Answer 1: A few critical items related to telemedicine programs include the following:
Scope of service with very specific deliverables. Answer the questions of what healthcare services will be provided, when, where, for how much, and if the cost includes out-of-pocket expenses.
Dispute resolution. If any dispute arises among the parties hereto, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its “Rules for Professional Accounting and Related Services Disputes” before resorting to litigation. The costs of any mediation proceeding shall be shared equally by all parties.
Governing law. The parties agree that any dispute or claim arising out of or relating to the engagement will be governed by and construed in accordance with the laws of the State of [state name] without regard to conflicts of law provisions.
Medicare access clause. This clause is required by Medicare if the agreement is more than one year and exceeds $10,000.
The documentation for this engagement is the property of the vendor and constitutes confidential information. However, as required by Public Law 96-0499 e952, we are required to make certain work papers, and certain books, documents, and records of our office available to the Secretary of Health and Human Services or the Comptroller General upon request for their regulatory oversight purposes. Access to the requested work papers will be provided to the Secretary of Health and Human Services or the Comptroller General under the supervision of [insert organization name] personnel and at a location designated by our company.
Depending on the vendor type other clauses may be necessary. Also, the contract should reference provisions of a Business Associate Agreement, if necessary.
This question was answered by: David A. Williams, FHFMA, CPA, partner, Horne LLP, and a member of HFMA’s Mississippi Chapter.
Answer 2: The first part of the telehealth question depends a lot on what state(s) you are in. There are no national, federal laws in this area except the requirements in the Medicare Conditions of Participation for Hospitals, which mostly relate to credentialing (42 CFR 482). There are laws in some states that have to be complied with. As to insurance, I am sure it is possible to buy such coverage; also I’m sure that not every physician does.
This question was answered by: Marty Knutson, a health lawyer with a private law practice.
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