Telehealth, Virtual Visits, e-Visits, and Remote Care for Nursing Homes during the COVID-19 Public Health Emergency (PHE)

The burden on the staff and residents of long-term care facilities, including nursing facilities and skilled nursing facilities, has increased significantly around the country. The Centers for Medicare and Medicaid Services (CMS), in response to feedback from industry stakeholders, and under new 1135 waiver authorities granted to it in the Coronavirus Preparedness and Response Supplemental Appropriations Act, implemented several policy changes to support long term care facilities, including changes enabling practitioners to remotely provide services to these facilities and to remotely supervise on-site providers.

Carrie Nixon on the Future of Telehealth in Healthcare Finance News

‘We'll likely need a legislative change for these changes to be permanent,’ said Nixon. ‘There will be more of an impetus now. Once patients have had telehealth, it's likely they won't want to go back.’”

NEW! Medicare to Reimburse for Acupuncture Services

On January 21, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized a decision (under National Coverage Determination (NCD) 30.3.3) to cover acupuncture for Medicare patients, specifically those with chronic low back pain (cLBP).

Principal Care Management (PCM) Reimbursement under the 2020 Medicare Physician Fee Schedule

The 2020 Medicare Physician Fee Schedule (the “Final Rule”), released on November 1, 2019, finalized two new codes in a new category of reimbursement titled “Principal Care Management” (PCM) Services. The new codes will be effective as of January 1, 2020, and provide reimbursement for managing a patient’s care for a single high-risk disease or complex chronic condition.

Proposed Anti-Kickback Statute "Care Coordination Arrangements" Safe Harbor: Implications for Remote Patient Monitoring and Care Management Services

In this article, we focus on the proposed Care Coordination Arrangements safe harbor to the Anti-Kickback Statute and discuss how this new safe harbor may affect vendors of care management services such as Remote Patient Monitoring, Chronic Care Management services, Transitional Care Management services, and Behavioral Health Integration services.

The “Lower Drug Costs Now Act”: See Change Possible for State and Federal Drug Transparency and Pricing

Despite division along party lines and industry pushback, the House of Representatives has passed legislation (H.R. 3), the “Lower Drug Costs Now Act”, which would require the Department of Health and Human Services (DHHS) to establish a “Fair Price Negotiation Program” responsible for negotiating Medicare payments for some of the most expensive drugs available to Medicare beneficiaries.

HHS Proposes New Safe Harbors Under the Anti-Kickback Statute and The Stark Law

In a pair of proposed rules released by the Department of Health and Human Services (DHHS), Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS), the DHHS is looking to increase the utilization of value-based arrangements to drive health outcomes and ease the regulatory burdens associated with patient care coordination. The proposed rules seek to change or add certain safe harbors or exceptions to the Anti-Kickback Statute (AKS), Physician Self-Referral prohibition (Stark Law), and the Civil Monetary Penalties (CMP) laws.

An overview of General Data Protection Regulation (GDPR), HIPAA, and what you need to do next

General Data Protection Regulation (GDPR) preparedness should be a priority and we will review the steps you need to take to make sure you’re in compliance. Though the GDPR comes from the European Union, businesses everywhere should apply GDPR principles in practice.

CMS’ New Coding Policy Will Speed up Reimbursement for New Drugs and Devices

When developing new medical device and drug products, it is important to understand how the product will be adopted and paid for in the marketplace. The development of new drugs and devices involves countless hours researching, testing, modifying, iterating, and testing some more… In larger companies, whole teams of people also dedicate the same effort into developing a market access plan—meaning careful planning for manufacturing, distribution, and insurance contracting. This strategic planning can be overlooked in start-up biotech companies operating on limited resources and which are squarely focused on innovating new technologies.

Virginia Cannabis Industry Association (VCIA) to Host Legislative Update and 2020 Session Preview

The Virginia Cannabis Industry Association (VCIA) will host a series of regional legislative forums over the next several weeks. Discussions will include an update about the Virginia cannabis industry and how outcomes of the November elections of all 140 seats of the Virginia General Assembly may affect the opportunities and challenges of this nascent industry.

Breakthrough Devices: CMS Removes Hurdles and Increases Payments for New Technology Add-On Payments Under the IPPS Final Rule

Hospitals and medical device manufacturers will both benefit from the Centers for Medicare and Medicaid Services’ (CMS) finalization of the 2020 Inpatient Prospective Payment System (IPPS) Final Rule (“Final Rule”) scheduled to be published on August 16, 2019. In an effort to increase Medicare beneficiaries’ access to innovative medical technologies, CMS has finalized certain changes to the “new technology add-on payment” “(NTAP) application and payment processes under the Final Rule. This change is likely to encourage hospital adoption of new technologies, which is intended to spur innovation and additional investment in these technologies.

New CMS Innovation Models: Primary Care First and Direct Contracting

In April, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced a new set of payment models meant to allow primary care providers deliver better care at a lower cost to their patients by removing unneccessary administrative and adjust payouts from procedures to outcomes.

Proposed Healthcare Legislation in the 2019 Virginia General Assembly

On January 9, the 2019 General Assembly Session will convene, and there are several bills that are set to be introduced that may have an impact on Virginia healthcare providers. We will update this post with additional legislation as session progresses.

Practice Agreement Requirements for Virginia Nurse Practitioners

In Virginia (and in many other states), NPs who do not have an autonomous practice must practice under the direct supervision of a physician as part of a patient care team, pursuant to what is called a “Practice Agreement,” or, “Collaborative Practice Agreement.” A Practice Agreement is an agreement between an NP and the NP’s supervising physician that describes the relationship between the parties, including the procedures to be followed and acts to be performed by the NP in the course of providing care to patients.

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Nixon Gwilt Law
216 Apple Blossom Court, Suite 200
Vienna, VA 22181

What You Need To Know

Nixon Gwilt Law216 Apple Blossom Court, Suite 200Vienna, VA 22181

Nixon Gwilt Law
216 Apple Blossom Court, Suite 200
Vienna, VA 22181