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Welcome
Welcome to our third issue of 2025 of The Health Record -- our healthcare law insights e-newsletter.
In this edition, we look at the possible expiration of telehealth flexibilities for Medicare patients, the potential impact of executive orders threatening funding for programs that promote gender-affirming care to youth, the stalled certificate of need issue in West Virginia, pricing transparency laws in Ohio, how uncertainty in the healthcare space is affecting healthcare executives, the latest regarding limited competition, the impact on the NLRB under President Trump, an update on pay transparency, how discipline should be handled in the workplace, and the ever-changing status of the Corporate Transparency Act. And finally, Matt Georgitis walks us through his legal recommendations regarding nursing homes and compliance.
We hope you enjoy this issue and will let us know if you have any questions or suggestions.
Brienne T. Marco
Member, Chair of the Corporate Department, and Editor of The Health Record
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“Advocates say the coverage has bipartisan support, but efforts to make it permanent have been unsuccessful.”
Why this is important: During the COVID-19 public health emergency, telehealth flexibilities were implemented by the federal government to make healthcare more accessible for Medicare patients. Those flexibilities are set to expire March 31, 2025, unless Congress takes action to extend them. Through the end of March, patients with Medicare can receive telehealth services from any location in the United States, including the patient’s home. Starting April 1, 2025, patients must be present in person in an office or medical facility located in a rural area in the United States to receive most telehealth services. For Medicare patients living in rural areas, the expiration of these flexibilities will create hardship and make healthcare less accessible. --- Brienne T. Marco
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“U.S. District Court Judge Lauren King previously granted a two-week restraining order after the Democratic attorneys general of Washington, Oregon and Minnesota sued the Trump administration — Colorado has since joined the case.”
Why this is important: Earlier this year, President Trump signed two executive orders aiming to cut off federal funding for research, grants, and programs that “promote gender ideology” or provide gender-affirming care to individuals under age 19.
After the executive orders were challenged by the Attorneys General of Washington, Oregon, Minnesota, and Colorado, U.S. District Court Judge Lauren King issued a preliminary injunction blocking the majority of these executive orders pending a final decision on the merits of the case. One of the few portions not blocked by the preliminary injunction was the portion protecting against female genital mutilation since female genital mutilation is already illegal in the four states that are part of the lawsuit.
The outcome of this case has the potential to seriously impact the future of healthcare for transgender patients. If left unchecked, the executive orders would, among other things, prevent federally funded medical providers from providing necessary medical treatments to transgender youth that are entirely unrelated to gender identity. As an example, cancer treatment sometimes requires patients to take puberty blockers. President Trump’s executive orders would prevent federally funded providers from giving those necessary puberty blockers to patients if they are transgender. --- Arianna P. Webb
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“A bill in the Senate that would repeal CON is still moving through the Legislature and could be brought up for consideration by the Senate Health Committee at any time.”
Why this is important: With the demise of House Bill 2007 in the House Health Committee, West Virginia Governor Morrisey sustained an early setback to one of the policy initiatives he championed in his State of the State Address last month. In that speech, Governor Morrisey stated “repealing Certificate of Need laws will improve access to care for some of our most vulnerable citizens and provide services that barely exist in some parts of our state. New health care facilities in West Virginia should not be required to request a permission slip from the government to set up services. That’s big government activism at its worst.” Certificate of Need is a regulatory process that requires entities seeking to open or expand health care services in the state to receive approval from the state for those new facilities or services. The CON process is meant to prevent an over-saturation of the healthcare market, while ensuring that underserved areas get access to care.
House Bill 2007 was presented for public hearing where representatives from the major hospital systems spoke in favor of maintaining CON; representatives from the conservative Cardinal Institute and Americans for Prosperity spoke in opposition. The bill was advanced to the mark-up/vote stage where it surprisingly went down in defeat on a vote of 12-13. Some committee members attributed this shocking defeat of the Governor’s bill to allegedly heavy-handed lobbying efforts. However, CON repeal bills have been introduced every year since 2017 and have never advanced out of committee. Even still, both sides acknowledge that there is plenty of time remaining in the session for that effort to be revived as there are other House bills that accomplish the same or similar purpose and there still remains the Senate version of the Governor’s bill pending in the Health Committee of that chamber. --- Alexander Macia
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“Healthcare providers in Ohio will soon have to show you up-front, dollars-and-cents pricing for your care.”
Why this is important: Ohio is looking to get rid of the black box that often surrounds the pricing and cost of receiving healthcare. Ohio is the first state to require transparency in medical billing by having hospitals publish a list of standard charges for their services, both with and without insurance. Hospitals that do not publish the list of costs can instead offer an online price estimator. However, if a hospital utilizes the estimator, it is not permitted to sell the data developed through the estimator or use it for targeted advertising. Failure to comply will result in fines issued by the Ohio Department of Health and publication on a list of non-compliant facilities.
--- Alexander L. Turner
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“In the 2025 pulse survey, executives at healthcare organizations with over $1 billion in earnings said they are preparing for significant changes tied to payment reform and workforce.”
Why this is important: This article discusses the results of a survey of 61 health system executives about their feelings as to the upcoming changes/trends for the healthcare space in the next 10 years. Most of the executives expect to see significant regulatory changes to affect their organizations, so much so, that those changes will affect the finances and recruitment/retention of physicians, which could impact patient care. It remains to be seen if those regulatory changes will come to fruition, and the effect of those changes won’t be truly felt for years to come, but the leadership teams of the largest healthcare systems are already planning for those changes. That planning will undoubtedly have a trickle-down effect on institutions sooner rather than later. --- Matthew W. Georgitis
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By Mitchell J. Rhein
One of the biggest hot topics during the Biden administration was the legality and enforceability of non-compete agreements in employment. The Biden administration aggressively tried to eliminate employer-imposed restraints on employee mobility on multiple fronts. For example, the Federal Trade Commission (FTC) proposed to invalidate or restrict the use of noncompetition and nonpoaching agreements. Indeed, just days before President Trump was inaugurated, the FTC and Department of Justice updated the 2016 Antitrust Guidance for Human Resources Professionals to explain that non-compete, nondisclosure agreements, training repayment, and non-solicitation agreements may violate antitrust laws. The guidance also repeated the FTC’s and DOJ’s opinion that agreements between employers not to hire, solicit, or otherwise compete for workers (i.e., no-poach agreements) may result in criminal or civil liability.
Likewise, the National Labor Relations Board (NLRB) and its General Counsel launched their own attacks on non-competes (see Memorandums GC-23-08, GC-25-01, and J.O. Mory, Inc., a decision by NLRB Region 25 finding non-compete and non-solicitation provisions in an employment agreement violate the National Labor Relations Act).
With the change in administration, what does the future look like for non-compete agreements and other restrictive covenants?
Click here to read the entire article.
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By Peter R. Rich
The installation of a new administration with a fundamentally different philosophical identity once again foreshadows fundamental changes in the relationship between private sector employees and employers governed by the National Labor Relations Act. Official acts taken since January 20 confirm that the changes will be at least as significant as those imposed under the Biden administration.
Click here to read the entire article.
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By Eric E. Kinder
One trend we see continuing in 2025 is state and local laws requiring employers to be more transparent in how they pay their employees. These requirements come in two varieties. First, more states and cities are requiring private sector employers to disclose the actual pay range for a job to both applicants and employees. This can mean either stating the pay range as part of the application or recruitment process, allowing employees to inquire about that range after hiring, or both. Pay ranges, sometimes called pay scales, are to set forth the reasonable maximum pay that a job would entail, either as a salary or hourly wage, and the minimum the employer would pay. In addition, some jurisdictions, such as Maryland, require a general description of the benefits and any other compensation that is available for the position be stated in the advertisement or recruiting materials. As of the date of this publication, there are 14 states that have implemented a statewide pay transparency law; those states range from the Pacific Northwest (Washington) to the East Coast (Maryland and New York) and include a few cities in between (Cincinnati and Toledo).
Click here to read the entire article.
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Treasury Department Announces Suspension of Enforcement of Corporate Transparency Act Against U.S. Citizens and Domestic Reporting Companies | |
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By Brienne T. Marco and Joseph C. Unger
After months of back-and-forth regarding the status of the Corporate Transparency Act (“CTA”), the U.S. Department of Treasury has effectively ended the CTA’s reporting obligations for U.S. citizens and domestic reporting companies. On March 2, 2025, the Department of Treasury announced that it will not enforce any penalties or fines associated with the beneficial ownership information reporting rule under the existing regulatory deadlines, and it will not enforce any penalties or fines against U.S. citizens or domestic reporting companies or their beneficial owners pursuant to the reporting rule.
The Department of Treasury will further be issuing a proposed rulemaking that will narrow the scope of the reporting rule to apply to non-U.S. reporting companies only. This means that domestic U.S. companies and U.S. citizens are no longer required to submit beneficial owner information under the CTA. We will provide further updates regarding the proposed rulemaking when details become available.
We have a team of attorneys who are prepared to assist with any questions you may have regarding the CTA. If you have questions, please contact a member of our team.
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Featured Attorney Question & Answer | |
This is our Featured Attorney Q&A to introduce you to our large healthcare law team. To help you get to know our team a little better, we are highlighting attorneys in each issue by asking them a healthcare-related question. We hope their responses will be insightful for you. | |
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Matthew W. Georgitis
Member
Co-Chair, Nursing Home Practice Group
Co-Chair, Medical Malpractice Group
Winston-Salem, NC
336.727.7642
mgeorgitis@spilmanlaw.com
Q. As we all know, the rules and regulations surrounding nursing homes are quite involved and can be cumbersome. As the Co-Chair of Spilman’s Nursing Home Practice Group and someone with extensive experience in this unique area of law, what are your best practice recommendations for compliance? Is it enough to cover all compliance rules? Or should nursing homes be doing more?
A. Nursing homes must comply with so many federal, state, and local regulations, while also having to maintain high quality standards for their residents. But, there are certain things that can be done to make sure that compliance is more streamlined and easier to oversee.
Obviously, you need to make sure you are staying up-to-date on all regulations. They can change often, and many organizations offer training programs, legal updates and audits to make sure you and your staff are on the leading edge.
Your staff is going to be your front-line defense when it comes to compliance. Extensive training – that is held often – is very helpful. And making sure your employees know your standard operating procedures is essential. Do your Resident Safety and Quality Care protocols go above and beyond the norm? Just being in compliance is not always enough. Going beyond that compliance – and making sure your employees know your baseline of acceptability – can go a long way.
As we also know, there are going to be complaints in any healthcare situation. How are you addressing those? How quickly are you addressing those? What is your process? Do you have a process? And do your employees know those processes inside and out? And making sure you are addressing complaints quickly and extensively can diffuse a situation and prevent others.
Record keeping and proper data security are critical as well. Making sure your data storage systems are secure will not only help in preventing a breach but it will also help with obtaining and keeping insurance. Insurance companies almost always require proper security measures when it comes to confidential data storage such as medical records.
Financial compliance is a huge part of the nursing home realm, including ethical billing. More and more, nursing homes are being scrutinized for billing processes. Making sure your billing process is as transparent as possible is going to be key. Knowing Medicare and Medicaid billing practices is essential and vital to avoiding bigger issues.
Knowing that you can and will be inspected will get you ahead of the game. Have all documents and records organized and easily obtainable. If you see any discrepancies, address them immediately and document everything.
At Spilman, we have the capabilities to help you with all of the above and more. If you ever need guidance, please feel free to reach out.
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