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Will AI Work for Diagnostic Medicine?

A recent Wall Street Journal article in their “The Future of Everything” commentary stream discusses the use of artificial intelligence (AI) to “tap the treasure trove of information locked in electronic health records to treat people in real time”. An interesting concept.  Not all that long ago this would have been disparaged as “cookie-cutter medicine”.  … Continue Reading

Mandatory COVID Vaccine for Healthcare Workers

The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule requiring COVID-19 vaccinations for workers in most institutional care settings.  A copy of the CMS press release can be found at https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care. This rule applies to those facilities subject to CMS regulations. Several facilities are regulated by the CMS, but this does … Continue Reading

PA Senate Approves Another Telemedicine Bill

The Pennsylvania Senate announced on October 26, 2021 that it has passed Senate Bill 705, and a copy of the Senate Press Release can be found at https://www.pasenategop.com/blog/senate-approves-telemedicine-bill/. A previous telemedicine bill was passed in Pennsylvania in July of 2018, when the Pennsylvania Senate approved Bill 780, which was discussed in my MedLaw Blog article … Continue Reading

Medical Practices Face Liability for COVID Accelerated and Advance Payments and PPP Loans

Medical practices are now beginning to encounter Medicare payment claw backs by CMS for COVID Accelerated and Advanced Payments (CAAP) and Department of Justice (DOJ) prosecution for Paycheck Protection Program (PPP) abuses. Please check the following links below for additional information. Justice Department Takes Action Against COVID-19 Fraud: Justice Department Takes Action Against COVID-19 Fraud … Continue Reading

Proposed HIPAA Changes Intended to “Empower Patients” and “Improve Coordination of Care”

On December 10, 2020, the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) collaborated on announcing proposed HIPAA changes, intended to “empower patients” and “improve coordination of care”. That’s encouraging, although one would have thought that to be unnecessary by now.  HIPAA was enacted in 1996.  It is a … Continue Reading

2021 Medicare Fee Schedule Conversion Factor Reduction Reversed

CY 2021 Physician Fee Schedule Update On December 27, 2020, the Consolidated Appropriations Act modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS): Provided a 3.75% increase in MPFS payments for CY 2021 Suspended the 2% payment adjustment (sequestration) through March 31, 2021 Reinstated the 1.0 floor on the work Geographic Practice Cost … Continue Reading

Potential Federal Action Regarding Surprise Billing

Recent reports indicate that House and Senate Committee leaders have apparently mutually agreed on a bipartisan arrangement for correcting or preventing surprise medical bills, although legislation has not yet been passed. Attached is an outline of the “No Surprise Act”, which essentially deals with insured patients receiving unexpected bills for medical services. Note that this … Continue Reading

Cybersecurity AKS Safe Harbor and Stark Exception

EHR Safe Harbor Permanent The existing electronic health records items and services Safe Harbor in 42 CFR Section 1001.952(y) was amended by deleting the sunset provision, thereby making the protection permanent. Cybersecurity Technology and Services A new Safe Harbor for cybersecurity and technology services is added in 42 CFR Section 1001.952(jj) to facilitate improved cybersecurity.  … Continue Reading

Sprint to Coordinated Care AKS Safe Harbors and Stark Exceptions Finalized

On December 2, 2020, the Department of Health and Human Services (HHS), the Office of Inspector General (OIG) and the Center for Medicare and Medicaid Services (CMS) will jointly publish the final regulations first proposed on October 17, 2019: 1.     AKS Safe Harbors: https://public-inspection.federalregister.gov/2020-26072.pdf 2.     Stark Exceptions:  https://public-inspection.federalregister.gov/2020-26140.pdf The regulations will become effective January 19, … Continue Reading

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 … Continue Reading

Federal Court Rejects American Hospital Association Challenge to Trump Price Transparency Rule

On June 23, 2020, the United States District Court for the District of Columbia denied the American Hospital Association’s (AHA) summary judgment motion claiming the Trump Administration had exceeded its authority and violated the First Amendment when it issued a new rule requiring greater price transparency. The Opinion is attached in the link below.  It … Continue Reading

CMS Issues Toolkit to Aid Nursing Homes in Fighting COVID-19

Yesterday (May 13, 2020), the Centers for Medicare and Medicaid Services (CMS) issued a 74-page “toolkit” to help nursing homes mitigate COVID-19 in their facilities.  A copy of the CMS publication can be found here:  https://www.cms.gov/files/document/covid-toolkit-states-mitigate-covid-19-nursing-homes.pdf The toolkit provides resources dedicated to addressing the very specific challenges facing nursing homes during this crisis.  It is … Continue Reading
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