Our Introduction to Telehealth, Technology and Federal Enforcement chapter was published in the Thomson Reuters 2025 Health Law Handbook. It reviewed a number of telehealth Medicare revisions, both permanent and temporary, enacted by a series of consolidated appropriation acts and physician fee schedule amendments arising out of the 2020 COVID pandemic. The temporary telehealth provisions … Continue Reading
The final Medicare Physician Fee Schedule was issued on November 1st for calendar year 2025. Attached is a link to both the Press Release describing all of the Medicare changes and the link to the entire Final Rule. The Medicare Conversion Factor for the Physician Fee Schedule was decreased from $33.29 from 2024 to $32.35 … Continue Reading
Mike Cassidy and Adam Appleberry have had a chapter published in the Thomson Reuters Health Law Handbook: “Introduction to Telehealth, Technology, and Federal Enforcement”.… Continue Reading
CMS proposed several telehealth changes in the 2025 Medicare Physician Fee Schedule Proposed Rule, issued July 10, 2024. Interactive Telecommunication Beginning January 1, 2025, an interactive telecommunication system may include two-way, real-time audio-only communication technology for any telehealth service furnished to a beneficiary in their home, if the distant site physician or practitioner is technically … Continue Reading
Click here for the CMS Announcement on July 10, 2024 proposing a reduction in the Medicare Conversion Factor payment from $33.29 to $32.36, i.e. 2.8% There are a host of other changes in the 24 page Release, which we will address in due course.… Continue Reading
The Press has announced that the Merger Agreement between UPMC and Washington Health System was approved by the Pennsylvania Attorney General with certain conditions, one of which was that UPMC would honor existing employment contracts and not impose restrictive covenants or non-compete agreements more restrictive than those that currently exist. We will be researching that … Continue Reading
As expected, businesses have sued the FTC challenging the recent final rule that ends non-compete agreements, as reported by the Wall Street Journal Wednesday morning (read WSJ article here). The U.S. Chamber of Commerce challenged the final rule in federal court in East Texas, which has been joined by other business groups. A lawsuit was … Continue Reading
The Allegheny County Medical Society has reported that the Pennsylvania House of Representatives has passed a bill to bar non-compete agreements in healthcare employment. Click here for a copy of the Press Release, and a copy of the legislation. There are limitations: It now goes to the Pennsylvania Senate.… Continue Reading
The 2024 Consolidated Appropriations Act passed and signed on Saturday, March 23, 2024, increased of Medicare Conversion Factor from $32.7442 to $33.2875, an increase of slightly over $0.54. … Continue Reading
During the American Bar Association’s 39th National Institute on White Collar Crime, the most senior executives of the DOJ (Attorney General Merrick B. Garland and Deputy Attorney General Lisa Monaco) delivered remarks promoting the success of DOJ compliance and enforcement by: Here are links to the remarks of Attorney General Garland and Deputy Attorney General … Continue Reading
“On February 21, 2024, Change Healthcare, a subsidiary of UnitedHealth Group was the victim of the most significant cyberattack on the US healthcare system in American history. Change Healthcare is the predominant source of more than 100 critical functions that keep the healthcare system operating.” –American Hospital Association Letter March 4, 2024 This hack was … Continue Reading
In furtherance of the National Cybersecurity Strategy announced March 2023, HHS has released an Introduction to the Strategy of the U.S. Department of Health and Human Services for Healthcare Sector Cybersecurity. Click here for the PDF.… Continue Reading
When negotiating physician compensation issues, hospitals frequently rely upon the premise they must pay fair market value compensation in order to comply with the provisions of the Stark Act prohibiting referrals in exchange for compensation, and sometimes non-profit inurement issues. Although the prohibitions are clear, determining what constitutes fair market value is often not. Provisions … Continue Reading
CMS issued the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023, for payments to be effective on or after January 1, 2024. Fee Schedule Link The overall payment rates under the PFS will be reduced by 1.25% in calendar year 2024. The final PFS conversion factor will be $32.74, … Continue Reading
As reported earlier in the MedLaw Blog (August 9, 2023), a federal District Court vacated portions of the No Surprises Act federal regulations. Thereafter, CMS halted the arbitration process for resolving disputes regarding out-of-network surprise bills. On October 20, 2023, HHS, Treasury, and the US Office Personnel Management submitted a notice indicating their attempt to … Continue Reading
Michael A. Cassidy and Adam J. Appleberry co-wrote an article titled “Contracting Essentials for All Physicians, Especially Residents and Fellows”. This article will appear in the Legal Summary section of the August 2023 Allegheny County Medical Society (ACMS) Bulletin. The ACMS Bulletin is the Allegheny County Medical Society’s signature publication which reaches over 2,000 physicians in Southwestern Pennsylvania … Continue Reading
Michael Cassidy has been recognized again in the 30th edition of the Best Lawyers in America for his “exceptional work in healthcare law”. … Continue Reading
CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows: UNPLANNED OUTAGE “On August 3, 2023, the U.S. District Court for the Eastern District of Texas issued a judgment and order in Texas Medical Association, et al. v. United States Department of Health … Continue Reading
The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75. CMS is also proposing the following: Attached is the Fact Sheet released by CMS on July 13, 2023.… Continue Reading
Since the private equity issue was last addressed in the Bulletin in the Summer of 2022, the volume of healthcare private equity deals has subsided somewhat, according to statistics presented at the March 2023 Pennsylvania Bar Institute Health Law Conference, and that has generally been attributed to unfavorable market conditions affecting investments of all types. … Continue Reading
On February 24, 2023, the DEA announced “Proposed Permanent Rules” for the prescribing of controlled medications on a telemedicine or telehealth basis. Attached are: A summary will follow later this week.… Continue Reading
On January 5, 2023, the Federal Trade Commission (FTC) took a dramatic step by proposing a new rule that would prohibit companies from entering into non-compete agreements with its workers. The proposed rule, if approved, takes sweeping action to prohibit employers from entering into non-compete agreements with both employees and independent contractors. And the proposed … Continue Reading
The final “2023 Omnibus Bill” which is the spending bill passed by Congress and signed by President Biden at the end of 2022, provides partial relief from the scheduled Medicare Physician Fee Schedule Conversion Factor cuts. As previously reported, the changes to the Medicare Physician Schedule Conversion Factor would have reduced physician reimbursement by 4.5%. … Continue Reading
Both the federal government and the Pennsylvania state government are taking steps to reform the prior authorization process. Take a look at the Pennsylvania Insurance Department press release that was issued November 3, 2022, touting the passage and signing of Pennsylvania Act 146, which is described as creating a new and more effective process for prior authorization … Continue Reading
