COVERED HEALTH CARE SERVICES IN RESPONSE TO NOVEL CORONAVIRUS (COVID-19), April 23, 2020
VIRGINIA EXECUTIVE ORDER NUMBER FIFTY-NINE: POSTPONING MAY 5, 2020 GENERAL AND SPECIAL ELECTIONS TO MAY 19, 2020 DUE TO NOVEL CORONAVIRUS (COVID-19), April 24, 2020
VIRGINIA EXECUTIVE ORDER NUMBER SIXTY: CLARIFICATION OF CERTAIN IMMUNITY FROM LIABILITY FOR HEALTHCARE PROVIDERS IN RESPONSE TO NOVEL CORONAVIRUS (COVID-19), April 28, 2020
VIRGINIA EXECUTIVE ORDER NUMBER SIXTY-ONE AND ORDER OF PUBLIC HEALTH EMERGENCY THREE: PHASE ONE EASING OF CERTAIN TEMPORARY RESTRICTIONS DUE TO NOVEL CORONAVIRUS (COVID-19), May 8, 2020

FEDERAL LEGISLATION AND AGENCY GUIDANCE:
Paycheck Protection Program and Health Care Enhancement Act, passed by the Senate 4/21/20
Coronavirus Aid, Relief, and Economic Security Act (CARES Act)
H.R. 6201, FAMILIES FIRST CORONAVIRUS RESPONSE ACT (passed House 3/13/20)
H.R. 6201, FAMILIES FIRST CORONAVIRUS RESPONSE ACT (full text)
Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, Pub. L. 116-123 (3/6/20) ($8.3 billion in emergency funding for federal agencies to respond to COVID-19 outbreak and providing waiver authority for Medicare coverage of telehealth services during certain emergencies)
Secretary of HHS’s Declaration of Pubic Emergency (1/31/20)
Treasury, IRS and Labor March 20, 2020 Press Release Regarding Implementing Coronavirus-related Paid Leave and Tax Credits for Coronavirus-related Leave
DOL April 1, 2020 Temporary Regulations Implementing FFCRA Emergency FMLA Leave and Emergency Paid Sick Leave
DOL March 24, 2020 Guidance on Families First Coronavirus Response Act: Employee Paid Leave Rights
DOL March 24, 2020 Guidance on Families First Coronavirus Response Act: Employer Paid Leave Requirements
DOL March 24, 2020 Guidance on Families First Coronavirus Response Act: Questions and Answers
DOL Guidance on COVID-19 and the Fair Labor Standards Act Questions and Answers
DOL Guidance on COVID-19 and the Family and Medical Leave Act Questions and Answers
FCCRA Model Notice
Families First Coronavirus Response Act Notice – Frequently Asked Questions
Field Assistance Bulletin 2020-1: Temporary Non-Enforcement Period Applicable to the Families First Coronavirus Response Act (FFCRA)
April 9, 2020 Enforcement Discretion Regarding COVID-19 Community-Based Testing Sites (CBTS) During the COVID-19 Nationwide Public Health Emergency
HHS to Begin Immediate Delivery of Initial $30 Billion of CARES Act Provider Relief Funding 4/10/20
NPDB Query Fees Waived Through May 31, 2020
April, 2020 Guidelines for Opening Up America Again
Allocation of CARES Act Provider Relief Fund April 22, 2020
DEA Emergency Disaster Relief Guidance
US Dept. of Justice, Drug Enforcement Administration, Diversion Control Division COVID-19 Information Page
HHS Telehealth Resource Page

US CENTERS FOR DISEASE CONTROL AND PREVENTION:
Guidance on Mass Gatherings or Community Events 3/15/20
Interim Guidance for Protecting Health Care Workers from Exposure to 2019 Novel Coronavirus (2019-nCoV)
Coronavirus Disease 2019 (COVID-19) Hospital Preparedness Assessment Tool, Centers for Disease Control and Preparedness
Evaluating and reporting Persons Under Investigation (PUI), Centers for Disease Control and Preparedness
CDC Travel Notices
April 8, 2020 Interim Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19
Whitehouse Guidance: Opening Up America Again, April, 2020

CMS:
CMS Coronavirus Waivers 2020
CMS Blanket Waivers of Section 1877(g) of the Social Security Act (the federal Physician Self-Referral Law/Stark Law)
CMS Section 1135 Waiver Flexibilities – Virginia
CMS Section 1135 Waiver Flexibilities – Link to All Approved States Waiver webpages

CMS Fact Sheets on 1135 Waivers:

Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19
Ambulances: CMS Flexibilities to Fight COVID-19
Hospitals: CMS Flexibilities to Fight COVID-19
Teaching Hospitals, Teaching Physicians and Medical Residents: CMS Flexibilities to Fight COVID-19
Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities): CMS Flexibilities to Fight COVID-19
Home Health Agencies: CMS Flexibilities to Fight COVID-19
Hospices: CMS Flexibilities to Fight COVID-19
Inpatient Rehabilitation Facilities: CMS Flexibilities to Fight COVID-19
Long Term Care Hospitals: CMS Flexibilities to Fight COVID-19
Rural Health Clinics and Federally Qualified Health Centers: CMS Flexibilities to Fight COVID-19
Laboratories: CMS Flexibilities to Fight COVID-19
End Stage Renal Disease Facilities: CMS Flexibilities to Fight COVID-19
Durable Medical Equipment, Prosthetics, Orthotics and Supplies: CMS Flexibilities to Fight COVID-19
Participants in Medicare Diabetes Prevention Programs: CMS Flexibilities to Fight COVID-19
Medicare Advantage and Part D

Plans: CMS Flexibilities to Fight COVID-19Emergency Medical Treatment and Labor Act (EMTALA) and Ebola Virus Disease (EVD)—Questions and Answers (Q+A), Ref: S&C: 15-24-Hospitals, dated February 13, 2015
CMS COVID-19 FAQs (3/6/20)
CMS Fact Sheet re Coverage and Payment Related to COVID-19 – Medicare (3/5/20)
CMS Fact Sheet re Coverage and Payment Related to COVID-19 – Medicaid and CHIP (3/5/20)
CMS Fact Sheet re Coverage and Payment Related to COVID-19 – Individual and Small Group Market Insurance Coverage (3/5/20)
CMS Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV), Ref: QSO 20-09-ALL, Department of Health & Human Services, Centers for Medicare & Medicaid Services, dated February 6, 2020
CMS Information for Healthcare Professionals Landing Page re Current Emergencies, including COVID-19
CMS Information to Medicare Advantage Organizations Related to COVID-19 (3/10/20)
QSO-20-19-ESRD, Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in dialysis facilities (3/10/20)
QSO-20-18-HHA, Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs) (3/10/20)
QSO-20-17-ALL, Guidance for use of Certain Industrial Respirators by Health Care Personnel (3/10/20)
QSO-20-16-Hospice, Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) by Hospice Agencies (3/9/20)
QSO-20-15 Hospital/CAH/EMTALA, Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19) (3/9/20)
QSO-20-14-NH Revised, Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (revised 3/9/20)
QSO-20-13-Hospitals, Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge (3/4/20)
QSO-20-12-All, Suspension of Survey Activities (3/4/20)
QSO-20-10-CLIA, Notification to Surveyors of the Authorization for Emergency Use of the CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel Assay and Guidance for use in CDC Qualified Laboratories (2/6/20)
QSO-20-09-ALL, Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV) (2/6/20)
Centers for Medicare & Medicaid Services (CMS) Recommendations Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I, April 19, 2020
Upcoming Requirements for Notification of Confirmed COVID-19 (or COVID19 Persons under Investigation) Among Residents and Staff in Nursing Homes, April 19. 2020

US EQUAL EMPLOYMENT OPPORTUNITY COMMISSION:
What you should know about the ADA, the Rehabilitation Act and the Coronavirus
Pandemic Prepared in the Workplace and the Americans With Disabilities Act, updated March 21, 2020

OIG GUIDANCE:
March 17, 2020 OIG Policy Statement Regarding Physicians and Other Practitioners That Reduce or Waive Amounts Owed by Federal Health Care Program Beneficiaries for Telehealth Services During the 2019 Novel Coronavirus (COVID-19) Outbreak
April 3, 2020 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 (announcing enforcement discretion not to impose administrative sanctions under the Federal anti-kickback statute)

OFFICE FOR CIVIL RIGHTS:
Office for Civil Rights, U.S. Department of Health and Human Services Bulletin: HIPAA Privacy and Novel Coronavirus, dated February 2020
COVID-19 and HIPAA: Disclosures to law enforcement, paramedics, other first responders and public health authorities, March 24, 2020

OSHA:
Safety and Health Topics | COVID-19 – Standards | Occupational Safety and Health Administration
Temporary Enforcement Guidance March 14, 2020- Healthcare Respiratory Protection Annual Fit-Testing for N95 Filtering Facepieces During the COVID-19 Outbreak
April 3, 2020 Enforcement Guidance for Respiratory Protection and the N95 Shortage Due to the Coronavirus Disease 2019 (COVID-19) Pandemic
Ten Steps All Workplaces Can Take to Reduce Risk of Exposure to COVID-19
Guidance on Preparing Workplaces for COVID-19
Interim Enforcement Response Plan for Coronavirus Disease 2019 (COVID-19), April 13, 2020
Enforcement Guidance for Recording Cases of Coronavirus Disease 2019 (COVID-19), April 10, 2020

CREDENTIALING AND ACCREDITATION ORGANIZATION GUIDANCE:
AMBS Statement to DIOs Regarding Coronavirus Disease 2019 (COVID-19), March 13, 20202
The Joint Commission Bulletin, updated February 14, 2020
The Joint Commission standard on Infection Prevention & Control
The Joint Commission March 18, 2020 FAQ: Reappointment and Re-privileging Time During A Disaster
The Joint Commission Statement on Use of Face Masks Brought from Home
The Joint Commission FAQs to its Homemade Face Masks Statement
The Joint Commission extends suspension of regular surveys until end of May
FSMB COVID-19 Resource Page
NCQA Coronavirus Information Page

NATIONAL TRADE ASSOCIATION GUIDANCE:
The following links to COVID-19 guidance have been issued by various national health care trade associations. While this guidance is not government-issued, the information may be helpful and instructive:
American Hospital Association COVID-19 Landing Page
Federation of American Hospitals COVID-19 Landing Page
American Health Care Association / National Center for Assisted Living COVID-19 Landing Page
AMA announces new CPT codes for COVID-19 antibody tests

NATIONAL AND STATE ASSOCIATION GUIDANCE:
Virginia Dental Association Recommendation to Members
Responding to COVID-19—8 Steps for Hospitals to Protect Patients, Employees, and Communities
April 7, 2020 Letter to Governor Northam Requesting Legal Protections for Healthcare Providers (authored by LeadingAge Virginia, Medical Society of Virginia, Richmond Academy of Medicine, Psychiatric Society of Virginia, The American College of Obstetricians and Gynecologists, Virginia Academy of Physician Assistants, Virginia Association for Home Care and Hospice, Virginia Association for Hospices & Palliative Care, Virginia College of Emergency Physicians, Virginia Council of Nurse Practitioners, Virginia Dental Association, Virginia’s Family Physicians, Virginia Health Care Association – Virginia Center for Assisted Living, Virginia Hospital and Healthcare Association, Virginia Nurses Association, Virginia Orthopaedic Society, Virginia Society of Eye Physicians and Surgeons, Virginia Society of Oral & Maxillofacial Surgeons, Virginia Society of Plastic Surgeons)
American College of Surgeons, Local Resumption of Elective Surgery Guidance April 17, 2020
AMA COVID-19 volunteer guide for health care professionals, April 21, 2020

SMALL BUSINESS ASSOCIATION (SBA) GUIDANCE:
Coronavirus (COVID-19): Small Business Guidance & Loan Resources
SBA Paycheck Protection Program Information page
COVID-19 Economic Injury Disaster Loan Application
Paycheck Protection Program Borrower Application Form
PPP Affiliation Interim Final Rule
Affiliation Rules for Paycheck Protection Program
Paycheck Protection Program Loans: Frequently Asked Questions, April 29, 2020
CARES Act Assistance for Small Businesses (US Dept of Treasury)