Legal and practical healthcare information.
Who are the relevant state entities? The Division of Developmental Disabilities (“DDD”) operates under the Arizona Department of Economic Security (“ADES”).[1] The DDD provides services to qualifying Arizona children with developmental disabilities. The Arizona Long Term Care System (“ALTCS”) is Arizona’s Medicaid program that provides long-term care services to DDD members. ALTCS operates under the …
Continue reading “State Funded Benefits for ASD in Arizona: The Basics”
What is Autism Spectrum Disorder (“ASD”)? Autism spectrum disorder (“ASD”) is a developmental disability.[1] Children with ASD may experience social, communication, learning, and behavioral challenges. The severity of ASD varies and some children require more assistance than others. There is no cure for ASD, but early intervention treatment for children between birth and 36 months …
On June 23, 2020, the Arizona Court of Appeals issued its opinion concerning In Re: MH2019-004895, vacating the trial court’s order for involuntary treatment because the trial court improperly allowed the patient’s clinical liaison to testify about confidential information in violation of the behavioral health professional-client privilege. This opinion has several important changes and clarifications …
In light of the COVID-19 pandemic, on March 30, 2020, the Secretary of the U.S. Department of Health and Human Services (the “Secretary”) released blanket waivers (the “Waivers”) under Section 1135 of the Social Security Act (the “Act”) as to certain referral-related activities that would normally result in sanctions under the Federal Physician Self-Referral Law, …
Continue reading “Stark Law and Anti-Kickback Statute Waivers for COVID-19”
On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (the “Act”). The purpose of the Act is to address the numerous areas impacted by the COVID-19 pandemic, including public health, business, economic, and others. This article sets forth major impacts of …
Continue reading “The CARES Act: Changes Specifically Impacting Health Care Providers and Suppliers”
In this country, people who need Substance Use Disorder (SUD) treatment often choose not to pursue professional treatment, not because of the cost, but because there is a societal negative stigma attached to the disease. In 1975, the federal government acted to eliminate the stigma and simultaneously encourage people suffering from SUD to voluntarily ask …
Continue reading “SUD Program Privacy Rules Modified by CARES ACT”
You’ve probably heard that every provider’s favorite laws, the Anti-Kickback Statute and its related, strict liability counterpart, the Stark Law (formally known as the Physician Self-Referral Law), are getting a makeover from the Department of Health and Human Services (HHS). Here’s what you need to know. Quick Legal Refresher: (A) What is the Anti-Kickback Statute? …
Erica A. Erman recently authored the article, “The importance of putting patient care above profits,” for Physicians Practice. The article discusses the case Wit v. United Behavioral Health and highlights eight principles that the court found to be generally accepted standards of care among behavioral professionals. “The importance of accessible quality behavioral health services is …
Continue reading “The Importance of Putting Patient Care Above Profits”
The American Medical Association CPT Editorial Panel released eight standardized and permanent codes for billing applied behavioral analytics (ABA) therapy services that became effective January 1, 2019. For the first time, adaptive behavior services are standardized for the purposes of billing and payment for those services by CMS and other third-party payors. This should be …
Purpose and Practicality The HIPAA Security Rule[1] was designed to protect the confidentiality, integrity, and availability of a patient’s protected health information (PHI) while allowing flexibility for each covered entity based on their size, complexity, technological capabilities, cost constraints, and the likelihood of potential risks to the electronic PHI (ePHI) they house. To make the …
Continue reading “Understanding the HIPAA Security Rule and Tailoring Policies to Fit Your Business”