text:
Store-and-Forward: Yes
Payment Parity: Yes
Licensure Compacts: ASLP-IC, CC, IMLC, NLC, OT, PSY, PTC
Audio-only explicitly reimbursed: No
Allowed to collect PPS rate for telehealth: No
Medicaid Program: Kentucky Medicaid
Administrator: Kentucky Dept. for Medicaid Services
Regional Telehealth Resource Center: Mid-Atlantic Telehealth Resource Center
Medicaid: COVID-19 Telehealth for Behavioral Health Providers
Medicaid: Provider Letter Regarding 1915(c) Waiver for Home and Community Based Services Waiver
Medicaid: Provider Letter Regarding 1915(c) Waiver for Home and Community Based Services Waiver Case Managers, Service Advisors and Support Brokers
Medicaid: Guidance on Well Child Visits during COVID-19
Medicaid: COVID-19 FAQs on Telehealth
STATUS: Active, until end of federal PHE
Medicaid 1915(c) Waiver: Appendix K – Acquired Brain Injury/Supports for Community Living/Home and Community Based Waiver/Model II Waiver
STATUS: Active, extended six months after end of federal PHE
Medicaid 1915(c) Waiver: Appendix K- Acquired Brain Injury/ Acquired Brain Injury Long Term Care/Supports for Community Living/Michelle P Waiver/Home and Community Based Waiver/Model II Waiver
STATUS: Active, Addendum extends waiver six months after end of federal PHE
Medicaid 1915(c) Waiver: Appendix K – Extension for Waivers Combined
Office of Health Data and Analytics: COVID-19 Actions, Guidance and Resources
Office of Health Data and Analytics: Kentucky COVID-19 Actions and Guidance Related to Telehealth
Previous COVID-19 waivers expired.
STATUS: Active, some of the policies have become permanent with updated regulations.
Medicaid: 1915(c) Home and Community Based Services Waiver Providers
STATUS: Active, waivers were extended until 6 months after the end of the federal PHE, See extension
Medicaid: COVID-19 FAQs for Medicaid 1915(c) Home and Community Based Services Waivers
STATUS: Active, extended six months after end of federal PHE; see Addendum below
"Telehealth" or "digital health" means a mode of delivering healthcare services through the use of telecommunication technologies, including but not limited to synchronous and asynchronous technology, remote patient monitoring technology, and audio-only encounters, by a health care provider to a patient or to another health care provider at a different location. Shall not include:
The delivery of health care services through electronic mail, text, chat, or facsimile unless a state agency authorized or required to promulgate administrative regulations relating to telehealth determines that health care services can be delivered via these modalities in ways that enhance recipient health and well-being and meet all clinical and technology guidelines for recipient safety and appropriate delivery of services; or
Basic communication between a health care provider and a patient, including but not limited to appointment scheduling, appointment reminders, voicemails, or any other similar communication intended to facilitate the actual provision of healthcare services either in-person or via telehealth; and
Unless waived by the applicable federal authority, shall be delivered over a secure communications connection that complies with the federal Health Insurance Portability and Accountability Act of 1996.
SOURCE: KY Revised Statute, Sec. 304.17A.138 which cites 211.332, (Accessed Nov. 2022).
A health benefit plan, issued or renewed on or after the effective date of this section, shall reimburse for covered services provided to an insured person through telehealth, including telehealth services provided by a home health agency licensed under KRS Chapter 216.
SOURCE: KY Revised Statute Sec. 304.17A-138. (Accessed Nov. 2022).
Telehealth coverage and reimbursement shall, except as provided in paragraph (b) of this subsection, be equivalent to the coverage for the same service provided in person unless the telehealth provider and the health benefit plan contractually agree to a lower reimbursement rate for telehealth services.
Rural health clinics, federally qualified health centers, and federally qualified health center look-alikes shall be reimbursed as an originating site in an amount equal to that which is permitted under 42 U.S.C. sec. 1395m for Medicare-participating providers, if the insured was physically located at the rural health clinic, federally qualified health center, or federally qualified health center look-alike at the time of service or consultation delivery and the provider of the telehealth service or telehealth consultation is not employed by the rural health clinic, federally qualified health center, or federally qualified health center look-alike.
A health benefit plan, issued or renewed on or after the effective date of this section, shall reimburse for covered services provided to an insured person through telehealth, including telehealth services provided by a home health agency licensed under KRS Chapter 216.Telehealth coverage and reimbursement shall, except as provided in paragraph (b) of this subsection, be equivalent to the coverage for the same service provided in person unless the telehealth provider and the health benefit plan contractually agree to a lower reimbursement rate for telehealth services.
A health plan shall not:
Require a provider to be physically present with a patient or client, unless the provider determines that it is necessary to perform those services in person;
Require prior authorization, medical review, or administrative clearance for telehealth that would not be required if a service were provided in person;
Require demonstration that it is necessary to provide services to a patient or client through telehealth;
Require a provider to be employed by another provider or agency in order to provide telehealth services that would not be required if that service were provided in person;
Restrict or deny coverage of telehealth based solely on the communication technology or application used to deliver the telehealth services; or
Require a provider to be part of a telehealth network.
A health plan Shall:
Require that telehealth services reimbursed under this section meet all clinical, technology, and medical coding guidelines for recipient safety and appropriate delivery of services established by the Department of Insurance or the provider's professional licensure board;
Require a telehealth provider to be licensed in Kentucky, or as allowed under the standards and provisions of a recognized interstate compact, in order to receive reimbursement for telehealth services; and
Reimburse a rural health clinic, federally qualified health clinic, or federally qualified health center look-alike for covered telehealth services provided by a provider employed by the rural health clinic, federally qualified health clinic, or federally qualified health center look-alike, regardless of whether the provider was physically located on the premises of the rural health clinic, federally qualified health clinic, or federally qualified health clinic look-alike when the telehealth service was provided; and
May utilize audits for medical coding accuracy in the review of telehealth services specific to audio-only encounters.
Benefits for a service provided through telehealth required by this section may be made subject to a deductible, copayment, or coinsurance requirement. A deductible, copayment, or coinsurance applicable to a particular service provided through telehealth shall not exceed the deductible, copayment, or coinsurance required by the health benefit plan for the same service provided in person.
The section does not require the health plan to:
Provide coverage for telehealth services that are not medically necessary; or
Reimburse any fees charged by a telehealth facility for transmission of a telehealth encounter.
Providers and home health agencies are strongly encouraged to use audio-only encounters as a mode of delivering telehealth services when no other approved mode of delivering telehealth services is available.
The cabinet, in consultation with the Division of Telehealth Services within the Office of Inspector General is required to promulgate administrative regulations to establish minimum requirements for the proper use and security of telehealth, including requirements for confidentiality and data integrity, privacy and security, informed consent, privileging and credentialing, reimbursement, and technology, among other things.
SOURCE: KY Statute Sec. 211.334, (Accessed Nov. 2022).
Health care providers performing a telehealth or digital health service shall obtain patient informed consent.
SOURCE: KY 900 KAR 12:005 (Accessed Nov. 2022).
SOURCE: KY Revised Statutes 211.332. (Accessed Nov. 2022).
"Telehealth consultation means a medical or health consultation, for purposes of patient diagnosis or treatment, that meets the definition of telehealth in this section."
SOURCE: KY Revised Statutes. 205.510. (Accessed Nov. 2022).
Telehealth means two (2)-way, real time interactive communication between a patient and a physician or practitioner located at a distant site for the purpose of improving a patient's health through the use of interactive telecommunication equipment that includes, at a minimum, audio and video equipment.
SOURCE: KY 907 KAR 1:055 (36). (Accessed Nov. 2022).
"Telemedicine" means two-way, real time interactive communication between a patient and a physician or practitioner located at a distant site for the purpose of improving a patient's health through the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.
SOURCE: KY 907 KAR 9:005. (Accessed Nov. 2022).
"Telehealth" or "digital health" is defined by KRS 211.332(5). "Telehealth" or "digital health": Means a mode of delivering healthcare services through the use of telecommunication technologies, including but not limited to synchronous and asynchronous technology, remote patient monitoring technology, and audio only encounters, by a health care provider to a patient or to another health care provider at a different location.
Shall not include:
Unless waived by the applicable federal authority, shall be delivered over a secure communications connection that complies with the federal Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. secs. 1320d to 1320d-9.
SOURCE: KY 900 KAR 12:005 & KY Revised Statute 211.332. (Accessed Nov. 2022).
Telehealth services and telehealth consultations shall not be reimbursable under this section if they are provided through the use of a facsimile machine, text, chat, or electronic mail unless the Department for Medicaid Services determines that telehealth can be provided via these modalities in ways that enhance recipient health and well-being and meet all clinical and technology guidelines for recipient safety and appropriate delivery of services.
Medicaid-participating practitioners and home health agencies are strongly encouraged to use audio-only encounters as a mode of delivering telehealth services only when no other approved mode of delivering telehealth services is available.
SOURCE: KY Revised Statute Sec. 205.559. (Accessed Nov. 2022).
Any recipient, upon being offered the option of an asynchronous or audio-only telehealth visit, shall have the opportunity or option to request to be accommodated by that provider in an in-person encounter or synchronous telehealth encounter.
If a telehealth service is delivered as an audio-only encounter and a telephonic code exists for the same or similar service, the department shall reimburse at the lower reimbursement rate between the two (2) types of services.
Telephonic Services. Telephonic code reimbursement shall be:
An alternative option for telehealth care providers to deliver audio-only telecommunications services, and shall not supersede reimbursement for an audio-only telehealth service as established pursuant to KRS 205.559 or 205.5591;
For a service that has an evidence base establishing the service's safety and efficacy;
Subject to any relevant licensure board restrictions of the telehealth care provider;
Subject to any synchronous telehealth limits of this administrative regulation or other state or federal law; and
For a service that is listed on the most recent version of the Medicaid Physician Fee Schedule, as established by 907 KAR 3:010, Section 1(17).
Health care providers performing a telehealth or digital health service shall, as appropriate for the service, provider, and recipient, utilize the following modalities of communication delivered over a secure communications connection that complies with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA):
Live or real-time audio and video synchronous telehealth technology;
Asynchronous store-and-forward telehealth technology;
Remote patient monitoring using wireless devices, wearable sensors, or implanted health monitors;
Audio-only telecommunications systems; or
Clinical text chat technology when:
Utilized within a secure, HIPAA compliant application or electronic health record system; and
The scope of the provider's professional licensure; and
The scope of practice of the provider; and
Comply with the following federal laws to prevent waste, fraud, and abuse relating to telehealth:
False Claims Act, 31 U.S.C. § 3729-3733;
Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b); and
Physician Self-Referral, Section 1877 of the Social Security Act
The department must reimburse an eligible telehealth care provider for a telehealth service in an amount that is at least 100 percent of the amount for a comparable in-person service. A managed care plan may establish a different rate for telehealth reimbursement via contract.
SOURCE: KY Admin. Regs. Title, 907, 3:170. (Accessed Nov. 2022).
A request for reimbursement shall not be denied solely because:
An in-person consultation between a Medicaid-participating practitioner and a patient did not occur; or
A Medicaid-participating provider employed by a rural health clinic, federally qualified health center, or federally qualified health center look-alike was not physically located on the premises of the clinic or health center when the telehealth service or telehealth consultation was provided.
The Department for Medicaid Services and any managed care organization with whom the department contracts for the delivery of Medicaid services shall not:
Require a Medicaid provider to be physically present with a Medicaid recipient, unless the provider determines that it is medically necessary to perform those services in person;
Require a Medicaid provider to be employed by another provider or agency in order to provide telehealth services that would not be required if that service were provided in person;
Require demonstration that it is necessary to provide services to a Medicaid recipient through telehealth;
Require a Medicaid provider to be part of a telehealth network.
Nothing in this section shall be construed to require the Medicaid program or a Medicaid managed care organization to:
The cabinet, in implementing Sections 2 and 3 of this Act, shall maintain telehealth policies and guidelines to providing care that ensure that Medicaid-eligible citizens will have safe, adequate, and efficient medical care, and that prevent waste, fraud, and abuse of the Medicaid program.
SOURCE: KY Revised Statute Sec. 205.5591, (Accessed Nov. 2022).
The Cabinet for Health and Family Services and any managed care organization with whom the Department for Medicaid Services contracts for the delivery of Medicaid services shall provide Medicaid reimbursement for covered telehealth services and telehealth consultations, if the telehealth service or telehealth consultation:
Is provided by a Medicaid-participating practitioner, including those employed by a home health agency licensed pursuant to KRS Chapter 216, to a Medicaid recipient or another Medicaid-participating practitioner at a different physical location; and
Meets all clinical, technology, and medical coding guidelines for recipient safety and appropriate delivery of services established by the Department for Medicaid Services or the provider's professional licensure board.
Telehealth service means any service that is provided by telehealth that is one of the following:
Consultation, including a telehealth consultation
Store-and-forward transfer
A service is not reimbursed if:
It is not medically necessary;
The equivalent service is not covered by the department if provided in a face-to-face setting; or
The provider is not enrolled, participating, or in good standing with the Medicaid program, is on an excluded or terminated provider list, or is an excluded individual or entity, as listed on the US Office of Inspector General List.
Reimbursement is not made for services that are not:
Medically necessary;
Compliant with administrative regulation;
Applicable to this administrative regulation; or
Compliant with state or federal law.
For rural health clinics, federally qualified health centers, and federally qualified health center look-alikes, reimbursement for covered telehealth services and telehealth consultations shall:
To the extent permitted under federal law, include an originating site fee in an amount equal to that which is permitted under 42 U.S.C. sec. 1395m for Medicare-participating providers if the Medicaid beneficiary who received the telehealth service or telehealth consultation was physically located at the rural health clinic, federally qualified health center, or federally qualified health center look-alike at the time of service or consultation delivery and the provider of the telehealth service or telehealth consultation is not employed by the rural health clinic, federally qualified health center, or federally qualified health center look-alike; or
If the telehealth service or telehealth consultation provider is employed by the rural health clinic, federally qualified health center, or federally qualified health center look-alike, include a supplemental reimbursement paid by the Department for Medicaid Services in an amount equal to the difference between the actual reimbursement amount paid by a Medicaid managed care organization and the amount that would have been paid if reimbursement had been made directly by the department.
A "telehealth care provider" is a Medicaid provider who is:
Currently enrolled as a Medicaid provider;
Currently participating as a Medicaid provider;
Operating within the scope of the provider's professional licensure; and
Operating within the provider's scope of practice.
Eligible providers for services NOT in a Community Mental Health Center:
A psychiatrist;
A licensed clinical social worker directly employed by a psychiatrist if the psychiatrist also interacts with the recipient during the encounter;
A psychologist with a license and a doctorate degree in psychology directly employed by a psychiatrist if the psychiatrist also interacts with the recipient during the encounter;
A licensed professional clinical counselor directly employed by a psychiatrist if the psychiatrist also interacts with the recipient during the encounter;
A licensed marriage and family therapist directly employed by a psychiatrist if the psychiatrist also interacts with the recipient during the encounter;
A physician;
An APRN;
Speech-language pathologist;
Occupational therapist;
Physical therapist;
Licensed dietitian or certified nutritionist; or
Registered nurse or dietitian
Eligible providers for services in a Community Mental Health Center:
Psychologist with a license in accordance with KRS 319.010(6);
A licensed marriage and family therapist;
A licensed professional clinical counselor;
A psychiatric medical resident;
A psychiatric registered nurse;
A licensed clinical social worker;
An advanced practice registered nurse
Restrictions apply for all professionals.
SOURCE: KY State Plan Amendment. Attachment 3.1-B. Approved 3/9/2011 (Accessed Nov. 2022).
Place of service is anywhere the patient is located at the time a telehealth service is provided, and includes telehealth services provided to a patient at home or office, or a clinic, school or workplace.
For rural health clinics, federally qualified health centers, and federally qualified health center look-alikes, reimbursement for covered telehealth services and telehealth consultations shall to the extent permitted under federal law, include an originating site fee in an amount equal to that which is permitted under 42 U.S.C. sec. 1395m for Medicare-participating providers if the Medicaid beneficiary who received the telehealth service or telehealth consultation was physically located at the rural health clinic, federally qualified health center, or federally qualified health center look-alike at the time of service or consultation delivery and the provider of the telehealth service or telehealth consultation is not employed by the rural health clinic, federally qualified health center, or federally qualified health center look-alike.
The cabinet, in consultation with the Division of Telehealth Services within the Office of Inspector General as established in KRS 194A.105, shall:
Provide guidance and direction to providers delivering health care services using telehealth or digital health
Promote access to health care services provided via telehealth or digital health
Maintain an online telehealth provider directory for consumer use; and
No later than thirty (30) days after the effective date of this Act, promulgate administrative regulations in accordance with KRS Chapter 13A to:
Establish a glossary of telehealth terminology to provide standard definitions for all healthcare providers who deliver health care services via telehealth, all state agencies authorized or required to promulgate administrative regulations relating to telehealth, and all payors;
Establish minimum requirements for the proper use and security of telehealth, including requirements for confidentiality and data integrity, privacy and security, informed consent, privileging and credentialing, reimbursement, and technology
Establish minimum requirements to prevent waste, fraud, and abuse related to telehealth; and
Maintain the discretion of state agencies authorized or required to promulgate administrative regulations relating to telehealth to establish requirements to authorize, prohibit, or otherwise govern the use of telehealth in accordance with the state agencies' respective jurisdictions.
The cabinet is also required to study the impact of telehealth on health care delivery and submit annual reports to the Legislative Research Commission. See statute for details.
SOURCE: KY Statute Sec. 211.334. (Accessed Nov. 2022).
A health-care facility that receives reimbursement under this section for consultations provided by a Medicaid-participating provider who practices in that facility and a health professional who obtains a consultation under this section shall establish quality-of-care protocols, which may include a requirement for an annual in-person or face-to-face consultation with a patient who receives telehealth services, and patient confidentiality guidelines to ensure that telehealth consultations meet all requirements and patient care standards as required by law.
The Department for Medicaid Services and any managed care organization with whom the department contracts for the delivery of Medicaid services shall not deny reimbursement for telehealth services covered by this section based solely on quality-of-care protocols adopted by a health-care facility.
The cabinet shall provide oversight, guidance, and direction to Medicaid providers delivering care using telehealth.
The Department for Medicaid Services shall within 30 days after the effective date of the Act do the following:
Promulgate administrative regulations in accordance with KRS Chapter 13A to establish requirements for telehealth coverage and reimbursement rates, which shall be equivalent to coverage requirements and reimbursement rates for the same service provided in person unless the telehealth provider and the department or a managed care organization contractually agree to a lower reimbursement rate for telehealth services; and
Create, establish, or designate the claim forms, records required, and authorization procedures to be followed in conjunction with this section and KRS 205.559,
Require that specialty care be rendered by a health care provider who is recognized and actively participating in the Medicaid program;
Require that any required prior authorization requesting a referral or consultation for specialty care be processed by the patient's primary care provider and that any specialist coordinates care with the patient's primary care provider; and
Require a telehealth provider to be licensed in Kentucky, or as allowed under the standards and provisions of a recognized interstate compact, in order to receive reimbursement for telehealth services.
The Cabinet for Health and Family Services cannot require a Medicaid provider to be a part of a telehealth network.
SOURCE: KY Statute Sec. 205.5591, (Accessed Nov. 2022).
For FQHCs and RHCs, a "visit" is defined as occurring in-person or via telehealth.
See rule for requirements of health care providers performing a telehealth or digital health service, including those related to confidentiality, patient privacy, consent, credentialing
The Telehealth Program
The program provides a repository of information and resources including state telehealth laws, policies and guidelines; answers to frequently asked questions; educational materials and webinars; statewide telehealth services directory; publications and journals; links to associations, organizations and professional licensure boards and other state and national programs and resources.
The program is one of five business units, along with the Cabinet Privacy Program, the Kentucky Health Benefit Exchange, the Kentucky Health Information Exchange (KHIE) and analytics for health and human services. Telehealth has the ability to work with the Cabinet Privacy Program dealing with HIPAA policies and procedures around the proper use and security for telehealth; with KHIE for providers to access clinical comprehensive care documents for telehealth services and with the analytics division to measure the value and effectiveness of telehealth.
SOURCE: Kentucky Cabinet for Health and Family Services. (Accessed Nov. 2022).
Behavioral Health Conditional Dismissal Pilot Program
A pilot program shall be established in no less than ten (10) counties selected by the Chief Justice of the Supreme Court to participate in a behavioral health conditional dismissal program. The pilot program shall begin January 1, 2023, and shall last for four (4) years unless extended or limited by the General Assembly.
Notwithstanding any other provision to the contrary, the clinical assessment may be conducted through telehealth or in person, whether the person charged is in the custody of the jail or has been released.
SOURCE: KY Revised Statutes 533.272 & 533.276. (Accessed Nov. 2022)
The Department of Corrections shall:
Promulgate administrative regulations to:
Require telehealth services in county jails
The department may promulgate administrative regulations in accordance with KRS Chapter 13A to implement a program that provides for reimbursement of telehealth consultations.
See statute for additional Information.
SOURCE: KY Revised Statutes 197.020. (Nov. 2022).
The Division of Telehealth Services has a Telehealth Terminology Glossary available.
SOURCE: KY 900 KAR 12:005E. (Accessed Nov. 2022).
KY Medicaid program shall require a telehealth provider to be licensed in Kentucky, or as allowed under the standards and provisions of a recognized interstate compact, in order to receive reimbursement for telehealth services.
SOURCE: KY Statute Sec. 205.5591. (Accessed Nov. 2022).
Telehealth Provided by an Out-of-State Telehealth Care Provider.
The department shall evaluate and monitor the healthcare quality and outcomes for recipients who are receiving healthcare services from out-of-state telehealth care providers.
The department shall implement any in-state or out-of-state participation restrictions established by a state licensing board for the impacted provider.
SOURCE: 907 KAR 003:170. (Accessed Nov. 2022).
KY Medicaid pays for live video telehealth, store-and-forward, remote patient monitoring and audio-only communication under certain circumstances. See below for more information.
The Medicaid program and managed care are required to reimburse for services delivered through telehealth. The department is required to promulgate administrative regulations to establish requirements for telehealth coverage and reimbursement, which shall be equivalent to the coverage for the same service provided in person unless the telehealth provider and the Medicaid program or a Medicaid managed care organization contractually agree to a lower reimbursement rate for telehealth services, or the department establishes a different reimbursement rate.
Kentucky's definition of telehealth includes synchronous and asynchronous technology, remote patient monitoring technology, and audio-only encounters. Store-and-forward is reimbursed by KY Medicaid under certain circumstances and remote patient monitoring is not considered an eligible telehealth service for reimbursement although included as part of KY's glossary (see reference below).
KY Medicaid is required to reimburse for telehealth services and telehealth consultations under certain circumstances, including the RHCs, FQHCs and FQHC look-alikes. Medicaid participating practitioners and home heath agencies are strongly encouraged to use audio-only encounters as a mode of delivering telehealth services only when no other approved mode of delivering telehealth services is available.
SOURCE: KY Revised Statute Sec. 211.332(5), KY Revised Statute 205.559 & KY 900 KAR 12:005E (Accessed Oct. 2022).
Pursuant to Section 7 of this administrative regulation, remote patient monitoring shall be an eligible telehealth service within the fee-for-service and managed care Medicaid programs.
A recipient participating in a remote patient monitoring service shall:
Have the capability to utilize any monitoring tools involved with the ordered remote patient monitoring service. For the purposes of this paragraph, capability shall include the regular presence of an individual in the home who can utilize the involved monitoring tools; and
Have the internet or cellular internet connection necessary to accommodate any needed remote patient monitoring equipment in the home.
The department may restrict the remote patient monitoring benefit by excluding:
Remote patient monitoring equipment;
Upgrades to remote patient monitoring equipment; or
An internet connection necessary to transmit the results of the services.
Conditions for which remote patient monitoring shall be covered include:
Pregnancy;
Cancer;
Chronic obstructive pulmonary disease;
Hypertension;
Congestive heart failure;
Mental illness or serious emotional disturbance;
Myocardial infarction;
Stroke; or
Any condition that the department determines would be appropriate and effective for remote patient monitoring.
Except for a recipient participating due to a pregnancy, a recipient receiving remote patient monitoring services shall have two (2) or more of the following risk factors:
Two (2) or more inpatient hospital stays during the prior twelve (12) month period;
Two (2) or more emergency department admissions during the prior twelve (12) month period;
An inpatient hospital stay and a separate emergency department visit during the prior twelve (12) month period;
A documented history of poor adherence to ordered medication regimens;
A documented history of falls in the prior six (6) month period;
Limited or absent informal support systems;
Living alone or being home alone for extended periods of time;
A documented history of care access challenges; or
A documented history of consistently missed appointments with health care providers.
A recipient may participate in a remote patient monitoring program as the result of a pregnancy if the provider documents that the recipient has a condition that would be improved by a remote patient monitoring service.
Remote patient monitoring shall be ordered by:
An advanced practice registered nurse;
A physician assistant; or
When operating within their scope of practice and licensure, the following behavioral health practitioners:
A licensed psychologist;
A licensed psychological practitioner;
A certified psychologist with autonomous functioning;
A licensed professional art therapist;
A licensed clinical alcohol and drug counselor; or
A licensed behavior analyst.
Providers who may provide remote patient monitoring services include:
A home health agency;
A hospital;
A federally qualified health center;
A rural health center;
A primary care center;
A physician assistant;
A behavioral health multi-specialty group participating in the Medicaid Program pursuant to 907 KAR 15:010;
A behavioral health services organization participating in the Medicaid Program pursuant to 907 KAR 15:020 or 907 KAR 15:022;
A residential crisis stabilization unit participating in the Medicaid Program pursuant to 907 KAR 15:070;
A chemical dependency treatment center participating in the Medicaid Program pursuant to 907 KAR 15:080;
A community mental health center that is participating in the Medicaid Program in compliance with 907 KAR 1:044, 907 KAR 1:045, or 907 KAR 1:047; or
A certified community behavioral health clinic that is participating in the Medicaid Program.
KY Medicaid reimburses for telehealth consultations, the definition of which encompasses store-and-forward.
SOURCE: KY Revised Statutes 205.559. For definition, see: KY Revised Statute 205.510 & 211.332. (Accessed Nov. 2022).
"Asynchronous telehealth" means a store and forward telehealth service that is electronically mediated.
A store and forward service shall be permissible if the primary purpose of the asynchronous interaction involves high quality digital data transfer, such as digital image transfers.
An asynchronous telehealth service shall be reimbursable if that service supports an upcoming synchronous telehealth or face-to-face visit to a provider that is providing one of the eligible specialties (see next section).
The department shall evaluate available asynchronous telehealth services quarterly, and may clarify that certain asynchronous telehealth services meet the requirements to be included as permissible asynchronous telehealth, as appropriate and as funds are available, if those asynchronous telehealth services have an evidence base establishing the service's:
Safety; and
Efficacy.
A provider shall not receive additional reimbursement for an asynchronous telehealth service if the service is an included or integral part of the billed office visit code or service code.
SOURCE: KY 900 KAR 12:005 (Accessed Aug. 2022).
An asynchronous telehealth service within the following specialties or instances of care that meets the criteria established in this section shall be reimbursable as a store-and-forward telehealth service:
Radiology;
Cardiology;
Oncology;
Obstetrics and gynecology;
Ophthalmology and optometry, including a retinal exam;
Dentistry;
Nephrology;
Infectious disease;
Dermatology;
Orthopedics;
Wound care consultation;
A store and forward telehealth service in which a clear digital image is integral and necessary to make a diagnosis or continue a course of treatment;
A speech language pathology service that involves the analysis of a digital image, video, or sound file, such as for a speech language pathology diagnosis or consultation; or
Any code or group of services included as an allowed asynchronous telehealth service.
TRANSMISSION FEE
The treating physician who delivers or facilitates the telehealth service shall obtain the informed consent of the patient before services are provided.
SOURCE: KY Revised Statutes § 311.5975. (Accessed Nov. 2022).
Patient consent must be obtained by:
Physicians;
Chiropractors;
Nurses;
Dentists;
Dieticians or nutritionist;
Pharmacist;
Psychologists or psychological associate;
Occupational therapists;
Optometrist;
Physical therapists;
Speech language pathologists or audiologists;
Social workers;
Marriage/family therapists;
Respiratory care practitioner
SOURCE: KY Revised Statutes 310.200, 311.5975, 312.220, 313.060, 314.155, 314A.230, 315.310, 319.140, 319A.300, 320.390, 327.200, 334A.200, 335.158, 335.380 & 314A.330, Originated from HB 177 (2000). (Accessed Nov. 2022).
Also see listing of Professional Board Regulation in Miscellaneous section for regulatory requirements for informed consent by profession.
The Board of Speech Language Pathology and Audiology requires their licensees to inform the client in writing, in an initial in-person meeting, about:
The limitations of using technology in the provision of telepractice;
Potential risks to confidentiality of information due to technology in the provision of telepractice;
Potential risks of disruption in the use of telepractice;
When and how the licensee will respond to routine electronic messages;
In what circumstances the licensee will use alternative communications for emergency purposes;
Who else may have access to client communications with the licensee;
How communications can be directed to a specific licensee;
How the licensee stores electronic communications from the client; and
That the licensee may elect to discontinue the provision of services through telehealth.
SOURCE: KY 201 KAR 17:110. (Accessed Nov. 2022).
See Medicaid Consent section for consent requirements established by the Cabinet for Health and Family Services.
A provider must be licensed in Kentucky with the exception of persons who, being nonresidents of Kentucky and lawfully licensed to practice medicine or osteopathy in their states of actual residence, infrequently engage in the practice of medicine or osteopathy within this state, when called to see or attend particular patients in consultation and association with a Kentucky-licensed physician.
SOURCE: KY Revised Statutes § 311.560. (Accessed Nov. 2022).
Recently Passed Legislation
If a state agency authorized or required to promulgate administrative regulations relating to telehealth chooses to promulgate an administrative regulation relating to telehealth, the state agency:
Shall not:
Prohibit the delivery of telehealth services to a person located in Kentucky by a provider who is a participant in a recognized interstate compact and delivers telehealth services to a person in Kentucky under the standards and provisions of that interstate compact; …
Prohibit the delivery of telehealth services to a person who is a permanent resident of Kentucky who is temporarily located outside of Kentucky by a provider who is credentialed by a Kentucky professional licensure board;
Prohibit the delivery of telehealth services to a person who is not a permanent resident of Kentucky who is temporarily located in Kentucky by a provider who is credentialed by a professional licensure board in the person's state of permanent residence; or
Require a health care provider to be physically located in the state that he or she is credentialed in by a professional licensure board in order to provide telehealth services to a person who is a permanent resident of the same state. Nothing in this paragraph shall be construed to imply that the Kentucky Medicaid program would be responsible for reimbursement for any services provided in Kentucky by a provider not credentialed by the Kentucky Medicaid program; and
May promulgate administrative regulations, which shall be no more restrictive than administrative regulations for providers who deliver healthcare services in person, to establish additional requirements relating to telehealth, including requirements:
For the proper use and security of telehealth;
To address emergency situations, including but not limited to suicidal ideations or plans; threats to self or others; evidence of dependency, neglect, or abuse; or other life-threatening conditions;
To prevent waste, fraud, and abuse of telehealth services, both in general and specific to the provision of telehealth services delivered via audio-only encounters; or
That a telehealth provider be licensed in Kentucky, or as allowed under the standards and provisions of a recognized interstate compact, in order to receive reimbursement for telehealth services.
See Professional Board Standards section for the complete statute.
SOURCE: KY Revised Statutes 211.336 as amended by HB 188 (2022 Session). (Accessed Aug. 2022).
SOURCE: KY Revised Statute 211.332. (Accessed Nov. 2022).
"Telehealth means the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic media for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education."
SOURCE: KY Revised Statutes § 310.200, 312.220, 314.155, 315.310, 319.140, 319A.300, 320.390, 327.200, 334A.200, 335.158, 335.380 , 314A.330, & KAR Title 501, Ch. 13, Sec. 010. (Accessed Nov. 2022).
Member of Interstate Medical Licensure Compact.
SOURCE: Interstate Medical Licensure, Compact Map. (Accessed Nov. 2022).
Member of Nurse Licensure Compact.
SOURCE: Nurse Licensure Compact. Current NLC States and Status. NCSBN. (Accessed Nov. 2022).
Member of Physical Therapy Compact.
SOURCE: PT Compact. Compact Map. (Accessed Nov. 2022).
Member of the Audiology and Speech-Language Pathology Compact
SOURCE: ASLP-IC, Compact Map, (Accessed Nov. 2022).
Member of Psychology Interjurisdictional Compact.
SOURCE: PSYPACT, Map, (Accessed Nov. 2022).
Member of the Occupational Therapy Licensure Compact.
SOURCE: Occupational Therapy Licensure Compact. (Accessed Nov. 2022).
Member of the Counseling Compact.
SOURCE: Counseling Compact Map. (Accessed Nov. 2022).
There is hereby created a Division of Telehealth Services within the Office of Inspector General to be headed by a director appointed by the secretary pursuant to KRS 12.050. The division shall:
Provide guidance and direction to healthcare providers delivering care using telehealth;
Develop guidance, resources, and education to help promote access to healthcare services in the Commonwealth;
Assist the Cabinet for Health and Family Services with the implementation of KRS 211.334; and
Provide the Department for Medicaid Services with any additional information deemed relevant by the division for inclusion in the report required by KRS 211.334(3).
SOURCE: KY Revised Statute 194A.105, (Accessed Aug. 2022).
See Medicaid Misc. section for regulation outlining requirements established by the Cabinet for Health and Family Services on health care providers performing a telehealth or digital health service, including those related to confidentiality, patient privacy, consent, credentialing.
Statewide system for heart attack response and treatment – Care levels and standards
Level I Comprehensive Cardiac Centers, Level II Primary Heart Attack Centers, and Level III Acute Heart Attack Ready hospitals are encouraged to coordinate, through a coordinating heart attack care agreement, within their service area to provide appropriate access to care for acute heart attack patients. A coordinating heart attack care agreement shall be in writing and include at a minimum:
Transfer protocols for the transport and acceptance of heart attack patients for treatment therapies which the transferring facility is not capable of providing; and
Communication criteria and protocols that include but are not limited to telemedicine systems.
The department may suspend or revoke a hospital's designation as Level I Comprehensive Cardiac Center, Level II Primary Heart Attack Center, or Level III Acute Heart Attack Ready if the department determines that the hospital is not in compliance with the requirements of KRS 211.340 to 211.343.
SOURCE: KY Revised Statutes 211.341. (Accessed Nov. 2022)
As used in KRS 311.595(9), "dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public or any member thereof" shall include but not be limited to the following acts by a licensee:
Prescribes or dispenses any medication:
In response to any communication transmitted or received by computer or other electronic means, when the licensee fails to take the following actions to establish and maintain a proper physician-patient relationship:
Verification that the person requesting medication is in fact who the patient claims to be;
Establishment of a documented diagnosis through the use of accepted medical practices; and
Maintenance of a current medical record.
For the purposes of this paragraph, an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation.
A "good faith prior examination" (needed to establish a physician-patient relationship) can be done through telehealth. Not applicable to hospice providers.
SOURCE: KY Revised Statute § 218A.010(18). (Accessed Nov. 2022).
A practitioner-patient relationship may commence via telehealth. An in-person initial meeting shall not be required unless the provider determines it is medically necessary to perform those services in person as set forth in KRS 211.336(2)(a). A licensed health care practitioner may represent the licensee at the initial meeting.
See rule for additional requirements.
A physician performing or inducing an abortion shall be present in-person and in the same room with the patient. The use of telehealth shall not be allowed in the performance of an abortion.
Professional Board Standards
Speech Language Pathology and Audiology
SOURCE: Title 201, Ch. 17, Sec. 110. (Accessed Nov. 2022).
Board of Dentistry Examiners
SOURCE: Title 201, Ch. 8, Sec. 590. (Accessed Nov. 2022).
Dietitians and Nutritionists
Board of Psychology
Board of Optometric Examiners
If a state agency authorized or required to promulgate administrative regulations relating to telehealth chooses to promulgate an administrative regulation relating to telehealth, the state agency shall
Use terminology consistent with the glossary of telehealth terminology established by the cabinet pursuant to Section 2 of this Act; and
Comply with the minimum requirements established below.
State agencies shall not:
Require a provider to be physically present with the recipient, unless the state agency or provider determines that it is medically necessary to perform those services in person;
Require demonstration that it is necessary to provide services to a patient through telehealth;
Restrict or deny coverage of telehealth based solely on the communication technology or application used to deliver the telehealth services;
Prohibit the delivery of telehealth services to a person located in Kentucky by a provider who is a participant in a recognized interstate compact and delivers telehealth services to a person in Kentucky under the standards and provisions of that interstate compact;
Prohibit an insurer or managed care organization from utilizing audits for medical coding accuracy in the review of telehealth services specific to audio-only encounters; or
Require a provider to be part of a telehealth network;
SOURCE: KY Revised Statute Sec. 211.336 (Accessed Nov. 2022).
See Medicaid definitions and Misc. section for regulation outlining requirements established by the Cabinet for Health and Family Services on health care providers performing a telehealth or digital health service, including definitions, and requirements related to confidentiality, patient privacy, consent, credentialing.
"Visit" means an encounter:
Between a recipient or enrollee and a health care provider during which an FQHC, FQHC look-alike, or RHC service is delivered; and
That occurs:
In person; or
Via telehealth if authorized by 907 KAR 3:170.
SOURCE: KY 907 KAR 1:055 (37). (Accessed Oct. 2022).
SOURCE: KY Revised Statute Sec. 205.559. (Accessed Oct. 2022).
SOURCE: KY Statute Sec. 205.559. (Accessed Oct. 2022).
See: KY Medicaid Live Video Eligible Providers
SOURCE: KY Revised Statute Sec. 304.17A-138. (Accessed Oct. 2022).
See: KY Medicaid Live Video Eligible Sites.
See: Medicaid Live Video Facility/Transmission Fee
Health insurers shall:
Reimburse a rural health clinic, federally qualified health clinic, or federally qualified health center look-alike for covered telehealth services provided by a provider employed by the rural health clinic, federally qualified health clinic, or federally qualified health center lookalike, regardless of whether the provider was physically located on the premises of the rural health clinic, federally qualified health clinic, or federally qualified health clinic look-alike when the telehealth service was provided.
SOURCE: KY Admin. Regs. Title, 907, 3:170. (Accessed Oct. 2022).
See: KY Medicaid Live Video
KY Medicaid reimburses for store-and-forward, however it's not explicitly stated whether or not FQHCs qualify for reimbursement.
See: KY Medicaid Store and Forward
A federally qualified health center
See: KY Medicaid Remote Patient Monitoring
The definition for telehealth or digital health includes audio-only encounters, and Medicaid has added reimbursement for telephonic services but does not explicitly state FQHCs are eligible.
See: KY Medicaid Audio-Only
SEE Kentucky >


It has over the last 16 years become THE annual A Cappella competition, allowing singers to watch and learn from other teams and to assess for themselves the development of standards across the categories each year.
Quote "PAssion" as the promotion code to enjoy $5 off ticket price.
Bus 45, 50, 72, 88, 159.


text:
Professor Athol Wells
Consultant chest physician
Professor Athol Wells is a consultant chest physician based at Royal Brompton Hospital.
How to be referred
+44(0)207 352 8121 (Switchboard)
Professor Athol Wells trained at Green Lane Hospital in Auckland, New Zealand. He then came to Royal Brompton Hospital in 1989 for his post-graduate studies.
Professor Wells is a consultant physician at the Trust. He specialises in diffuse lung disease. His areas of expertise include:
lung fibrosis
associated autoimmune disorders
idiopathic pulmonary fibrosis
other lung scarring disorders
all forms of sarcoidosis.
Professor Wells' research interests include:
prognostic evaluation in diffuse lung disease using HRCT and pulmonary function tests.
defining the relationship between structure and function in diffuse lung disease.
defining disease types and severity in genetic and laboratory studies
studying new therapies in diffuse lung disease.
Professor Wells speaks around the world at major conferences, including the American Thoracic Society and European Respiratory Society.
Professor Wells chairs the British Thoracic Society group revising diffuse lung disease guidelines. He sits on the American Thoracic Society and European Respiratory Society group revising idiopathic pulmonary fibrosis guidelines.
He also sits on several other joint group defining guidelines for conditions such as:
non-specific interstitial pneumonia
smoking-related diffuse lung disease
acute exacerbations of idiopathic pulmonary fibrosis
Professor Wells is on the advisory board of the:
American Journal of Respiratory and Critical Care Medicine
He is also principal or co-editor of three books on his specialist interests.
Private patient referral
If you would like to make an appointment with this specialist for private care, contact the RB&HH Specialist care team.
"Mortality in bronchiectasis: a long term study assessing the factors influencing survival"
There is little literature about the mortality associated with bronchiectasis. The aim of the present study was to investigate factors affecting mortality in patients with bronchiectasis.
Nontuberculous mycobacterial disease and Aspergillus-related lung disease in bronchiectasis
The aim of the present study was to determine whether patients with bronchiectasis and nontuberculous mycobacteria (NTM) have a higher prevalence of Aspergillus-related lung disease.

redpajama_set_name: RedPajamaCommonCrawl


We aren't your Mama's garden club!
We are a community-based organization focused on helping make the world around us a better, happier place. With the help of our volunteers, we organize the annual Garden Expo and Spokane in Bloom Garden Tour.
Are you passionate about what we're doing? Let us know! We are always looking for volunteers to help us make our vision a reality. We'll help you find a way to volunteer that best suits you. We're excited to have you join our group.
Whether you help through joining the garden club, volunteering your time, or spreading our mission through word-of-mouth, thank you. We couldn't accomplish our goals without the help of supporters like you.
We are dedicated to improving the lives of those in our community. Your joining us today helps us make a difference.
CHECK OUT OUR TWO BIG EVENTS OF THE YEAR!
Copyright © 2019 The Inland Empire Gardeners - All Rights Reserved.


Wir waren dabei und können sagen: "Es war geil!!!"
Schwarze Pfütze // Enduro Training Schweinfurt - Duration: 5 minutes, 58 seconds.
Erzberg Rodeo 2018 // SpZo Aftermovie // Hard Enduro - RedBull Hare Scramble // Sturm auf Eisenerz - Duration: 10 minutes.
NEW BIKE // KTM EXC 300 TPI SIX DAYS - Duration: 3 minutes, 19 seconds.
The smell of 2stroke :D Gooooons ! - Duration: 5 minutes, 44 seconds.
BIG BIKE Meet 2017 // SpZo AFTERMOVIE - Duration: 5 minutes, 59 seconds.
KTM EXC 300 Crash // Wheelie fail into Water - Duration: 2 minutes, 5 seconds.
just Enduro things ! fails crashes skills - Duration: 6 minutes, 6 seconds.
SpZo X-Mas Ride '16 - Duration: 4 minutes, 29 seconds.
Goodbye Summer - ENDURO vs SUPERMOTO - Duration: 3 minutes, 3 seconds.
Enduro in the Quarry with KTM EXC 300 and Honda CRF 250 - Duration: 3 minutes, 51 seconds.
Summer2K16 // Enduro love // Wheelie // Crew lifestyle // CR250 // EXC300 // FE450 - Duration: 4 minutes, 20 seconds.
BMW E92 3.0 BiTurbo vs Hyundai Genesis Coupe GT 3.8 - Duration: 102 seconds.
Summer 2k15 || Enduro || Yamaha DT 80 - Duration: 4 minutes, 32 seconds.
Some pieces of Summer 2015 - Duration: 3 minutes, 6 seconds.


text:
Q: JsonSchema.Validate() ObjectExpected: #/myField I'm trying to validate some json using the JSON.Net Schema support for validation. The JSON has a field called extra which is optional - sometimes it will be supplied with null. I'm trying the following code:
var json = "{ \"id\": 1, \"extra\": null }";

var schema = new JsonSchema4();
var extraProp = new JsonProperty {
    Type = JsonObjectType.Object,
    IsRequired = false
};

schema.Properties.Add( "extra", extraProp );

schema.Validate(json);

And am receiving the following validation error:
ObjectExpected: #/extra

How can I set the schema up to tolerate the "extra" field being null sometimes?

A: If I remove the field from the JSON altogether, it validates. Setting it to null is not sufficient.
var json = "{ \"id\": 1 }";

A: Since you have defined the Type for the extraProp as Object it will not allow null value.
If you want to allow null then you can use oneOf to do so.
Define extraProp as below and it should allow nulls.
var extraProp = new JsonProperty();
extraProp.OneOf.Add(new JsonSchema4(){Type = JsonObjectType.Null});
extraProp.OneOf.Add(new JsonSchema4(){Type = JsonObjectType.Object});

Also you can check if your propery definition allows nulls as follow
Console.Write(extraProp.IsNullable(NullHandling.JsonSchema));

Hope this helps.
Let me know if you need anything else.

redpajama_set_name: RedPajamaStackExchange


text:
Category Archives: Subrogation
THERE ARE TIMES AN EQUITABLE SUBROGATION CLAIM IS THE MOST PRACTICAL RECOURSE FOR REIMBURSEMENT
Posted on April 22, 2018 April 22, 2018 by David Adelstein
Equitable subrogation is a claim that can be pursued when a party (referred to as the subrogee) pays for damages to protect its interest–perhaps to mitigate its own exposure–seeks reimbursement from another party primarily liable for the damages. There are times a party seeking reimbursement for purely economic losses is best able to pursue an equitable subrogation claim, as opposed to a common law indemnification or negligence claim.
Equitable subrogation is generally appropriate where: (1) the subrogee made the payment to protect [its] own interest, (2) the subrogee did not act as a volunteer, (3) the subrogee was not primarily liable for the debt, (4) the subrogee paid off the entire debt, and (5) subrogation would not work any injustice to the rights of a third party.
Tank Tech, Inc. v. Valley Tank Testing, L.L.C., 43 Fla.L.Weekly D868a (Fla. 2d DCA 2018) quoting Dade Cty. Sch. Bd. v. Radio Station WQBA, 731 So.2d 638, 646 (Fla. 1999).
Equitable subrogation is not dependent on a contract—it is simply an "equitable remedy for restitution to one [the subrogee] who in the performance of some duty has discharged a legal obligation which should have been met, either wholly or partially, by another." Tank Tech, Inc., supra, quoting W. Am. Ins. Co. v. Yellow Cab Co. of Orlando, Inc., 495 So.2d 204, 206 (Fla. 5th DCA 1986).
As shown in the recent decision below, there are times an equitable subrogation claim will generate more traction for purposes of a reimbursement claim than a negligence claim or common law indemnification claim, because an equitable subrogation claim does not require the party seeking reimbursement to show a duty is owed to it by the party it is seeking reimbursement from.
The recent decision of Tank Tech, Inc. involved damage to underground petroleum storage tanks at Circle K locations. Company "A," the subrogee, had been hired by Circle K to retrofit existing tanks by adding an interior wall inside of the tanks. Company "B" was separately hired by Circle K to test the interstitial space between the new interior wall installed by Company "A" and the existing tank wall. There was no contractual relationship between Company "A" and Company "B."
After the tanks were retrofitted, Circle K notified Company "A" that the modified tanks were damaged and failing. Although Company's "A" investigation revealed the failure was the result of Company's "B's" testing methodology, Company "A" nevertheless repaired the damage to the tanks because its contract with Circle K required it to do so regardless of whether the damage was caused by a third party, such as Company "B."
Company "A" then sued Company "B" for reimbursement of its repair costs under various claims, one of which was equitable subrogation. Each party had expert opinions that pointed to the other for the cause of the tanks' failure and damage. The trial court granted a motion for summary judgment in favor of Company "B" finding that equitable subrogation did not apply. This summary judgment was reversed on appeal as the Second District maintained that there were factual issues supporting the basis of the equitable subrogation claim:
Tank Tech's [Company "A"] contract with Circle K obligated it to repair damages to the USTs [tanks]. But Tank Tech's contractual obligation to Circle K did not convert Tank Tech into a "volunteer" to pay for damages caused by a third party and thus did not prevent the application of the equitable subrogation doctrine. Instead, Tank Tech was merely fulfilling its legal obligation to Circle K which was a necessary means of protecting itself from liability to Circle K. And Tank Tech, by virtue of Dr. Cignatta's affidavit [expert opinion establishing Company "B" caused failure to tanks], established a genuine issue of material fact regarding whether Tank Tech or Valley Tank [Company "B"] was primarily liable for the damages. If Tank Tech is ultimately successful in proving that Valley Tank caused the damage to the USTs, then it would be entitled to seek any damages it incurred as a result of having to repair the damaged USTs. To hold that Tank Tech is precluded from pursuing a claim for subrogation would leave Tank Tech without a remedy, a "most unfair and inequitable result."
Tank Tech, Inc., supra (internal citations omitted).
Negligence and Common Law Indemnification
Relatedly, Company "A" also sued Company "B" for negligence and common law indemnification for repairing tanks it claimed were caused by Company "B's" testing methodology. The trial court also granted summary judgment in favor of Company "B" on these claims. Unlike the equitable subrogation claim, the Second District affirmed the summary judgment in favor of Company "B" on these claims.
For Company "A" to sustain a negligence claim, it would have to establish that Company "B" owed it a duty. Without a duty owed, there is no negligence claim. Whether there is a duty is a question of law for the court. In this case, when dealing with only economic losses, the relationship between the parties—Company "A" and Company "B"—needs to be examined to determine whether a special relationship exists to warrant creating a duty to protect the economic interests of another. "[I]n order to proceed on a common law negligence claim based solely on economic loss, there must be some sort of link between the parties or some other extraordinary circumstance that justifies recognition of such a claim." Tank Tech, Inc., supra. Here, the Second District agreed that Company "B" did not owe Company "A" a duty to support a negligence claim:
The reason why the negligence claim fails here is because there is neither a special relationship between Valley Tank [Company "B"] and Tank Tech [Company "A"] nor any extraordinary circumstance that would require imposition of a duty. Tank Tech's injury did not flow from Valley Tank's testing of the USTs [tanks]. Instead, Tank Tech seeks to recover the money it spent in repairing the USTs, an expense that was the result of a negotiated contract between Tank Tech and Circle K. There was no contract between Valley Tank and Tank Tech obligating Valley Tank to repair any USTs it damaged during testing or otherwise obligating Valley Tank to repay Tank Tech for the expenses incurred pursuant to Tank Tech's contract with Circle K. And Valley Tank's testing did not cause any personal injury or property damage to Tank Tech, the types of injuries for which the common law of negligence has historically permitted recovery.
This is simply a case of a party attempting to bring a tort claim to recover monies that it spent as a result of a contractual obligation to a third party. But negligence claims cannot proceed based on a party's desire to relieve itself from a bad bargain.
Tank Tech, Inc., supra.
Likewise, regarding the common law indemnification claim, "actions for indemnity have been restricted to situations involving either a duty, an express contract, or the existence of active and passive negligence." Tank Tech, Inc., supra, quoting Hiller Grp., Inc. v. Redwing Carriers, Inc., 779 So.2d 602, 603 (Fla. 2d DCA 2001). Since the Second District already agreed there was no special relationship between Company "A" and Company "B" and, thus, no duty owed, the common law indemnification claim failed for the same reasons as the negligence claim.
SUING FEDERAL GOVERNMENT ON A CONTRACT CLAIM; EQUITABLE SUBROGATION CLAIM BY LIABILITY INSURER AGAINST GOVERNMENT NOT ALLOWED
Posted on November 22, 2014 November 22, 2014 by David Adelstein
Equitable subrogation is a doctrine that liability insurers rely on when paying a claim on behalf of an insured. Under this doctrine, the insurer equitably subrogates—steps in the shoes—to the rights of the insured and sues as an equitable subrogee of the insured in order to seek reimbursement for the claim it paid.
What if the liability insurer tried to pursue an equitable subrogation claim against the federal government? In other words, what if the insurer paid out insurance proceeds on behalf of its insured-prime contractor and then tried to recoup the insurance proceeds from the federal government as an equitable subrogee of the prime contractor? The United States Court of Federal Claims in Fidelity and Guaranty Insurance Underwriters v. U.S., 2014 WL 6491835 (Fed.Cl. 2014) explained that a liability insurer CANNOT sue the federal government as an equitable subrogee of the prime contractor in order to recoup insurance proceeds paid out on a claim.
In this case, the government hired a prime contractor to abate asbestos at a post office. The prime contractor was having difficulty obtaining CGL liability insurance to specifically cover asbestos removal for a reasonable premium and the government, through the contracting officer, agreed to execute an addendum to the prime contract that required the government to save harmless and indemnify the contractor from personal injury claims attributable to the asbestos removal work.
More than ten years later, a former government employee sued the prime contractor claiming he contracted cancer from his exposure to asbestos while it was being removed and abated at the project. The prime contractor demanded that the government defend and indemnify it for this claim; however, the government refused. The prime contractor then tendered the claim to its CGL liability insurer and its insurer settled the claim. After the settlement, the prime contractor once again demanded that the government reimburse it by honoring the indemnification language in the addendum; again, the government refused.
The prime contractor's liability insurer then filed suit against the federal government as the equitable subrogee of the prime contractor in order to recoup the insurance proceeds it paid to the former government employee. The thrust of the claim was that the government breached the indemnification provision. The government moved to dismiss the lawsuit contending that the Court of Federal Claims does not have subject matter jurisdiction to entertain the lawsuit because the liability insurer is not in privity with the government and, therefore, cannot sue the government. The Court of Federal Claims agreed and dismissed the lawsuit. Why? Because a plaintiff suing the federal government on a contract claim must be in privity of contract with the federal government with limited exceptions to this rule:
"The Federal Circuit has recognized limited exceptions to the requirement that parties seeking relief for breach of contract against the government under the Tucker Act must be in privity of contract with the United States. These limited exceptions include (1) actions against the United States by an intended third-party beneficiary; (2) pass-through suits by a subcontractor where the prime contractor is liable to the subcontractor for the subcontractor's damages; and (3) actions by a Miller Act surety for funds that the government improperly disbursed to a prime contractor [after the surety financed completion of a defaulted subcontractor]. As the court of appeals has observed, the common thread that unites these exceptions is that the party standing outside of privity by contractual obligation stands in the shoes of a party within privity."
Fidelity and Guaranty Insurance Underwriters, supra(internal quotations and citations omitted).
Since none of the limited exceptions applied to allow a liability insurer to sue the government as an equitable subrogee of its insured-prime contractor, the Court of Federal Claims lacked subject matter jurisdiction.
This ruling does not prevent the prime contractor from suing the government directly for breaching the indemnification provision; it simply prevents the liability insurer from suing as an equitable subrogee of the prime contractor. Even though the insurer paid the claim, perhaps it can enter into an agreement with the prime contractor whereby the prime contractor sues the government directly for breach of contract.
The case demonstrates the limited exceptions available to a claimant on a construction project that wants to pursue a claim directly against the government when the claimant is not the prime contractor hired by the government. While prime contractors can sue the government for breach of contract, subcontractors, in particular, that want to pursue a claim against the government can only do so as a pass-through claim, meaning they are suing in the name of the prime contractor and will require the cooperation of the prime contractor.
Also, as an aside, the indemnification provision from the government and the prime contractor required the government to save harmless and indemnify the prime contractor. I always like to include the word "defend" in an indemnification provision so it is crystal clear that the indemnitor's indemnification obligations extend to its contractual obligation to defend the indemnitees for any claim.
A BUILDER'S RISK INSURANCE TIDBIT
Posted on August 29, 2014 August 29, 2014 by David Adelstein
Builder's risk insurance is a form of all-risk property insurance that protects an owner's property / project from perils during the course of construction subject to the exclusions identified in the policy. Sometimes there is the question when negotiating a contract between an owner and general contractor whether to name the contractor as an additional named insured (along with the owner) and/or a loss payee under the builder's risk insurance policy procured by the owner. A contractor prefers, and should prefer, to be included as a named insured and/or loss payee to ensure it is protected and paid for a covered loss during construction. In reality, it is much better for the contractor to be identified as a named insured; being identified as a loss payee simply means the contractor can be paid insurance proceeds (it can be named on the check), but it is not an insured under the policy.
Each of the standard form construction agreements contain slightly different language regarding a contractor's interest under a builder's risk policy procured by the owner. For example, the AIA would require the builder's risk insurance to include the interests of the owner, the general contractor, subcontractors, and sub-subcontractors. Ok; this makes sense but it does not specifically require the owner to name these entities as named insureds under the policy and/or loss payees. Rather, the AIA contains language that allows the owner to adjust the claim as a fiduciary with the payment made to the owner as a fiduciary. The ConsensusDOCS provide better language for the contractor that would require the owner to name the contractor as a named insured. Again, being identified as a named insured is preferable as it allows the contractor to assert a builder's risk claim directly against the policy as an insured. And, from an owner's perspective, sometimes it is preferable to allow the contractor to assert a claim for a loss associated with a peril that may be covered even if the peril is due to the negligence of the contractor. While the standard form contracts require the owner to bear the cost of the deductible, an owner may want to shift that deductible to the contractor if the contractor is seeking to recoup losses under the policy for a peril due to its negligence.
Finally, the standard form contracts do contain a waiver of subrogation for losses against the owner, contractor, subcontractors, etc. to the extent covered by property insurance. This means that the property insurer is waiving rights to recoup insurance proceeds it paid associated with a claim against a third party included in the waiver of subrogation provision. This provision should not be deleted as the contractual waiver of subrogation benefits both the owner and contractor.
UNDERSTANDING AN INSURER'S SUBROGATION RIGHTS
Posted on May 30, 2013 May 30, 2013 by David Adelstein
There are situations where an owner sues its property insurer (or builders risk insurer) in addition to suing its contractor or design professional for defects / damage. Sometimes, the owner's lawsuit against its insurer is filed simultaneously with the lawsuit against its contractor and sometimes it is filed before or after it settles its dispute with its contractor. The contractor, if it knows the owner is suing its insurer, wants to ensure that once it settles with an owner, that the owner's insurer will not pursue a subrogation claim against it. (In a subrogation claim, an insurer that pays its insured can stand in the shoes of the insured and sue third parties deemed liable for the claim.)
If a contractor settles with an owner and obtains a well-written release (that would release the contractor for all claims [known and unknown], damages, etc. arising out of or relating to the project and subject matter of the lawsuit/claim, etc.) the insurer will be precluded from asserting a subrogation claim against the contractor. The reason being is that the insured owner already released the contractor. See, e.g., Landmark American Ins. Co. v. Santa Rosa Beach Development Corp., 107 So.3d 1135 (Fla. 1st DCA 2012) (condominium development's agreement with developer and contractor that was interpreted as containing release barred development's insurer from seeking subrogation claim).
However, if the insurer is already suing the contractor in a subrogation claim or has perfected its rights, the contractor cannot try to settle with the owner and obtain a release thinking that the insurer's claim would then be barred. The insurer cannot be prejudiced like this, especially if it already perfected its subrogation rights. For instance, in Twin City Fire Ins. Co. v. Jones, 918 So.2d 403 (Fla. 5th DCA 2006), an insurer paid an insured's claim and then sued the defendants in a subrogation claim. The insured also filed a separate lawsuit against the defendants. The insured settled with the defendants and released the defendants. The defendants used the release to argue that the insurer should be barred from its subrogation claim. The Fifth District held that "a settlement executed by the insured cannot act as a bar to an action for subrogation by the insurer against a third party tortfeasor if, prior to the settlement, the tortfeasor learns of the insurer's perfected subrogation rights. Twin City Fire Ins. Co., 918 So.2d at 404 quoting Lincoln Nat'l Health & Cas. Ins. Co. v. Mitsubishi Motor Sales of Am., Inc., 666 So.2d 159, 163 (Fla. 5th DCA 1995).
Understanding an insurer's subrogation rights is important in construction. Oftentimes, there are waiver of subrogation rights that are set forth in contracts. Sometimes, these provisions are either stricken or the contract does not contain a waiver of subrogation. It is important to consider subrogation as a contractor if you have knowledge that the party suing you is also suing an insurer and/or you are being sued by an insurer in a subrogation claim (or the insurer has taken steps to perfect subrogation rights) so that you know your rights and options as the dispute progresses to settlement.


The prime minister visited the governor-general this morning to dissolve the Parliament and set a federal election for May 18. The campaign will be a 35-day PR drive, and small businesses can expect to be frequently mentioned. The Coalition government and opposition Labor party alike are acutely aware that small businesses employ around half of the private sector workforce and can help swing an election. So expect a drip feed of policies from the major parties over the next 35 days.
Before we consider what the campaign might contain, let's straighten out how the major parties compare on policies.
On tax cuts, the Coalition legislated and expedited small, medium and unincorporated tax cuts with Labor's support. Unless an announcement is made during the election, both parties have the same business tax policies.
On access to the Australian Business Securitisation Fund and the expanded instant asset write-off, both initiatives were legislated in the last week of Parliament with opposition support. The fund will supply $2 billion to smaller banks and non-bank lenders to lend to small businesses on competitive terms. The opposition is, however, endorsing its minimum 30 percent tax on trust distributions and Australian Investment Guarantee – allowing all businesses an immediate 20 percent deduction on applicable investments above $20,000. This gives Labor a one-up on investment incentives and a markdown on higher taxes.
Personal tax cuts will be a point of difference between the two major parties, but in the short run, policies are similar. From 1 July, someone earning under $37,000 will be around $100 better off under Labor. In the long run, the Coalition has legislated and flagged broad reforms that will mostly benefit those earning more than $90,000. The opposition disagrees with this approach, pledging to repeal legislation and ignore the proposal to leave taxes as they are for those unaffected by cuts taking effect this year.
In terms of skills, the Coalition has offered to support 80,000 new apprentices and offer bigger incentives for employers. Labor has promised to almost double the funding allocation for technical and further education, including TAFE upgrades and incentives.
So with both major parties starting on a relatively level footing in terms of small business policies, what can we expect the campaign to include?
The Government will be first and foremost campaigning on its record of economic success. The opposition will campaign on dissatisfaction and argue the economy is not working for everybody.
How this relates to small business is the key to understanding what will unfold in the next 35 days. We can expect policy proposals from the Coalition including further moves on payment times and digitisation initiatives, better access to business information and protection for subcontractors. From the opposition, we know to expect a commitment to reinstate penalty rates, changes to the rules that determine minimum wage increases and greater rights for casual workers.
It is my hope that both parties campaign for measures to improve business productivity and create a business environment primed for success in a rapidly changing global economy. Xero strives to enable this productivity by connecting businesses with the accounting tools, apps and the thousands of connections business owners need in one place, available at any time, on any device. But, there is a role for governments to play to ensure that people have the skills, regulatory environment and infrastructure required to make the technology decisions that will benefit them most. The Government must move to be a digital leader by exploring how every interaction with the public functions in an economy so intertwined with digital processes it is impossible to decouple.
Broadly speaking, this election differs from recent contests in that Australians will be faced with two markedly different platforms to take the nation forward. As the small business policies from both parties become clear, we will continue to dissect them to understand how they are likely to affect the small business sector as well as its accounting and bookkeeping advisers.
The post Australian election called, small business in focus appeared first on Xero Blog.


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Tourism Tax Commission Tables TripAdvisor Program, But Radio Campaigns Move Ahead
By Editor | October 22, 2019 | 0
Two more months of search engine marketing through Madden Media at $330 a month was approved by the city of Ste. Genevieve's Tourism Tax Commission on October 16, as was a new radio campaign.
A three-month experiment with TripAdvisor, however, was tabled until spring.
Radio advertising totaling $6,455 also was approved. The ads include a fall campaign for $2,000 on the St. Louis National Public Radio (NPR) station and $2,625 for an early holiday campaign with Entercom, which includes radio stations KMOX and KEZK.
Commission member Lawnce Myers asked how effective the TripAdvisor program would be during the slower winter months.
Commission member Mike Fallert suggested the commission might "get more bang for our buck by putting it off a little bit," waiting to hit the busier spring and summer seasons.
"I'm not opposed to the idea," Myers said, "I'm just not sure if, going into the winter, it would be really effective."
There seemed to be consensus that the program would be a good thing to consider at some point, such as next spring.
Cabot presented two potential radio advertising packages that would target the St. Louis area.
For $2,000, 22 spots would air on the St. Louis NPR station, KWMU (FM 90.7).
The script would read, "Support [for public radio] comes from historic Ste. Genevieve, an ideal fall destination for exploring historic sites, shops, wineries, dining, hiking and more. Just one hour south of St. Louis on Interstate 55. Details about fall festivals, hotels, bed and breakfast inns and tour ideas at visitstegen.com."
An additional 11 bonus spots would be thrown in free, for a total of 33 ads, or about eight per week.
The Entercom ads — on KEZK (FM 102.5), KMOX (AM 1120), KYKY (FM 98.1), KNOU (FM 96.3) and KFTK (FM 97.1) — would be played November 30 through December 25.
Hooper said he likes the timing on the Entercom ads, leading up to Christmas.
See complete story in the October 23 edition of the Herald.
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Image Credit: Siasat
Comedian Munawar Faruqui Gets Interim Bail, Supreme Court Says 'FIR Vague'
India, 5 Feb 2021 6:11 AM GMT | Updated 2021-02-05T12:40:19+05:30check update history
Munawar was arrested along with four others on January 1 for allegedly insulting and making indecent remarks on Hindu deities during a New Year show in Indore.
Stand up comedian Munawar Faruqui, who was put behind bars over allegations of "insulting Hindu Gods and Goddesses" during a show in Indore on January 1, was granted interim bail on Friday, February 5, by the Supreme Court, LiveLaw reported.
A bench comprising Justices Rohinton Fali Nariman and BR Gavai also granted Munawar interim protection from arrest and issued a notice to the Madhya Pradesh police.
The Madhya Pradesh High Court's Indore Bench on Thursday, January 28, had rejected the bail applications filed by Munawar and co-accused Nalin Yadav.
Dismissing the applications, Justice Rohit Arya had observed that the evidence/material gathered so far suggested that the "show was organized under the garb of standup comedy at a public place on commercial lines. The show outraged the religious feelings of a particular section of the citizens of India."
"There is also a specific assertion by the learned counsel for the complainant that the applicant along with other co-accused persons allegedly making outraging filthy jokes in social media deliberately against Hindu Gods, Lord Shriram and Goddess Seeta hurting religious sentiments of Hindus for the last 18 months despite, protest on various social media platforms. There is nothing on record to the contrary," the Court had observed.
Munawar was arrested along with four others on January 1 for allegedly insulting and making indecent remarks on Hindu deities and Union Home Minister Amit Shah during a New Year show in Indore.
The four others arrested include Prakhar Vyas, Priyam Vyas, Nalin Yadav, and event coordinator Edwin Anthony.
The arrests were made based on a complaint filed at the Tukoganj police station, by Eklavya Singh Gaur, son of a local BJP legislator Malini Laxman Singh Gaur.
Additionally, the SHO of Tukojiganj police station Kamlesh Sharma had admitted that the police had not found any evidence against the comedian.
The Indore Superintendent of Police Vijay Khatri also said that Munawar had not made any jokes about Hindu deities, or even begun his performance when he was arrested by the Madhya Pradesh Police. "The comedian was arrested only on the basis of claims made by a Hindutva vigilante group," the cop said.
Khatri said that the arrest was made on basis of a complaint by Eklavya Singh Gaur, who said he had overheard jokes during rehearsal. However, the cop, said that the lack of video evidence "was not a concern".
Also Read: 'Outraged Religious Feelings': Madhya Pradesh HC Rejects Bail Applications Of Munawar Faruqui, Nalin Yadav
Faruqui
Interim Bail


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MUNGO MacCALLUM. Who is to blame for the last Liberal Party election failure – Turnbull or Nutt.
By Mungo MacCallum | On 10 April 2017
Malcolm Turnbull will plough ahead pushing the doors marked pull and ignoring the lessons, not just from the last election, but from all the polling since.
There is an old and wise maxim that a politician should never institute an inquiry unless he knows precisely what the result is going to be.
But there are always exceptions to the rule, and the most intransigent one is when you have suffered an electoral disaster and you feel the need to find a scapegoat.
Normally, the patsy can be identified relatively easily, and disposed of tactfully and, with any luck, quietly. But just occasionally it is no longer possible to heap all the obloquy on just one person: the blame has to be spread around, even among some of those who set up the inquiry in the first place.
When this happens, the imperative is to suppress the damning report, and indeed there is little prospect that anything more than the most bowdlerized version of the probe into what went wrong in the lead up to the debacle of last July was ever supposed to become public.
But this is the faction ridden, strife-torn government of Malcolm Turnbull we are talking about, so the big leak came right on cue – before the dust had settled behind the retreating form of Tony Nutt, the hapless Liberal campaign director who had suddenly found it necessary to move aside for a newer and less tainted regime.
The problem is that Nutt, while obviously one of the most anticipated victims, was not the only one – although we are assured that Andrew Robb and his fellow inquisitors have not actually named names, it is abundantly clear that they were afar from happy with Turnbull himself, his predecessor Tony Abbott, or just about anyone else who had a hand in the cesspit that gave up 14 seats and very nearly lost the government.
And the bad timing wended its way from the past to the future: the report criticized all aspects of the flawed campaign, but made much of the failure of the jobs and growth strategy, underpinned by the promise of corporate tax cuts, just as Turnbull was trying to reboot them.
Having negotiated the reductions for small to medium firms through the senate, it was thought that he would take his winnings and retire – that the cuts for the big end of town would be quietly removed from the table. But not a bit of it: he will plough ahead pushing the doors marked pull and ignoring the lessons, not just from the last election, but from all the polling since.
This is not an idea that has enthused masses – indeed, if anything it has turned them away in droves, confirming the belief well-nourished by Bill Shorten that Turnbull is a rich and powerful man only interested in looking after other rich and powerful men. And as Tony Nutt moves on to become a rich and powerful director of the various companies he has no doubt prepared for his arrival, he might well be the nearest thing to a winner.
He may have been attacked by many of his parliamentary colleagues and implicitly admonished by the Robb report, but so has everyone else. The difference is that Nutt will be crying all the way to the bank. Malcolm Turnbull will have to get back on the horse – even if, it appears, the one he chooses is an increasingly moribund beast.
Mungo MacCallum is a former senior member of the Canberra Press Gallery.
Mungo MacCallum
Mungo MacCallum is a veteran political journalist and commentator. His books include Run Johnny Run, Poll Dancing, and Punch and Judy.
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