On June 22, 2021, the Governor's office announced that Georgia's Public Health Emergency (PHE) will end on July 1, 2021. For hospitals and other healthcare entities, this will mean the end of certain Georgia-specific waivers that were issued to prepare for the COVID-19 pandemic. The end of Georgia's PHE will not have any effect on waivers that were permissible through the federal PHE. Hospitals and healthcare entities should wind down the following Georgia-specific practices:
1. Certificate of Need Waivers
For any hospitals or other healthcare facilities that obtained temporary permission for expansion sites, or the ability to offer certain services during the pandemic pursuant to an O.C.G.A. 31-6-40 suspension request, such hospitals should begin to decrease any such temporary expansion or services.
Any facilities that received such permissions are required to submit a report within 90 days of the end of the PHE verifying that the hospital has ceased providing the temporary service. DCH has indicated via email that the form of such report is forthcoming.
The Composite Medical Board issued Ga. R & Regs. § 360-3-0.10-.08 allowing for electronic prescribing of pharmaceuticals during the emergency. This modification allowed Drug Enforcement Administration (DEA) registered practitioners to issue prescriptions for controlled substances for patients for whom they have not conducted an in-person medical evaluation. Beginning on July 1, 2021, the requirement will resume that all patients receiving controlled substance prescriptions must first have an in-person evaluation.
The governor issued an order permitting pharmacists to issue computer-based prescriptions at alternative locations, including their homes. Beginning July 1, 2021, this waiver will end.
3. Temporary Permits for Healthcare Workers
On March 5, 2020, the Georgia Composite Medical Board announced that it would issue emergency practice permits to previously unlicensed physicians, physician assistants, advance practice registered nurses, respiratory care professionals, and pharmacists who wish to practice medicine during the COVID-19 emergency response with the Board's approval of the application.
The Governor also issued orders allowing former licensees with lapsed licenses (such as retired physicians) to temporarily resume practice to respond to the public health emergency.
Any practitioners still practicing under an emergency practice permit should take steps to obtain a permanent permit, or cease practicing on July 1, 2021. Healthcare facilities and their credentialing committees should verify that all practitioners are fully licensed.
Georgia historically has not issued temporary permits for locums tenens physicians or traveling nurses, therefore these personnel will also be subject to full permitting requirements.
Here to Stay
Although certain waivers have ended, the Legislature took steps to make other waivers permanent, particularly those relating to telemedicine. For the purposes of billing telemedicine services to Georgia Medicaid, DCH waived:
- The Medicaid telemedicine originating site requirements to allow Medicaid members to receive telemedicine services in their homes. Similarly, distant site requirements were waived to allow providers to provide telemedicine services from their homes (or other non-facility locations).
- The Medicaid requirements for HIPAA-compliant telehealth applications, allowing telemedicine services to be provided via telephone, webcam or other a/v technology, and video chat via cell phones (such as FaceTime or Skype apps).
- The requirement that Medicaid members receiving telemedicine services must physically sign an informed consent document, allowing instead for the consent to be documented virtually.
Effective July 1, 2021, however, the Legislature amended the Georgia Telehealth Act to cement most of these changes into law (HB 307, codified at O.C.G.A. 33-24-56.4). The amendments will allow Medicaid members to continue receiving telehealth services in their home and providers to continue providing such services from their homes. The amendments will also continue to allow audio-only services where it can be documented that two way video services are not practicable due to lack of broadband or due to the patient's inability to afford or operate two way audio technology (such as a smartphone).
If you have any questions about the content of this legal update, please contact a member of MMM's Healthcare group.