Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Bill of Health

JUNE 15, 2023

By Laura Dolbow Merck recently filed a lawsuit that challenges the constitutionality of the Medicare price negotiation program created by the Inflation Reduction Act. Merck argues that this form of price regulation charts a “ radical new course ” for Medicare that violates the Takings Clause of the Fifth Amendment.

Medicare 190

Medicare Medicare Medicaid Medicaid 190

Healthcare IT News - Telehealth

JUNE 8, 2022

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. Here's what she had to say. Agency enforcement discretion.

US Department of Health and Human Services 182

US Department of Health and Human Services Compliance Overpayments Overpayment 182

Innovaare Compliance

OCTOBER 6, 2022

Annual Election Period (AEP) is about two weeks away when Medicare Advantage Prescription Drug Plans (MAPD) will be signing up new enrollees by the thousands. According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. In 2022, 48% of all eligible Medicare beneficiaries are enrolled in MAPD.

Medicare 52

Medicare Medicare Compliance Public Health 52

Health Care Law Brief

JUNE 2, 2022

The onset of the COVID-19 public health emergency (“PHE”) led to a surge in the use of telehealth by health care providers. Provider Licenses. Are all providers licensed or otherwise authorized to render care via telehealth to patients located in a given state?

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Healthcare IT News - Telehealth

JANUARY 25, 2021

According to a press statement from Thompson's office, it would: Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site. This is a common-sense step to make sure our policies keep pace with our technology," he added.

COVID-19 210

COVID-19 Medicare Medicare Telemedicine 210

Healthcare IT News - Telehealth

MARCH 18, 2020

" Covered entities seeking to use audio or video communication tech to reach patients where they live "can use any non-public facing remote communication product that is available to communicate with patients," said the agency. ON THE RECORD.

COVID-19 193

COVID-19 HIPAA Nursing Homes Medicare 193

Hall Render

DECEMBER 30, 2022

Medicare payment policy changes established under the CMS CY 2023 Medicare Physician Fee Schedule (“MPFS”) Final Rule , issued on November 1, 2022, become effective January 1, 2023. These services will be reported with three separate Medicare-specific G codes. Behavioral Health Services. Split/Shared E/M Visits.

Medicare 40

Medicare Medicare Licensing Health Services Administration 40

Jane Sarashon

MAY 9, 2024

Some of the policies would add to the supply of licensed health care workers to provide telehealth services, and to bolster rural clinics and Federally Qualified Health Centers to offer (and be covered for) virtual care under Medicare.

Telemedicine 56

Telemedicine Licensing Hospitals Medicare 56

Healthcare IT News - Telehealth

SEPTEMBER 23, 2022

Now that President Joe Biden has declared the COVID-19 pandemic over, the ATA's Telehealth Awareness Week policy update webinar explored how federal and state telehealth policies may be affected as Congress decides whether or not to end the public health emergency (PHE). THE LARGER TREND.

COVID-19 126

COVID-19 Medicare Medicare Public Health 126

Healthcare IT News - Telehealth

NOVEMBER 22, 2021

It also pointed to actions taken by the Center for Program Integrity against more than 50 medical providers for alleged schemes relating to Centers for Medicare and Medicaid Services programs. Advocates and experts have raised concerns about the longevity of telehealth policies after the end of the COVID-19 public health emergency.

Fraud 180

Fraud COVID-19 Medicare Medicare 180

Healthcare IT News - Telehealth

JULY 28, 2020

Lots of industry groups want to see the temporary government waivers enacted early on during the COVID-19 public health emergency – the ones enabling the vast expansion of telehealth and remote patient monitoring over the past four months – to be made permanent once the storm has subsided. And some legislators do too.

COVID-19 189

COVID-19 Public Health Nurses Medicare 189

Healthcare Law Today

JANUARY 10, 2023

about what is in store for digital health in the new year. And how will the end of the Public Health Emergency (PHE) waivers affect telemedicine services and patient care? Outside of Medicare coverage, we could see more activity around state medical licensing. What legal and policy changes can we expect to see?

Telemedicine 93

Telemedicine Medicare Medicare Licensing 93

Verisys

MARCH 17, 2023

This bill establishes license length, eligibility, qualifications, permitted duties and supervision requirements. This bill establishes license length, eligibility, qualifications, permitted duties and supervision requirements. The proposed amendments have been posted for public comment.

COVID-19 52

COVID-19 Nurses Licensing Public Health 52

HIT Consultant

OCTOBER 27, 2022

Color’s behavioral health solution creates timely access to behavioral health screening and counseling, embeds care access points and resources directly into neighborhoods and community spaces, is in-network with leading Medicaid and Medicare plans in all 50 states and delivers multilingual, culturally appropriate care.

Medicaid 52

Medicaid Medicaid Public Health Medicare 52

MedTrainer

DECEMBER 7, 2023

Hawaii Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Hawaii Department of Health (DOH) is a state agency responsible for overseeing public health and environmental protection initiatives across the Hawaiian Islands.

Compliance 52

Compliance Compliance Officers Licensing Medicaid 52

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Med-Net Compliance

AUGUST 19, 2022

In addition, she was never licensed by the State of Michigan as required under the Michigan Public Health Code. The woman continuously presented herself as a certified and licensed BCBA through professional business cards, verbal statements, and written documents. Where required, drug screens are also necessary.

Licensing 59

Licensing Public Health Medicare Medicare 59

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Recommended voluntary billing codes, modifiers and place-of-service designations for telehealth and other virtual health care services. The simplification or alignment of provider licensing, credentialing and enrollment protocols with respect to telehealth across states, state Medicaid plans and Medicaid managed care organizations.

US Department of Health and Human Services 151

US Department of Health and Human Services COVID-19 Medicaid Medicaid 151

Healthcare IT News - Telehealth

SEPTEMBER 16, 2022

With the COVID-19 pandemic – especially thanks to an expansion of Medicare telehealth benefits during the public health emergency – driving increased use of virtual psychiatric care, many behavioral health providers ventured into telemedicine and onboarded digital telehealth platforms. " THE LARGER TREND.

HIPAA 134

HIPAA COVID-19 Telemedicine Licensing 134

Provider Trust

JULY 26, 2022

District Attorney alleges that Pickering was hired in 2019 as a licensed physician’s assistant at a family practice in Norcross, Georgia but had not been a licensed physician’s assistant in Georgia, or any state, since March 2014. The Importance of Conducting License Verification and Monitoring. According to the U.S.

Licensing 52

Licensing Fraud Compliance Nurses 52

MedTrainer

NOVEMBER 27, 2023

Ohio Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Ohio Department of Health (ODH) is key to safeguarding and enhancing the health of Ohio residents. The State Medical Board of Ohio provides licensing and regulatory guidelines for medical providers in Ohio State.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID).

COVID-19 Vaccine 52

COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

Healthcare IT News - Telehealth

FEBRUARY 5, 2024

Despite the end of the public health emergency, individuals and informed political leaders will continue to work with pharmacies to continue access to vital care for individuals in need of medication for mental health because mental health is part of overall health. Your third prediction concerns medication.

COVID-19 141

COVID-19 Public Health Licensing FDA 141

MedTrainer

DECEMBER 7, 2023

The Maine Hospital Association (MHA) is a pivotal organization that advocates for and supports hospitals and health care systems across Maine, striving to improve healthcare quality and accessibility for all Mainers. Regulations Unique to Maine To meet the standards of healthcare compliance in Maine , there are a few additional regulations.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

MedTrainer

NOVEMBER 20, 2023

The TSBEPC ensures practitioners adhere to licensing requirements and maintain high standards of competence and ethical practice. The Texas Hospital Association (THA) is a networking and leadership organization that advocates for legislation that supports budgeting for Texas hospitals and health care systems.

Compliance 52

Compliance Licensing Public Health Governance 52

Verisys

NOVEMBER 13, 2022

Waiver of State Licensure Requirements: Any health care professional listed below that holds a valid, unrestricted, unencumbered license in any state may provide services authorized under their existing license. Certain conditions of participation for individual health care providers or types of healthcare providers.

Compliance 52

Compliance Licensing Nurses COVID-19 52

Healthcare IT News - Telehealth

MAY 30, 2023

The COVID-19 public health emergency came to an end on May 11. This also happens to coincide with the World Health Organization declaring an end to the COVID-19 global health emergency. What does the end of the public health emergency mean for the future of the healthcare industry?

Telemedicine 189

Telemedicine COVID-19 Governance Medicare 189

MedTrainer

JULY 28, 2023

OIG Inspections in Healthcare The OIG focuses its resources on oversight of Medicare and Medicaid — programs that represent a large portion of the federal budget. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers. Response to Emergencies or Outbreaks.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

MedTrainer

DECEMBER 7, 2023

The Idaho State Board of Medicine within the Division Of Occupational And Professional Licenses (DOPL) is a regulatory body responsible for licensing and overseeing medical professionals in Idaho, ensuring they meet the required standards for safe and ethical practice.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

HIT Consultant

NOVEMBER 24, 2022

. – Prescription hearing aids will require a consumer to have a prescription for a hearing aid from a physician, audiologist or a licensed hearing instrument specialist. Health plans could, for example, consider covering OTC hearing devices as part of the hearing benefits package provided to their Medicare Advantage plan members.

FDA 98

FDA Public Health Medicare Medicare 98

Healthcare IT News - Telehealth

JUNE 5, 2020

Department of Health and Human Services Premier made the case that some two-dozen federal regulatory waivers – enacted early in the coronavirus pandemic to enable rapid response to COVID-19 – should be made permanent once the public health emergency has ended. WHY IT MATTERS. ON THE RECORD.

COVID-19 142

COVID-19 Licensing Public Health Nurses 142

MedTrainer

DECEMBER 7, 2023

The New Mexico Medical Board is responsible for licensing and regulating medical practitioners in the state, ensuring that they meet professional standards for safe and ethical medical practice. These agencies help maintain the integrity and quality of healthcare services in New Mexico , protecting the public and promoting patient safety.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Healthcare IT Today

MARCH 27, 2023

A Surge in Virtual Health Overnight, the pandemic exposed shortcomings in the healthcare system, leading to widespread adoption of virtual care services by patients and clinicians. The company currently supports some major players in the space including big name pharmacies, retailers and hospitals and health systems.

Health Outcomes 106

Health Outcomes Licensing Medicaid Medicaid 106

HIPAA Journal

JUNE 26, 2023

For example, the Secretary can waive the requirements for out-of-state healthcare professionals to be licensed before being allowed to practice, or exercise discretion when investigating violations of the physician self-referral law (§1877 of the Social Security Act).

HIPAA 73

HIPAA COVID-19 COVID-19 Vaccine Public Health 73

Health Populi

APRIL 16, 2024

Presidential elections to that point, and that the last retiring Baby Boomer enrolls in Medicare that year. Let’s take a walk with “Quincy” through each of the four worlds to see how their health care experience might play out across the key driving forces. In 2030, every Boomer will have been eligible for Medicare.

Public Health 73

Public Health Governance Medicare Medicare 73

HIPAA Journal

APRIL 25, 2023

Data breaches have recently been announced by Santa Clara Family Health Plan, United Steelworkers Local 286, Robeson Health Care Corporation, Two Rivers Public Health Department, and NewBridge Services.

Health Insurance 84

Health Insurance Public Health Ransomware Fraud 84