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
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
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
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
The Center for Telehealth and e-Health Law (CTeL) is presenting its virtual 2020 Fall Summit on December 1st through December 4th. Mike Cassidy will participate in the Keynote Panel addressing the telehealth issues presented in the OIG’s September 2020 National Health Care Fraud and Opioid Takedown. … Continue Reading
Michael Cassidy has been included by his peers in the Health Care Law category in The Best Lawyers in America 2021. Best 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 … Continue Reading
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
Mike Cassidy’s article, “Return to practice under the COVID threat” appears in the Bulletin of the Allegheny County Medical Society June edition.… Continue Reading
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
This is a link to the update of the OIG Work Plan that you will see it includes several new entries regarding COVID issues at nursing homes: Meeting the challenges presented by COVID Audit of nursing homes reporting of COVID-19 information Nursing home oversight during COVID-19.… Continue Reading
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
Although the Office of the Inspector General (“OIG”) has previously announced that it would exercise discretion with respect to financial arrangements entered into to facilitate and enhance the availability of COVID-19 testing, the attached Memorandum from the Office of Attorney General also indicates enhanced enforcement scrutiny with respect to fraudulent testing.… Continue Reading
The following are just some random thoughts or curated information regarding the impact the COVID pandemic will have on privacy in general, and health information privacy in particular. I have attached a link to information issued by HHS explaining that, not only are HHS and OCR specifically advising that the release of patient information regarding … Continue Reading
Attached is a PDF issued by CMS regarding blanket waivers of the Stark Law in order to allow physicians and hospitals to adjust 18 different potential financial relationships in order to deal with the COVID-19 emergency. The waivers were issued on March 30, 2020, with a retroactive effective date of March 1, 2020. They will … Continue Reading
Although many believe the HIPAA rules already allow for disclosure of COVID-19 cases on the basis of a public emergency, OCR just issued Guidance, attached in the link below, confirming disclosure is permitted when needed to provide treatment, with the notification is required by law and in order to prevent or control the spread of … Continue Reading
A vast majority of current physician employment contracts, both with larger systems and in individual practice, have some sort of productivity component for compensation, dependent upon the production of: WRVUs (Work Relative Value Unit) Collections Net Profits Even if there are no negotiated “resource” provisions, most contracts also have what was always thought to be … Continue Reading
Just a few short weeks ago, the Center for Disease Control’s Director of the National Center for Immunization and Respiratory Diseases warned that the spread of coronavirus in the U.S. was “not a question of if, but when.” As of this updated posting, the entire country is locked in an unprecedented grip of uncertainty and … Continue Reading
Just a few short weeks ago, during a press briefing by the Center for Disease Control’s Director of the National Center for Immunization and Respiratory Diseases, the director warned that the spread of coronavirus in the U.S. was “not a question of if, but when.” As of the date of this posting, there are now … Continue Reading
Click on the link to an article published in the New York Times (12/4, Abelson) reporting the American Hospital Association and other hospital groups filed a lawsuit against the Trump Administration “over a new federal rule that would require them to disclose the discounted prices they give insurers for all sorts of procedures.” The hospital groups … Continue Reading
As another part of the Regulatory Sprint to Coordinated Care, OIG proposed revisions to the existing EHR Anti-Kickback Safe Harbor and added a cybersecurity component. The initial EHR Safe Harbor was developed in response to President George W. Bush’s 2004 initiative to extend EHR nationwide within 10 years, i.e. 2014. The proponents of those EHR … Continue Reading
The Pennsylvania Commonwealth Court, on remand from the Pennsylvania Supreme Court, has again decided that the previously agreed termination date of the access provisions contained in the UPMC/Highmark Consent Decrees, i.e. June 30, 2019, is not a term subject to the modification provisions of those Consent Decrees, and is definite. The adjudication of the Commonwealth … Continue Reading
This article by Mike Cassidy originally appeared in the Allegheny County Medical Society Bulletin June Edition. To read the article click here.… Continue Reading
Michael Cassidy has been included by his peers in the Health Care Law category in The Best Lawyers in America 2021. Best 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 … Continue Reading
Just a few short weeks ago, the Center for Disease Control’s Director of the National Center for Immunization and Respiratory Diseases warned that the spread of coronavirus in the U.S. was “not a question of if, but when.” As of this updated posting, the entire country is locked in an unprecedented grip of uncertainty and … Continue Reading
The Pennsylvania Commonwealth Court, on remand from the Pennsylvania Supreme Court, has again decided that the previously agreed termination date of the access provisions contained in the UPMC/Highmark Consent Decrees, i.e. June 30, 2019, is not a term subject to the modification provisions of those Consent Decrees, and is definite. The adjudication of the Commonwealth … Continue Reading
