COVID- 19 Me dic al- L e gal Impac t on He alth Car e Mar k A. F - - PowerPoint PPT Presentation

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COVID- 19 Me dic al- L e gal Impac t on He alth Car e Mar k A. F - - PowerPoint PPT Presentation

Dec 19, 2023 140 likes •302 views

COVID- 19 Me dic al- L e gal Impac t on He alth Car e Mar k A. F ogg Color ado De fe nse L awye r s Assoc iation 821 17 th Str e e t, Suite 500, De nve r , CO 80202 P (303) 296- 7300 F (720) 625- 3637 ChildsMc Cune .c om I N T

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SLIDE 1

COVID- 19

Me dic al- L e gal Impac t on He alth Car e Mar k A. F

  • gg

Color ado De fe nse L awye r s Assoc iation

821 17th Str e e t, Suite 500, De nve r , CO 80202 P (303) 296- 7300 F (720) 625- 3637 ChildsMc Cune .c om

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SLIDE 2

I N T HE BE GI NNI NG

F e de r al He alth & Human Se r vic e s Mar c h 17th Notic e of De c lar ation unde r the PRE P Ac t

  • Qualifie d immunity for

HC pr

  • fe ssionals &

e ntitie s

  • Applie s to me dic al “c ove r

e d c ounte r

  • me asur

e s”

  • Pr
  • te c tions ar

e pr

  • duc t- or

ie nte d

  • May be limite d to COVID- 19 patie nts only
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SLIDE 3

E ARL Y RI SK MANAGE ME NT COUNSE L I NG

Doc ume nt alte r ations in c ar e de live r y due to COVID- 19 to maximize liability pr

  • te c tions (e .g. te le he alth was use d

be c ause … ) Still the fir st line of de fe nse : What is r e asonable unde r the c ir c umstanc e s at the time ?

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SLIDE 4

L OOSE NI NG OF T E L E HE AL T HRUL E S

  • HHS Offic e of Civil Rights Mar

c h 17th Notific ation

  • Waive r
  • f pote ntial HIPAA pe naltie s for

good faith use

  • f te le he alth
  • Can use any non-public fac ing r

e mote c ommunic ation

  • Applie s to all patie nts, not Just COVID- 19
  • CMS Re imbur

se me nt for te le he alth visits by a physic ian lic e nse d in anothe r state , Notific ation Mar c h 13

  • Cr

e ate d massive c onfusion

  • DE

A e xc e ption on Ryan Haight Ac t

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SLIDE 5

VOL UNT E E R I MMUNI T Y

Pr ior : Volunte e r Pr

  • te c tion Ac t and state statute s
  • Hodge podge of fe de r

al and state L aws Ne w: CARE S ACT Volunte e r Immunity (Se c tion 3215)

  • Unpaid volunte e r

, limite d to COVID- 19 patie nts, qualifie d immunity, must be within sc ope of pr ac tic e

  • No liability unde r

state or fe de r al law, pr

  • te c tion e xists

dur ing public he alth e me r ge nc y L imite d r

  • le of Good Samar

itan statute s

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SLIDE 6

DE L AY OF E L E CT I VE AND NON-E SSE NT I AL SURGE RI E S AND PROCE DURE S

Gove rnors issue E xe c utive Orde rs in almost all state s orde ring de lay of e le c tive s to prote c t PPE Colorado- E O 2020-009, Marc h 23 – April 26: All hospitals,

  • utpatie nt surge rie s and proc e dure provide rs are dire c te d to

c e ase all e le c tive and non-e sse ntial surge rie s and proc e dure s

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SLIDE 7

RE SUL T I NG GAPS

  • Conc e r

n ove r lac k of liability immunity to c ove r alte r ations with c ar e de live r y due to COVID- 19

  • Ne e d pr
  • te c tion for

de lays and alte r e d c ar e de live r y in non-COVID- 19 patie nts as we ll

  • Pr

ac tic ing without a lic e nse in othe r state s (e .g. te le he alth)

  • Pr
  • te c t r

e asonable judgme nts on de lays of e le c tive sur ge r ie s and pr

  • c e dur

e s

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SLIDE 8

RE SPONSE : E XE CUT I VE ORDE RS L I ABI L I T Y I MMUNI T Y

Powe r to ame nd or modify statute s Ne w Yor k: Gov ame nds the Good Samar itan statute He althc ar e pr

  • vide r

s as state age nts with state immunity pr

  • te c tions

Mic higan: HC as “E me r ge nc y Manage me nt Wor ke r s” Adjusting be st pr ac tic e s to be st e ffor ts Cr isis Standar ds of Car e Color ado: Gove r nor ’s E xpe r t E me r ge nc y E pide mic Re sponse Committe e (“GE E E RC”)

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SLIDE 9

RE SPONSE : I NCRE ASE D F L E XI BI L I T Y I N T E L E HE AL T H, L I CE NSI NG, AND SCOPE OF PRACT I CE

  • F

le xibility in c ommunic ation modalitie s (audio inc lude d in te le he alth de finition)

  • Ability to obtain te mpor

ar y lic e nse s, te le he alth lic e nse s, e xpe dite d lic e nse s, r e ac tivate lic e nse s

  • Allowing out of state lic e nse d physic ians to pr

ac tic e within a state

  • E

xpand sc ope of pr ac tic e and foc us on e duc ation and skill se ts to allow pr ac tic ing outside of tr aditional sc ope Ge ne r ally, E xe c utive Or de r s e xpir e 30 days afte r te r mination

  • f state of e me r

ge nc y

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SLIDE 10

COL ORADO APPROACH: COL ORADO DI SAST E R E ME RGE NCY ACT

Inte r play be twe e n Gove r nor ’s author ity, r e gulator y statute s, and the Gove r nor ’s E xpe r t E me r ge nc y E pide mic Re sponse Committe e (“GE E E RC”) CRS §§24- 33.5- 704(2): Gove r nor may issue E xe c utive Or de r s that have the for c e and e ffe c t of law § 24- 33.5- 704(7)(a): Gove r nor may suspe nd the pr

  • visions of any

r e gulator y statute whic h would hinde r c oping with the e me r ge nc y § 24- 335- 704.5: GE E E RC standing c ommitte e de ve lops c r isis standar ds of c ar e and advise s the Gove r nor Cr isis standar ds de viate fr

  • m usual standar

ds due to r e sour c e alloc ation

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SLIDE 11

GE E E RC AND COVI D-19

Cr isis Standar ds of Car e that GE E E RC Cr e ate d:

  • E

me rg e nc y Me dic a l Se rvic e s

  • Pe rso na l Pro te c tive E

q uipme nt

  • Ho spita l, I

nc luding Crisis T ria g e

Chie f Me dic al Offic e r

  • f CDPHE

ac tivate d E MS and PPE c r isis standar ds of c ar e , but not hospital c r isis tr iage

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SLIDE 12

APPL I CAT I ON OF COL ORADO L I ABI L I T Y I MMUNI T Y F OR HE AL T H CARE

CRS 24- 33.5-711.5(2)

  • He althc ar

e pr

  • vide r

s will r e asonably assist the state to suc c e ssfully c ontr

  • l e me r

ge nc y e pide mic s

  • Pr
  • vide r

s that in “good faith c omply c omple te ly” with Boar d of He alth r ule s and E xe c utive Or de r s shall be immune fr

  • m c ivil or

c r iminal liability

  • Pote ntial Immunity:
  • De la y o f e le c tive pro c e dure s ma nda te d b y

E xe c utive Orde r

  • Re sumptio n o f e le c tive pro c e dure s pursua nt to

Pub lic He a lth De pa rtme nt Orde rs

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SLIDE 13

RE SUMPT I ON OF E L E CT I VE SURGE RI E S AND PROCE DURE S

  • Sugge ste d appr
  • ac h, r

e sour c e s, and spe c ial COVID- 19 c onse nt for m for e le c tive s poste d on Childs Mc Cune we bsite :

  • Colle c t and r

e tain bac kgr

  • und data that it is a safe

e nvir

  • nme nt to pe r

for m e le c tive sur ge r ie s/ pr

  • c e dur

e s

  • Cr

e ate a patie nt e duc ation c ommunic ation on e le c tive sur ge r ie s/ pr

  • c e dur

e s dur ing the COVID- 19 pande mic

  • Utilize a spe c ial c onse nt for

m for e le c tive s

  • CDPHE

ame nde d Public He alth Or de r 20- 29 (May 5, 2020)

  • PPE

Re se r ve s, ade quate sc r e e ning and te sting, CDC r e c omme nde d infe c tion c ontr

  • l, fac e masks
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SLIDE 14

COVI D-19: F UT URE HC COVI D-19 CASE S?

Na tiona l Pla intiff F irms – L a rg e popula tion c e nte rs

  • Ina de qua te infe c tion c ontrol
  • Ina de qua te supplie s
  • Nursing home s

L ic e nsing Ca se s

  • Ka nsa s Boa rd sta te me nt tha t COVID- 19 issue s a re mitig a ting fa c tors
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SLIDE 15

RE CE NT F E DE RAL L E GI SL AT I VE ACT I VI T Y ON L I ABI L I T Y I MMUNI T Y

COVID- 19 He althc ar e Pr

  • vide r

Ac t of 2020

  • L

anguage c ur r e ntly c ir c ulating in le gislative c ommitte e s and in the c hambe r

  • Br
  • ad de finition of pr
  • vide r

s, applie s to COVID and non- COVID patie nts

  • Claims r

e le gate d to gr

  • ss ne glige nc e
  • Pr

e e mpts state law

  • One ye ar

S/ L