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California Authorities Issue a Wide Range of Rules and Guidance on COVID-19


Time to Read: 6 minutes Practices: Health Care

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APRIL 10, 2020 UPDATE

This is an update to the client alert published on March 20, 2020, California Authorities Issue a Wide Range of Rules and Guidance on COVID-19, which was previously updated on March 29, 2020. Accordingly, these are developments that have become publicly available from the period of March 30, 2020 through April 9, 2020. 

This Alert is one of a series of advisories, podcasts and webinars by Ropes & Gray addressing a wide range of COVID-19 topics. These resources may be found at our Coronavirus Resource Center

Governor’s Executive Orders

  • Executive Order 43-20 (April 3, 2020). This Order expands legal protections to medical providers who are using video or teleconferencing services to provide routine and non-emergency medical appointments. It also relaxes certain state privacy and security laws for medical providers offering telehealth services, including suspending certain state telehealth consent requirements, suspending penalties for violation of timely breach notification requirements, and suspending penalties for violation of certain state law health information safeguards in certain circumstances.
  • Executive Order N-39-20 (March 30, 2020). This Order allows the Director of the California Emergency Medical Services Authority to suspend licensing requirements for certain licensed EMS personnel. Also, the certification and permitting requirements of the Radiologic Technology Act are suspended for those who fall within an enumerated personnel category, which includes being certified by another state to perform radiologic technology or holding an expired certificate or permit issued pursuant to the Radiological Technology Act, so long as they are working under the supervision of a licensed person and are deemed necessary by a California health facility. The order also allows the Director of the Department of Developmental Services to lease any real or personal property, or enter into any other agreement to procure residences or facilities and necessary equipment, goods or services, in order to serve those individuals with developmental disabilities in response to COVID-19. 

Other News From the Governor’s Office

  • The Governor created a COVID-19 Testing Task Force, a public-private collaboration that will work with stakeholders to rapidly boost testing capacity. (April 4, 2020) 

California Department of Managed Health Care (“DMHC”) Guidance

  • Telehealth Services (April 7, 2020). This all plan letter provides guidance on how providers should bill services rendered via telehealth and clarifies the scope of All Plan Letter 20-009. It explains that when a provider delivers a service virtually that would normally be delivered in-person, the provider should document and bill the service as if it had occurred in person, with Use Place of Service “02” to designate telehealth. 

DHCS Requests to CMS for State Plan Amendments and Demonstration Authority 

  • Request for Additional State Plan Amendments Related to COVID-19 National Emergency/Public Health Emergency (April 3, 2020). This letter requests CMS approval of additional Section 1135 flexibilities, which have not yet been granted, pertaining to the California State Plan, including those listed below:
    • Increased Drug Medi-Cal (DMC) reimbursement for non-Narcotic Treatment Program services;
    • Reimbursement of DMC state plan services provided by telehealth as if they had been provided face to face;
    • Increased specialty mental health services reimbursement;
    • Increased clinical laboratory and laboratory service reimbursement rates to equal the Medicare payment equivalent;
    • Increased reimbursement for certain long-term care facilities; and
    • Suspension of premiums and cash-sharing for applicable Medicaid and Children’s Health Insurance Program beneficiaries for COVID-19-related treatment.
  • Request for Section 1115 Demonstration Authority Related to COVID-19 Public Health Emergency (April 3, 2020). This letter requests CMS approval of Section 1115 flexibilities geared towards maintaining safe and sufficient beneficiary access to covered services during the COVID-19 pandemic, including those listed below. Note that this request has not yet been granted. 
    • Waiver of the 16-bed limitation applicable to certain Institutions for Mental Disease;
    • Extension of coverage of COVID-19 treatment to the optional uninsured category at the 100 percent FMAP rate; 
    • Classification of COVID-19 testing and treatment provided to Medi-Cal beneficiaries as emergency services, regardless of whether the treatment is provided outside of hospital emergency rooms; 
    • Waiver of certain utilization limits applicable to the resident treatment benefit provided in approved Drug Medi-Cal-Organized Delivery System (DMC-ODS) pilots under the Medi-Cal 2020 Demonstration; 
    • Reimbursement for retainer payments in specified Home and Community-Based Services programs; 
    • Waiver of the interim rate setting methodology for DMC-ODS pilots approved under the Medi-Cal 2020 Demonstration; and 
    • Authorization of DHCS and contracted managed care plans to make incentive payments on a pay-for-reporting basis within the Public Hospital Redesign and Incentives in Medi-Cal program and the Quality Incentive Pool directed payment program.

DHCS Medi-Cal Guidance

California’s governmental response to the COVID-19 pandemic is evolving rapidly. Please revisit this page for periodic updates. 

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