Partner Jacob Harper and associate Tesch Leigh West spoke with MedPage Today about what is next for Medicaid, telehealth, and other parts of the healthcare industry as policies put in place during the COVID-19 public health emergency (PHE) wind down. Tesch said one area to watch has to do with waivers for Medicaid to cover home-and-community-based services, pointing out that waivers provided through a regulation called 1915(c) will extend to December 11, 2023.
"Some states want to finalize and allow those new payment allowances to continue beyond the PHE, some states are not sure, and some don't want them to continue,” Tesch said.
Jacob said clinicians in the months ahead should keep an eye out for possible audits and “lookbacks” from the federal government to make sure rules were being followed during the PHE.
"It's sort of the old saying, 'No good deed goes unpunished,' and those providers that are trying to do the best they can to take care of patients [during a PHE] -- oftentimes they don't get a lot of credit on the back end,” Jacob said.
“To the extent that there's not compliance or there was an inappropriate relationship, remuneration, or a billing error that occurred, regulatory agencies are going to look back at what providers did."
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