President Trump Issues Surprise Billing Executive Order

On September 24, 2020, President Trump issued an Executive Order encouraging Congress to restrict surprise billing and prevent third party payors from denying care to patients with pre-existing conditions.  President Trump wants Congress to act prior to the end of the year, but obviously there is not much chance of that happening.

Orthopedic Practice Pays $1.5 Million for HIPAA Damages

Most medical practices view HIPAA compliance as maintaining appropriate documentation regarding patient notices and consents, and controlling access to the PHI within the office; that’s PRIVACY.  Practices tend to forget the technology/security side of HIPAA, which requires maintaining, or reasonably attempting to maintain, secure EHR/IT systems; that’s SECURITY.

Athens Orthopedic Clinic PA agreed to pay $1.5 million in damages to settle potential violations of HIPAA following a self-reported breach report informing OCR that approximately 208,000 patient files were affected because of a hacker breach.

The OCR investigation revealed “long standing, systemic non-compliance with the HIPAA privacy and security rules”.

Remember that HIPAA requires both PRIVACY and SECURITY.

AHLA and Health IT News Report Enormous Telehealth Hacking Increases

The American Health Law Association and Health IT News recently published reports indicating enormous increases in telehealth hacking attacks.

Sam Kassoumeh, COO of Health IT News and Co-Founder of SecurityScorecard, stated:

“The rapid pace at which telehealth applications were ruled out during the pandemic made them attractive targets for cyber criminals . . . Our report (SecurityScorecard) findings illustrate that in order for the health care industry to protect patients and provide data, bidding and enforcement security protocols around new technology providers remains paramount”.

The rapid increase is attributed to several factors:

  • Individual fears of the pandemic making them susceptible to phishing attacks
  • Patients connecting with telehealth providers using web-based applications with inadequate security protection
  • Insufficient endpoint security in medical devices and COVID diagnostic services
  • Telehealth services operating over under protected networks

A conclusion, stated by Andy Riley, Executive Director of Security Strategy at managed securities vendor, Nuspire, was:

“Any time you make a change to an IT environment, you have the potential to increase risk”.

For additional information contact Mike Cassidy.

Mike Cassidy Included Again in The Best Lawyers in America 2021

Michael Cassidy has been included by his peers in the Health Care Law category in The Best Lawyers in America 2021Best Lawyers is the oldest and most respected peer review publication in the legal profession, and has been compiling a list of best lawyers for 27 years.  Best Lawyers is widely regarded within the legal profession as a signal honor, confirmed upon lawyers by their peers.

Proposed 2021 Medicare Physician Fee Schedule Changes

Attached is a link to the fact sheet for “proposed policy, payment, and quality provisions changes to Medicare physician fee schedule for calendar year 2021”.

Among other things, Centers for Medicare & Medicaid Services (CMS) proposes to:

  • Significantly decrease the Medicare Work Relative Value Unit (WRVU) conversion factor from $36.09 to $32.26
  • Significantly revise the WRVU waiting and coding guidelines for popular E&M Codes 99211-99215
  • Significant WRVU decreases for radiology, CRNAs and chiropractors
  • Additional telehealth approved services

Contact Mike Cassidy for additional information.

CMS 2021 Fee Schedule Expands ASC Procedures

Centers for Medicare & Medicaid Services (CMS) published the new hospital outpatient and ambulatory surgical center fee schedule for 2021 on August 12, 2020 at this this link:  https://www.federalregister.gov/documents/2020/08/12/2020-17086/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment

As part of the proposed revisions, CMS intends to transfer over 1,500 procedures from the “inpatient only” category, including 266 musculo-skeletal procedures as of 2021, the explanation and list of which begins on page 386 in the attached link.

For additional information contact Mike Cassidy.

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