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COVID-19: Governor Issues Two New Executive Orders Impacting Health Care Providers

Executive Order Nos. 7DD & 7EE

April 24, 2020

In response to the ongoing developments regarding the COVID-19 outbreak, and building on the Governor’s previous orders, Governor Lamont issued Executive Order Nos. 7DD and 7EE on April 22nd and 23rd, respectively, setting forth several and significant changes to Connecticut’s public health and Medicaid statutes and regulations.  A summary of the regulatory changes is below. 

Executive Order 7DD

  1. Telehealth Changes:
  • Additions to Definition of Telehealth Provider.  Section 19a-906(a)(12) of the Connecticut General Statutes is modified to add any Connecticut licensed (a) dentist, (b) behavioral analyst, (c) genetic counselor, (d) music therapist, (e) art therapist, and (f) veterinarian to the definition of “telehealth provider”.
     
  • Change to the Established Patient Requirement for Telehealth Services Provided Via Audio-Only Telephones.  Pursuant to Executive Order No. 7G, Governor Lamont expressly revised the definition of telehealth to state that audio-only telephone calls would now qualify as telehealth.  Executive Order No. 7G further provided that for both Medicaid and commercially insured patients, audio-only calls are acceptable so long as the call is between a provider and their established patient (i.e., there is already an existing provider-patient relationship between the provider and the person/patient they are calling).  Executive Order 7DD now removes the requirement that the patient be an established patient for commercially insured patients.  The established patient requirement is still in place for Medicaid patients and providers.
  1. Out-of-State Healthcare Providers
    Section 19a-131j of the Connecticut General Statutes sets forth a list of providers that may be permitted by the DPH Commissioner to practice in Connecticut on a temporary basis and without a Connecticut license, so long as they are appropriately licensed, certified or registered in another state or territory of the United States or the District of Columbia.  Executive Order No. 7DD modifies the aforementioned statute and permits the DPH Commissioner to issue an order to suspend, for a period not to exceed 60 consecutive days, the requirements for licensure, certification or registration, for:  (a) occupational therapists; (b) alcohol and drug counselors; (c) radiographers; (d) radiologic technologists; (e) radiologist assistants; (f) nuclear medicine technologists; (g) dentists; (h) dental hygienists; (i) behavior analysts; (j) genetic counselors; (k) music therapists; (l) art therapists, (m) dieticians-nutritionists; and (n) speech and language pathologists.
     
  2. Participation in Intern, Resident Physician, or United States Medical Officer Candidate Training Programs Prior to Permit Issuance
    Section 20-11a of the Connecticut General Statutes is modified to allow a person to participate in an intern or resident physician program or United States Medical Officer candidate training program prior to issuance of a permit by DPH provided that the hospital administrator documents that the person has satisfied the requirements for such a permit set forth in the statute.
     
  3. Participation in Resident Physician Assistant Program Prior to Permit Issuance
    Section 20-12h of the Connecticut General Statutes is modified to allow a person to participate in a resident physician assistant program in a short-term hospital that provides a postgraduate medical education program accredited by the Accreditation Council for Graduate Medical Education, without a license or temporary permit issued pursuant to section 20-12b or a training permit issued by DPH, provided that the hospital administrator documents that the person is to be appointed a resident physician assistant in such hospital and has satisfied the requirements of subdivisions (1), (2) and (5) of subsection (a) of section 20-12b.
     
  4. Temporary Suspension of Certain Physician Assistant Supervision Requirements
    Section 20-12a of the Connecticut General Statutes is modified to suspend some of the supervision requirements for physician assistants.  More specifically, the supervising physician will no longer be required to:  (a) personally review the physician assistant's practice on a regular basis; (b) review the charts and records of the physician assistant on a regular basis; and/or (c) set forth a predetermined plan for emergency situations.
     
  5. Temporary Suspension of In-Person Supervision Requirement for Advanced Practice Registered Nurses
    Section 20-87a(b)(2) of the Connecticut General Statutes is modified to suspend the requirement that a physician, medically directing the prescriptive activity of an APRN who is prescribing and administering medical therapeutics during surgery, must be physically present in the institution, clinic or other setting where the surgery is being performed.
     
  6. Provision of Services by Respiratory Care Therapist and Respiratory Care Technician Students
    Section 20-162q(c) of the Connecticut General Statutes provides that Respiratory Care Therapist and Respiratory Care Technician Students do not need a DPH license to provide Respiratory Care Therapist and/or Respiratory Care Technician services so long as:  (a) such student is enrolled in a qualifying educational program; (b) such services are a required component of such person's course of study in such program, (c) the services are rendered under the direct and immediate supervision of a licensed respiratory care practitioner; (d) such person is designated by a title which clearly indicates his/her status as a student.  Section 20-162q(c) is now modified to allow such students to provide services in accordance with the requirements above except that the services are not required to be a component of such person's course of study.
     
  7. Suspension of Continuing Education Requirement for Health Care Providers
    The continuing education requirements in Chapters 370 (physicians and physician assistants), 373 (naturopaths), 376 (physical therapists), 376a (occupational therapists), 376b (alcohol and drug counselors), 376c (radiographers, radiologic technologists, radiologist assistants, and nuclear medicine technologists), 378 (nurses), 379 (dentists), 379a (dental hygienists), 380 (optometrists), 381 (opticians), 381a (respiratory care practitioners), 383 (psychologists), 383a (marital and family therapists), 383b (social workers), 383c (professional counselors), 383d (genetic counselors), 384 (veterinarians), 384a (massage therapists), 384c (acupuncturists), 385 (embalmers and funeral directors), 387a (tattoo technicians), 388 (electrologists), 397a (audiologists), 398 (hearing instrument specialists), 399 (speech and language pathologists) and Section 19a-515 of the General Statutes (nursing home administrator) are suspended for one (1) year for occupations and professions with annual education requirements, and for the other occupations and professions within said statutes, the continuing education completion period and reporting requirements are suspended for six (6) months. The continuing education requirements are modified as stated above for each person for the continuing education year in which March 10, 2020 lies for him or her.

Executive Order No. 7EE

  1. Mandatory Reporting by Managed Residential Communities
    Section 19a-694 of the Connecticut General Statutes is modified by adding the requirement that (1) all managed residential communities operating in Connecticut shall participate in and provide daily status reports in the form and manner requested by the Connecticut Hospital and Long Term Care Mutual Aid Plan (LTC MAP), and (2) that a managed residential community that fails to comply with the foregoing requirement shall be subject to a civil penalty of not more than $5,000 per violation.
     
  2. Mandatory Reporting by Nursing Homes
    Section 19a-521e of the Connecticut General Statutes is modified by adding the requirement that all nursing homes, as defined in Section 19a-490, operating in Connecticut shall participate in and provide daily status reports in the form and manner requested by the LTC MAP.  Failure of a nursing home to comply shall be classified as and constitute a Class A violation subject to a civil penalty of not more than $5,000 per violation.
     
  3. Waiving Certain Medicaid Prior Authorization Requirements
    The DSS Commissioner is authorized (temporarily) to waive, suspend, or modify, to the extent the Commissioner deems necessary, any Medicaid related prior authorization and other utilization review requirements. The Commissioner may issue any order and take other action that she deems necessary to implement this order.
     
  4. Waiving Medicaid Bed Reserve Day Requirements for Residents on Leave from Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs)
    The DSS Commissioner is authorized (temporarily) to waive, suspend, or modify, to the extent the Commissioner deems necessary, any Medicaid related requirements related to payments to ICF/IIDs for individuals residing in the ICF/IID who are on home leave or hospitalized and related requirements for ICF/IIDs with individuals on home leave or hospitalized, including, but not limited to, waiving the maximum day limit for the length of such home leave or hospitalization.  The Commissioner may issue any order and take other action that she deems necessary to implement this order.
     
  5. Waiving Requirements for Signed Delivery Receipt for Medical Equipment, Devices, and Supplies
    The DSS Commissioner is authorized (temporarily) to waive, suspend, or modify, to the extent the Commissioner deems necessary, any Medicaid related requirements for providers of medical equipment, devices, and supplies to obtain a signed delivery receipt from the Medicaid member as a condition of payment. The Commissioner may issue any order and take other action that she deems necessary to implement this order.

We expect to see additional Executive Orders from the Governor so stay tuned and refer to our Coronavirus (COVID-19) Resource Center for more information.

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