COVID-19 Legal Guidance for Healthcare Professionals and Healthcare Providers in Minnesota

by | Mar 21, 2020 | COVID-19, Healthcare, Small Business, Telemedicine | 0 comments

COVID-19 Legal Guidance for Healthcare Professionals and Healthcare Providers in Minnesota

Last update 8.15.2020 – 9am CST

Legal guidance for healthcare professionals and businesses operating in Minnesota. Contact Holt law for clarification on these resources to apply your situation to the law.

Required by June 29: COVID-19 Preparedness Plans for Critical Sector businesses

**** MN Executive Order 20-74 requires that by June 29, 2020, all Minnesota businesses – including Critical Businesses – fully adopt and implement a COVID-19 Preparedness Plan. **** A free template COVID-19 Preparedness Plan, which covers the above requirements, is available as part of the Plan Guidance, available on the Stay Safe Minnesota website (https://staysafe.mn.gov).

The Department of Labor & Industry (DLI) and the Department of Health (MDH) have created a template COVID-19 Preparedness Plan that any business may use – it is not required, but all businesses must address a variety of components outlined in the template.

In addition, the State of Minnesota has created industry-specific guidance for several industries that have unique work environments, may pose higher risks for potential virus transmission, or that employ more vulnerable workers, including:

For other industries and businesses, the General Guidance for All Businesses should be sufficient for writing and developing a COVID-19 Preparedness Plan. Minnesota OSHA is also prepared to assist any business with the development of their COVID-19 Preparedness Plans – if you need help, you can contact MNOSHA Workplace Safety Consultation at 651-284-5060 or OSHA.compliance@state.mn.us.

1. Minnesota Department of Human Services – COVID-19 Legal Changes to Telemedicine and Programs

  • Information about COVID-19 for providers of adult mental health services
  • Behavioral Health Telemedicine Waivers
  • Minnesota Health Care Programs Provider Manual – COVID-19 (includes telemedicine changes)
    • Telemedicine
      • Until further notice, Minnesota Health Care Programs (MHCP) is temporarily expanding coverage of telemedicine visits.These changes are effective April 1, 2020:
        • Providers can provide services virtually via telephone when providers determine it is safe and effective to do so. This coverage change applies to MHCP members in fee-for-service programs.
        • The current limitation of three telemedicine encounters per week will be suspended.
        • MHCP will cover evaluation and management services provided via telephone using the telephone services CPT codes. Follow CPT guidelines for use of 99441, 99442 and 99443.
        • In delivering telemedicine, the distant site (provider’s location) can be the eligible provider’s home. The originating site (member’s location) can be delivered to members while they are in their home.
        • Providers with current telemedicine assurance statements on file may begin providing telephonic telemedicine immediately.
        • Providers without a telemedicine assurance statement must submit the Telephonic Telemedicine Provider Assurance Statement (DHS-6806A) (PDF) before providing telemedicine services.
        • Billing Telemedicine. Providers who had an approved telemedicine assurance statement prior to April 1, 2020, and have a TD specialty code on their provider file, should continue to bill with place of service 02 for telemedicine. New telemedicine providers on or after April 1, 2020: Do not bill place of service 02 at this time. We are finalizing system edits to recognize this place of service. Effective April 1, 2020, Federally Qualified Health Center and Rural Health Clinic telemedicine services (including telephonic) will be included for the purposes of the face-to-face encounter payment methodology. Any service when provided face-to-face that would generate an encounter will continue to generate an encounter if provided via telemedicine, provided it meets all telemedicine requirements.

  • Temporary expansion of remote support for HCBS waiver services. As of May 4, 2020, the DHS commissioner will allow remote support (real-time, two-way communication) temporarily as a service delivery option for several waiver services. Remote support may be delivered through phone or other interactive technology medium.

  • Minnesota Department of Human Services via “Waivers and Modifications” now has temporary authority to waive or modify requirements during the COVID-19 pandemic. The following changes have been made:

2. Minnesota Law Changes and Executive Orders – COVID-19

3. Federal Law Changes – COVID-19; HIPAA, Medicare

  • HHS Waiving Penalties for certain HIPAA violations. Effective immediately, the HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency.
  • Medicare/CMS Telehealth Rules  Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances. This includes expanding the definition of originating site to include professional services furnished in all eligible health care settings, and in the patient’s residence.  Temporary guidelines expanding the technology that can be used to furnish an eligible telehealth service.
  • Federal Families First Coronavirus Response Act. The law expands the FMLA’s reach to provide job protection and partial wage replacement for impacted employees. The law provides a new paid sick leave entitlement to impacted employees.  The law provides tax credits to employers paying out leave benefits. The law allots $1 billion for unemployment insurance benefits. COPY OF EMPLOYER NOTICE POSTER IS HERE.
    • Employment–Paid Leave – Effective April 1- December 31, 2020. Generally provides that employees of *covered employers* are eligible for the following types of paid time off from work due to to the COVID-19 crisis:
      • Two weeks/up to 80 hours paid sick leave at regular rate of pay if employee is quarantined or experiencing COVID-19 symptoms
      • Two weeks/up to 80 hours paid sick leave at 2/3 regular rate of pay if employee is unable to work because of need to care for another as follows:
        • someone who is subject to quarantine,
        • a child (under 18) whose school or child care is closed due to COVID-19, and/or
        • the employee is experiencing a substantially similar condition as specified by particular governmental agencies.
      • Up to an additional 10 weeks of paid expanded family and medical leave at 2/3 regular rate of pay, where an employee (who has been employed for at least 30 days) is unable to work due to need to care for a child whose school or child care provider is closed due to COVID-19.
      • *Note that covered employers means fewer than 500 employees, and businesses with fewer than 50 may be exempt from the school closing/child care unavailability provisions if this would jeopardize business viability.*
    • More details, payment calculations, FAQs, scenarios, and definitions here and here and here and here
  • Pandemic Unemployment Assistance Program
    • Summary of Program: Congress authorized a new Pandemic Unemployment Assistance program that covers those who do not qualify for regular Unemployment Insurance benefits, such as independent contractors and self-employed people. The program was authorized but must be created by the states, so Minnesota must build out this program before it can be implemented. More information will be available soon, however it could be several weeks before payments begin.
    • Why this might make sense for you: If you are an independent contractor or self-employed person who would not typically be eligible for unemployment benefits, but you have lost income due to the COVID-19 pandemic.

4. LOANS AND GRANTS AND FINANCIAL RELIEF

  • Small Business Relief Grants Program$60 Million available as grants – conditions apply – apply by July 2, 2020. [Ended]

  • CARES Act Provider Relief Fund Payment relief fund payments made for healthcare-related expenses or lost revenue attributable to COVID-19. The U.S. Department of Health and Human Services (HHS) announced on June 9, 2020, additional distributions from the $50 billion Provider Relief Fund.
  • Small Business Emergency Loans Minnesota. Small Business Emergency Loans for Minnesota Business Owners. (1) Range from $2,500 to $35,000 and will be based on the firm’s economic injury and the financial need. (2) Interest free. (3) Paid back monthly over five years and the first payment will be deferred six months with potentially partial forgiveness.
  • SBA Disaster Loans – Federal. COVID-19 – Economic Injury Disaster Loan Program. Variable Interest Rates and pay back terms.
  • Small business COVID-19 Emergency Loan Checklist and Guide.
  • SBA Paycheck Protection Program (PPP)
    • Summary of Program: The SBA PPP is a new federal $350 billion loan program at SBA for small businesses, self-employed people, and gig workers to help them from going under due to the COVID-19 pandemic. If employers maintain payroll, the loans would be forgiven.
    • Why this might make sense for you: If a self-employed person needs compensation or a business or nonprofit needs funds for employee compensation, including: salaries, wages, commissions, or similar compensation; cash tips or equivalents; vacation, parental, family, medical, or sick leave; payment required for providing group health care benefits (including insurance premiums); payment of retirement benefits; and payroll taxes. Funding may also be used for payment of interest on mortgage obligations, rent, utilities, and interest on pre-existing debt obligations
  • SBA Debt Relief
    • The Small Business Administration (SBA) is providing a financial reprieve to small businesses during the COVID-19 pandemic.
    • SBA will pay the principal, interest and fees to banks on behalf of businesses for current SBA loans and new loans issued up until September 27, 2020. Businesses should ask their lender for this relief.
      • Note: This includes SBA export financing programs (i.e. EWCP, Export Express, and the International Trade Loan)
    • For existing SBA Disaster Loans (home and business), payments of these loans have been automatically deferred by the SBA. For more information, visit their SBA Debt Relief page or contact your local office.

5. Unemployment Insurance – Minnesota COVID-19

  • Unemployment Guidance for Employers and Employees. Relieves taxpaying employers of benefit charges associated with the COVID-19 pandemic. This means that your UI tax rate will not increase if your workers collect unemployment benefits because of COVID-19.
    • See also the Unemployment Insurance Shared Work Program. The Shared Work program offers an alternative to layoffs for employers facing a temporary downturn in business. Administered by DEED’s Unemployment Insurance Division, the program allows employers to divide available hours of work among a group of employees instead of implementing a full layoff. These employees may then receive partial unemployment insurance benefits while working reduced hours. The purpose of Shared Work is to avoid a layoff, not to subsidize wages. Shared Work can help employers avoid the difficulties that can go along with a layoff. If employees keep working during a temporary slowdown, employers can more quickly gear up when business conditions improve. Learn more about the Shared Work Program on the Unemployment Insurance Division’s website.
  • Unemployment Guidance for Self Employed and Independent Contractors Pandemic Unemployment Assistance (PUA) benefits are specifically for self-employed, independent contractors, and others unemployed as a direct result of COVID-19 who are not eligible for regular unemployment benefits or extended UI benefits in Minnesota or any other state. This means you must apply for regular unemployment benefits before you can qualify for PUA benefits. You can apply for regular unemployment benefits either online or by phone.

    Once we determine that you are not eligible for a regular or extended benefit account, we will automatically review your account to determine if you are eligible for PUA. You will not need to complete a separate application for PUA. If you need help in a language other than English, interpreters are available by phone. Internet translation tools are available on our Other languages page if you would like to apply online. You do not have to apply for the $600 additional compensation. You will automatically receive this CARES Act benefit if we determine that you are eligible for any unemployment benefit program.

6. Employment Guidance

7. Taxes

8. Other Resources

  • Minnesota Department of Health COVID-19 factsheets, statistics and information.  Health Questions for Patients and Staff: 651-201-3920 or 1-800-657-3903. This hotline is staffed by the MN Department of Health and will be operating from 7AM-7PM.
  • Guidance for Congregate Living Settings to Assist Residents Requesting Camera Placement
  • Health Insurance. If you are uninsured right now, you can get covered through MNsure. Apply on MNsure.org by April 21. In response to the potential growth of coronavirus (COVID-19) cases, MNsure is offering a special enrollment period to eligible Minnesotans.
  • Centers for Disease Control and Prevention COVID-19 Page
  • Home Health Agencies: Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies
  • UCare Minnesota to follow CMS guidance for private plans and DHS guidance for MHCP plans.  UCare will be waiving the three times a week limit for medically necessary telehealth services
  • Combined DEED Resources for MN Businesses. Combination of Resources available in Minnesota posted immediately from Minnesota DEED regarding COVID-19

  • FCC Announces $200 Million for COVID-19 Telehealth Program These funds, appropriated by the CARES Act (P.L. 116-136), will help healthcare providers purchase the connectivity and devices they need to care for patients remotely in response to COVID-19

  • Updates to PCA Worker Test and Training Online DHS planned this update before the COVID-19 pandemic, and we decided to go forward with it because the changes: (1) Required minimal resources for DHS to complete the implementation; (2) Require no action from people who use services, workers, providers agencies or lead agencies; (3) Allow PCA workers to search for their own certificate without needing to contact DHS; (4) Include features that allow DHS to enroll new PCA workers faster

  • Online job board helps workers and people with disabilities find each other. Direct Support Connect is a free, statewide resource. Anyone who wants to hire a support worker, establish a backup plan, or find employment as a PCA can get more information and create a profile at directsupportconnect.com.

  • COVID Cares offers free telephone support

    Free telephone support 833-HERE4MN (833-437-3466), 9 a.m. to 9 p.m., 7 days a week

    The COVID Cares Support Service is a free telephone support service staffed by volunteer licensed mental health and substance use disorder personnel. The volunteers are available for 20-minute support calls to listen, share resources and tools, and talk with all Minnesotans experiencing stress.

    The service started in April through a collaboration with volunteers from the Minnesota Psychiatric Society, the Minnesota Psychological Association, the Minnesota Black Psychologists, and Mental Health Minnesota. The free service is also accessible at FastTrackerMN.org where searchers can also find psychiatric and mental health services availability and real-time Substance Use Disorder Treatment program openings.

    COVID Cares Support Service Information Links:

    Find more information online at the COVID Cares telephone support services webpage.

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