von Briesen Health Law Blog

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July 30, 2010

CMS Has Published the Final “Meaningful Use” Rules

Filed under: Records and TechnologyClaudia Egan and Scott Thill @ 9:20 am

After a long wait, CMS has published the “meaningful use” rules on electronic health record technology.  Click here to review the final rule (276 pages) or view a quick summary in a CMS fact sheet. CMS has relaxed the final rules in some respects from its rules proposed in January.

July 26, 2010

Labor and Employment Law Update – July 2010

Filed under: Labor & EmploymentDan Dennehy @ 7:44 am

One topic that continues to have the most decisions and expensive settlements are class action wage and hour lawsuits. Millions of dollars are being awarded against employers or employers are paying such sums to settle these class action lawsuits.

The major issues involved in these lawsuits are the following:

  • employees not getting their uninterrupted 30-minute meal break and not being compensated when they do not;
  • automatic meal break deduction;
  • misclassification of employees as exempt;
  • unauthorized hours worked;
  • failure to record work time as required for telecommuting employees;
  • donning and doffing activities;
  • on-call time; and
  • travel time.

Read more…

July 15, 2010

HIPAA Revisions Officially Published for Comment

Filed under: Records and TechnologyClaudia Egan @ 1:15 pm

With a grace period for implementing Business Associate Agreements and lots of proposed revisions, it looks like its going to be a while before we know the “real” impacts of HITECH on HIPAA.  Stay tuned.  Here’s a link to the new, proposed regulations.  Let us know if you have comments!

July 11, 2010

HHS Releases Proposed Rule to Modify HIPAA Rules

Filed under: Medicare/Medicaid ComplianceSally Ihlenfeld @ 9:28 pm

On July 8, the Department of Health and Human Services (HHS) released a proposed rule to modify the HIPAA privacy, security, and enforcement rules, extending HIPAA compliance requirements to subcontractors of business associates (BA) and strengthening patient rights to health information privacy.

According to the Office for Civil Rights (OCR), which enforces the HIPAA privacy and security rules for HHS, the proposed ‘significant’ modifications include:

  • A requirement that BAs of HIPAA-covered entities be under most of the same rules as the covered entities
  • New limitations on the use and disclosure of protected health information (PHI) for marketing and fundraising purposes
  • Prohibition of the sale of PHI without an authorization
  • Expansion of individuals’ rights to access their information and to restrict certain types of disclosures of PHI to health plans
  • Provisions that strengthen and expand HIPAA’s enforcement rule

HHS will receive comments for up to 60 days after the proposed rule’s July 14 publication in the Federal Register, after which it will release an interim final rule.  According to HHS, it will give covered entities and BAs 180 days after the final rule becomes effective to comply with most of the provisions.

July 8, 2010

CMS Releases its CY 2011 Proposed Rules for HOPDs and ASCs

CMS released its CY 2011 proposed rules for hospital outpatient departments and ambulatory surgery centers on July 2, 2010.  The proposed rules update payment policies and rates for hospital outpatient departments and ambulatory surgery centers.  Some of the proposed provisions implement portions of the health reform legislation signed into law in March.  As described by CMS, notable provisions of the proposed rule include:

Hospital Outpatient Departments

  • Waiver of the deductible and copayment for certain preventive services.
  • Additional quality measures to report in CY 2011 (six additional measures, including a health information technology measure), CY 2012 (seven additional measures) and CY 2013 (six additional measures).
  • Validation of quality reporting, including review of randomly selected cases from each hospital.
  • Changes to the supervision requirements for certain non-surgical extended duration services to require direct supervision for the initiation period of such services, followed by general supervision.
  • Payment for the acquisition and pharmacy overhead costs of separately payable drugs and biologicals at an amount equal to the average sales price plus six percent.
  • Removal of CPT codes 21193, 21395 and 25909 from the inpatient-only list.

Ambulatory Surgical Centers

  • Waiver of the deductible and coinsurance for certain preventive services.
  • The addition of five surgical procedures to the list of Medicare-covered ASC procedures.

Other Proposed Rules

  • Reduced availability of the physician self-referral exceptions for ownership or investment interests in a “whole hospital” or “rural provider” for new physician-owned hospitals and those looking to expand capacity.
  • Changes relating to graduate medical education payment.

You can review a summary of most of these provisions on CMS’s website here.  A display copy of the proposed rule is available here.  CMS will accept comment until August 31, 2010.

CMS Releases its CY 2011 MPFS Proposed Rule

CMS recently released its CY 2011 Medicare Physician Fee Schedule Proposed Rule.  Among updated payment policies and rates for services paid under the Medicare Physician Fee Schedule, the proposed rule includes provisions to implement portions of the health reform legislation signed into law in March.  As described by CMS, the proposed rule includes provisions, among others, relating to the following:

  • Elimination of the deductible and coinsurance that would otherwise apply for most preventive services.
  • Coverage of annual wellness visits in which the beneficiary receives personalized prevention plan services.
  • Quarterly incentive payments for primary care services furnished by primary care practitioners.
  • Quarterly incentive payments for major surgical procedures provided by general surgeons in health professional shortage areas.
  • Permission for physician assistants to order post-hospital extended care services.
  • An increase in the Medicare payment for certified nurse-midwife services so that it equals 100% of the MPFS.
  • Extension of Medicare reasonable cost payments for certain clinical diagnostic laboratory tests performed by hospitals with fewer than 50 beds that are located in certain rural areas as part of their outpatient services.
  • An amendment to the in-office ancillary services exception for self-referrals.
  • Adjustments to the DMEPOS competitive bidding program (to add 21 metropolitan statistical areas to round 2).
  • Modification to the equipment utilization rate assumption for expensive diagnostic imaging equipment used in diagnostic computed tomography and magnetic resonance imaging services.
  • Payment revisions for power-driven wheelchairs.
  • Reduction of the maximum period for submission of Medicare fee-for-service claims to not more than 12 months.

You can review a summary of each of these provisions on CMS’s website here.  A display copy of the proposed rule is available here.  CMS will accept comments until August 24, 2010.