Louisiana State Medical Society
COVID-19 Bulletin # 2 (3/18/2020)
March 18, 2020 by Chris LeBouef
 

LSMS Requests Action and Clarification on Member Concerns

LSMS has heard from a number of members on the following items. Information, clarification and action has been requested through a number of authorities concerning:
 
Business Disruption Insurance
We are already hearing from members that insurers are denying that coverage extends to current circumstances, i.e. state order to cancel all elective procedures and surgeries. We’ve requested the Governor to include language in his next Proclamation that requires insurers cover all acts required by state orders/proclamations/rules, etc., when policies were in place prior to the emergency.

Personal Protection Equipment (PPE)
We recognize there is and will continue to be a shortage and have suggested varying departments work towards a Statewide PPE Conservation Strategy to slow the use of these items in the event the crisis grows before new equipment is available.
 
Telemedicine
We’ve communicated provider concerns relating to different rules for Medicare, Medicaid and private payer insurance. We’ve asked for one rule that applies to all and address payment parity.
 

New State Actions Taken

Louisiana Department of Health (LDH), Louisiana State Board of Medical Examiners (LSBME) Require Postponement of Elective Procedures/Surgeries
Following actions required by CDC and taken by other states, Louisiana today required postponement of all procedures and surgeries not considered medically necessary. Read it here. Also, please refer to the formal rule on Emergency Telemedicine here.
 
LDH Medicaid Rule for Telemedicine
LDH has released changes for coverage of Telemedicine through Medicaid. Read the full memo here. (Link COVID-19 Provider Update 3.17.2020) Key Additions Include:
  • More details about telemedicine/telehealth
  • General allowance for interactive audio-only telemedicine/telehealth when 1.) interactive audio/video equipment is not available and 2.) same standard of care can be met
  • For audio/video telehealth, everyday technology may be used (e.g., FaceTime, Skype)
  • New telehealth service: telehealth for PT/OT/SLT
  • New telehealth service: tele-ABA
  • 90-day DME supplies and extension of DME PAs to ensure a 90-day supply can be filled
  • 90-day prescription drug fills and early refills go into effect today
  • Suspension of hospital-based UM for medical stays
We did ask for further information specific to the paragraph on availability of HIPPA compliant devices contained in the document of the bottom of two. The Department offered further clarification. “Availability is at the determination of the provider. If they do not readily (in the moment it is needed) have access to a secure a/v HIPAA-compliant system then they may use everyday a/v technology such as FaceTime or Skype. If they do not have that capability (or the patient does not have that capability), they may use audio-only technology such as telephone as long as they can meet the same standard of care. The provider just needs to document the rationale for using audio-only.”
 
LDI Formalizes First Rule for Private Pay Insurers
LDI Emergency Rule 36 addresses prior authorizations, step therapy, co-pays, cost sharing, testing, drug coverage and more. It can be read here.
 

Federal Notes

DEA Relaxes Controlled Substance Prescribing Rules
As a result of moving healthcare more to Telemedicine instead of in-person visits, the DEA has provided information here.
 

LSMS Resources

LSMS has made a comprehensive list of information available on its website, click here.

Please recognize it’s a work in progress that we will continue to update as information becomes available. Again, at the bottom is a form for you to share information with us or ask questions to which we can help get answers.
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