1. Clinical Guidance
2. Malpractice Liability
4. Employer/Workers Compensation
II. Clinical Guidance.
1. PA Med: https://www.pamedsoc.org/education-cme/public-health/coronavirus
2. AMA: https://www.ama-assn.org/delivering-care/public-health/covid-19-2019- novel-coronavirus-resource-center-physicians
3. CMS: https://www.medicare.gov/medicare-coronavirus#500
4. CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html
5. WHO: https://www.who.int/health-topics/coronavirus
III. Medical Malpractice.
The medical malpractice category can be separated into two categories, i.e. following Clinical Practice Protocols and Malpractice Prevention.
1. Clinical Practice Protocols.
We reviewed many clinical practice protocols and decided the best combination of practical advice and risk management would be to publish the guidance Norcal, since it is one of the leading malpractice insurer.
2. Insurance Coverage.
In its most basic sense, medical malpractice occurs when a physician or other healthcare professional commits medical negligence. A doctor or healthcare professional commits medical negligence when they breach what is referred to as the “standard of care.” The “standard of care,” in turn, is the generally accepted medical practice used by medical professional in the same geographic area for patients suffering from a particular illness or condition. In addition to proving that a healthcare professional committed medical negligence by breaching the standard of care, a claimant must also prove that the alleged medical negligence of the professional directly resulted in (i.e., caused) the claimant’s injuries.
As healthcare professionals scramble to formulate policies in response to the COVID-19 outbreak, so too do medical professional liability insurers. Whether an insurer will defend against claims involving a patient contracting the virus while in the doctor’s office will be determined on a case-by-case basis depending on the particular facts and coverage involved. Practitioners who are concerned by this issue should contact their insurers directly to obtain information regarding their coverag
COVID-19 patient visits will presumably be treated as “E&M office visits,” of some degree of complexity (excluding Telehealth), which we will address below. Reimbursement levels, pre-authorization requirements, etc. will be dictated by the terms of the third party payer/insurance plan. Attached is guidance from:
1. Medicare: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicinehealth-care-provider-fact-sheet
2. Highmark: https://hbcbs.highmarkprc.com/Newsletters-Notices/COVID-19- CORONAVIRUS-INFORMATION-FOR-PROVIDERS
3. UPMC Health Plan: https://www.upmchealthplan.com/pdf/ReleasePdf/2020_03_13-telehealth-visits.html
4. Pennsylvania Medicaid: https://www.medicaid.gov/state-resourcecenter/disaster-response-toolkit/covid19/index.html
IV. Employment/Workers Compensation
1. COVID-19 Legal Update. President Trump signed the Families First Coronavirus Response Act (“FFCRA”) into law on Wednesday, March 18, 2020. It will take effect within 15 days
The FFCRA requires employers with fewer than 500 employees1 to provide two different kinds of paid leave for certain Coronavirus/COVID-19-related reasons, as follows:
1. Paid sick time. Employees shall receive paid sick leave if they are unable to work (or telework) due to a need for leave because: a. The employee is subject to a Federal, State, or local quarantine or isolation order related to COVID-19. b. The employee has been advised by a health care provider to self-quarantine due to concerns related to COVID-19; c. The employee is experiencing symptoms of COVID-19 and seeking a medical diagnosis; d. The employee is caring for an individual who is subject to an order as described in a., above, or has been advised as described in b., above; e. The employee is caring for a son or daughter whose school or place of care has been closed, or whose child care provider is unavailable, due to COVID-19 precautions; f. the employee is experiencing substantially similar conditions as specified by the Secretary of Health and Human Services, in consultation with the Secretaries of Labor and Treasury. 1 An employer may exclude employees who are health care providers or emergency responders from coverage under this law. Additionally, the Secretary of Labor has the authority to issue regulations to grant exemptions to businesses with fewer than 50 employees upon a showing that compliance would “jeopardize the viability of a business as a going concern.”
• This paid sick time shall be available for immediate use by employees regardless of how long any employee has been employed;
• The government will provide new tax credits to offset/cover the costs of the new leaves;
• The requirement to provide both leaves sunsets on December 31, 2020.
(i) It should definitely determine whether it has fewer than 500 employees. (ii) If it has fewer than 50 employees, determine whether it will seek a waiver;
(iii) If it is covered by this law, it should make sure that its FMLA administrator/HR staff fully understands what circumstances are and are not covered by these two leaves so that it is ready to properly determine individual employees’ eligibility.
• Option 2: An employee could file an “occupational disease” Workers’ Compensation claim, which would require showing that COVID-19 is occurring more in the employee’s industry or occupation than in the general population, such as the healthcare industry.
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