EMS Law COVID-19
Corona Update
Click Here for COVID-19 EMS Resources
NOTE: INFORMATION ON THIS PAGE IS CURRENT AS OF THE DATE POSTED OR REVISED. PLEASE CONSULT THE DATE LISTED BECAUSE INFORMATION MAY HAVE CHANGED SINCE THAT DATE.
We’re Providing Answers to Your Questions During this Crisis
We are receiving many questions on the legal issues related to COVID-19 and PWW will be providing regular updates as these questions come in and we develop a response.
Please note that our answers to these questions are for general information purposes only and should not be relied on as legal advice or a definitive statement of the law. We are not a government authority.
Contact Us with Your Specific Issues and Questions
PWW remains in full operational mode. Please contact any of our professional staff via email or by phone at any time. You may also contact us by sending your question to: info@pwwemslaw.com.
COVID-19 EMS Legal Questions and Answers (Questions Hyperlinked)
Medicare
1. Our ambulance service is due to revalidate with Medicare. Will my due date be extended?
Date added: 3/24/2020
2. Have Medicare’s patient signature rules been relaxed during the COVID-19 crisis?
Revised Date: 4/13/20
3. Does transport of an individual with isolation precautions due to confirmed (or suspected) COVID-19 meet the Medicare medical necessity requirement?
Date added: 3/30/2020
4. Will ambulances services be reimbursed for non-transport services provided to patients?
Date added: 3/30/2020
5. Do the new telemedicine options require special documentation practices for EMS?
Date added: 3/30/2020
6. What is the Accelerated and Advance Medicare payment program for COVID-19 and how does an agency qualify? If an agency receives accelerated and advance payment, how long will the agency have to repay the amount received?
Date added: 3/31/2020
7. What types of audit activities constitute "active medical review or program integrity investigation" that would preclude participation in the accelerated and advance program?
Date added: 3/31/2020
8. Will CMS reimburse ambulance services for transports to alternative destinations during the COVID-19 pandemic?
Revised Date: 4/9/20
9. Is CMS pausing the Scheduled, Non-Emergency Ambulance Transport Prior Authorization Model during the COVID-19 pandemic?
Revised Date: 07/14/20
10. Can ambulance services be reimbursed by Medicare for telehealth services? Can we bill practitioners for telehealth services that we help them provide to our patients?
Date added: 4/1/2020
11. Will CMS pay for treat-no-transport if medical command directs a patient with COVID-19 to stay home and self-quarantine?
Date added: 3/31/2020
12. What telehealth waivers are currently in place for the COVID-19 Public Health Emergency?
Date added: 4/1/2020
13. When should I use the “CR” modifier on an ambulance claim?
Revised Date: 05/7/20
14. We were asked to conduct in-home follow-up medical checks on patients who tested positive for COVID-19 but did not require hospital care. Can we charge for these wellness checks?
Date added: 4/9/2020
15. What are relief payments under the CARES Act? How much money will my agency receive? What are the conditions associated with the payments? (See CARES Act FAQ # 1 below)
Date added: 4/10/2020
16. I’ve heard about the CARES Act stimulus money payment, but our organization has not received anything. How can we find out more information about our payment amount and when it might be coming to us? (See CARES Act FAQ # 2 below)
Date added: 4/15/2020
17. As a condition of the CARES Act stimulus payment, we understand we are not allowed to “balance bill” the patient. How are we supposed to know what we can and cannot bill? (See CARES Act FAQ # 3 below)
Date added: 4/15/2020
18. We believe that lost revenue and other costs/expenses will be much less than our stimulus payment and we fear the quarterly reports will show this disparity and subject us to scrutiny. We are thinking about not accepting the money, but what are the advantages of keeping the stimulus payment? (See CARES Act FAQ # 4 below)
Date added: 4/18/2020
19. We have been told that insurance companies are waiving cost-sharing and deductible amounts for patients. Does this only apply to COVID-19 related conditions?
Date added: 4/18/2020
22. Providers are refusing to sign our PCS forms due to risk of COVID exposure with paper. What are our options?
Date added: 4/29/20
23. When should I use the “CS” modifier on an ambulance claim?
Date added: 05/12/20
24. When transporting a patient in Novitas or FCSO jurisdictions, do I still need to use the secondary Z Codes, or do the COVID-19 specific codes replace the need for such codes?
Date added: 05/12/20
25. Do Medicare Advantage plans follow CMS guidelines on Physician offices being a covered destination?
Date added: 05/15/20
26. Regarding a Physician’s office as a covered destination, does the treatment have to be COVID-19 related?
Date added: 05/15/20
CARES Act
1. What are relief payments under the CARES Act? How much money will my agency receive? What are the conditions associated with the payments?
Date added: 4/10/2020
2. I’ve heard about the CARES Act stimulus money payment, but our organization has not received anything. How can we find out more information about our payment amount and when it might be coming to us?
Date added: 4/15/2020
3. As a condition of the CARES Act stimulus payment, we understand we are not allowed to “balance bill” the patient. How are we supposed to know what we can and cannot bill?
Date added: 4/15/2020
5. Does the Payroll Protection Program under the new CARES Act include municipal or governmental EMS or ambulance services? Who exactly is eligible?
Date added: 4/9/2020
6. Is there a CFDA number associated with these funds?
Date added: 4/29/2020
8. What is the difference between the Terms and Conditions from HHS Stimulus Round 1 and those for Round 2?
Date added: 4/29/2020
13. In the Round 2 application, we had to provide revenue loss for March and April 2020. The HHS calculation does not appear to factor that into the equation. What gives?
Date added: 5/1/2020
14. I thought I understood that we could file ambulance claims for uninsured patients that were suspected COVID-19 but reading the terms and conditions page it says only the positive COVID-19 claims are covered. Which is correct?
Date added: 05/12/20
15. We have accepted the CARES Act funding, and the terms and conditions included a reporting requirement. What do we have to report to the government and when do we have to report it by?
Date added: 06/19/20
HIPAA
1. Can facilities and other healthcare providers share the COVID-19 status of patients with EMS and other first responders?
Date added: 3/27/2020
2. How can staff members work remotely and still be secure under HIPAA when dealing with health information?
Date added: 3/27/2020
3. How can we share COVID-19 information about patients within our agency?
Date added: 3/27/2020
4. How can we share COVID-19 information about patients with other first responders and health care providers?
Date added: 3/27/2020
5. What about dispatch communications? What can we share, and can we flag addresses with suspected COVID-19?
Date added: 3/27/2020
6. What if we think someone is in danger because they may have been exposed? Can we share COVID-19 information about a patient with that person?
Date added: 3/27/2020
7. Who can – and should - we report COVID-19 information to? Can we report to our health department or EMS regional council?
Date added: 3/27/2020
9. What information regarding COVID-19 calls can be shared with county executive and other county officials?
Date added: 3/31/2020
10. Does an employer have the right to be notified if one of their employees test positive for COVID-19?
Date added: 3/31/2020
11. Can our EMS agency notify other first responders – such as fire and PD about the COVID-19 status of a patient AFTER a transport if we know that status?
Date added: 3/31/2020
Workplace Staffing, Safety & Screening
1. Are hospitals required to let EMS personnel know if they had come into contact or possibly been exposed by a patient that was later diagnosed with COVID-19?
Date added: 3/30/2020
2. Does an EMS provider exposed to COVID-19 have to self-quarantine?
Date added: 3/30/2020
3. Can an EMS agency require employees to shave?
Date added: 3/30/2020
4. Can an EMS agency refuse to respond to a call because the patient is suspected of having COVID-19?
Date added: 3/30/2020
5. Are ambulance services considered essential businesses? Are billing services?
Date added: 3/30/2020
6. Is it acceptable for a first response agency to delay arriving on scene until dispatch has completed EMD to determine if the patient has COVID-19 like symptoms?
Date added: 3/30/2020
7. We take temperatures of employees per guidelines, if a provider has a fever, we won't allow them to work. Can we make them use sick time or do we put them on administrative time not charged to their leave?
Date added: 3/30/2020
8. Our EMS personnel are requesting to wear their body armor, as well as lawful firearms, while serving through this National Emergency. Should we relax our protocols to make these reasonable accommodations?
Date added? 3/30/2020
10. OSHA requires fit testing on each type of mask that may be used by an EMS provider, has this requirement been waived?
Date added: 3/30/2020
12. What proof or evidence must EMS personnel have (especially EMTs and Medics) to prove they are "essential" personnel or otherwise employed by a "life-sustaining business" when local or state government has issued a "stay in place or stay at home order"?
Date added: 3/31/2020
13. Does the Ryan White Act apply to COVID-19?
Date added: 3/30/2020
14. Can an employee refuse to work due to concerns over COVID-19?
Date added: 3/30/2020
15. Can an assisted living facility, or other health care facility, require EMS providers to fill out a questionnaire before allowing entry to their facility?
Date added: 3/30/2020
16. What defines an exposure to COVID-19, and can an employee continue work after being exposed?
Date added: 3/31/2020
Workers' Compensation
1. Are volunteer EMS personnel covered under state workers' compensation laws?
Date added: 3/30/2020
2. What is a full-time employer's workers' compensation obligation in the event an employee contract COVID-19, but works part-time as an EMS provider elsewhere?
Date added: 3/30/2020
3. Can an employee receive workers' compensation benefits in addition to Emergency Paid Sick Leave benefits if they test positive for COVID-19?
Date added: 3/30/2020
4. If an employee refuses to use Personal Protective Equipment ("PPE"), and contracts COVID-19, would it be covered by workers' compensation?
Date added: 3/30/2020
Employee Leave
1. Does the Emergency Paid Family and Medical Leave Act or emergency paid sick leave cover an employee afraid to work for fear of bringing the disease home?
Date added: 3/30/2020
2. Would an employee be eligible for FMLA over "anxiety" related to contracting COVID-19?
Date added: 3/30/2020
3. Can an employer elect to exclude employees from paid sick leave under the Families First Coronavirus Response Act ("FFCRA")?
Date added: 3/30/2020
4. Are local governments included in the Families First Coronavirus Response act ("FFCRA")?
Date added: 3/31/2020
5. Are organizations with less than 50 employees subjected to the emergency paid sick or family leave requirements of the Families First Coronavirus Response Act ("FFCRA")?
Date added: 3/31/2020
8. We have an employee that is in isolation due to her full-time job and being exposed to COVID-19. Do we have to pay her for her missed shift here?
Date added: 5/15/2020
Patient Care
1. Can an EMS provider refuse to transport a patient if that patient is suspected of having COVID-19 and refuses to wear a mask?
Date added: 3/30/2020
EMS Operations
1. Can hospital emergency departments go on diversion or refuse to accept patients?
Date added: 3/31/2020
Employee Wage & Benefits
1. Has the full-time employee hour requirement of the Affordable Care Act ("ACA") been waived?
Date added: 3/30/2020
3. Are EMS providers entitled to hazard pay?
Date added: 3/30/2020
4. Is there a limit to the number of hours or days a first responder, in any capacity, can be required to work during the COVID-19 Public Health Emergency?
Date added: 3/31/2020
5. Must employers pay employees if employees are required to stay after the end of their scheduled shift to clean equipment, shower, or complete PCRs and other paperwork?
Date added: 3/31/2020
6. Does the Payroll Protection Program under the new CARES Act include municipal or governmental EMS or ambulance services? Who exactly is eligible? (See CARES Act FAQ # 5 above)
Date added: 4/9/2020
Webinar Q&As
1. COVID Coding: What Ambulance Revenue Cycle Professionals Need to Know Webinar 4/20/2020 Q&A
Date added: 4/23/20
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COVID-19 RESOURCES: Any individual or entity who downloads or uses these documents or any modified version of any of these documents in any way is referred to as the "User." Some of the documents are sample forms and policies only, designed by Page, Wolfberg & Wirth, LLC (PWW). PWW created documents are not legal advice, and no attorney-client relationship is formed by their use. User bears all responsibility for compliance with all applicable laws and regulations, and the User agrees that neither PWW nor the individual designers of PWW created documents are responsible for their use, non-use or modification by any User. PWW created documents are licensed only for use by individual ambulance services, and may not be sold or distributed by any other individual or entity. Any other use or distribution of PWW created documents requires our express written permission. Please also note that we cannot be responsible to distribute new or updated documents to users. In addition, we do not guarantee that any of these documents will be updated to reflect new laws, regulations or other applicable authority. PWW created documents are Copyrighted by PWW and any use, reproduction or distribution that is not in accordance with these Terms of Use is strictly prohibited unless permitted in writing by PWW. PWW makes no copyright claim to any official government works.