On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the CY 2021 Physician Fee Schedule (PFS) proposed rule. We describe certain material provisions from the proposed rule below. Telehealth CMS proposes to add services to the Medicare telehealth list on a Category 1 basis. The additional services include group psychotherapy, … Continue reading
On Tuesday, June 9, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released a guide for patients who are considering their in-person care options following certain healthcare facilities re-opening for all medical services. As COVID-19 cases decline in some areas of the country, CMS created this guide to give patients recommendations, and to help … Continue reading
On June 2, 2020, the staffs of the Federal Trade Commission’s (FTC) Office of Policy Planning, Bureau of Economics, Bureau of Competition and Office of the General Counsel submitted a comment to the Centers for Medicare & Medicaid Services (CMS) on its Interim Final Rule regarding policy and regulatory revisions in response to the COVID-19 … Continue reading
On Sunday April 19, 2020, CMS issued guidance for permitting non-emergent, non-COVID-19 healthcare in states that have passed the Gating Criteria provided in the Guidelines for Opening Up America Again. CMS reiterated support for telehealth, stating that “[m]aximum use of all telehealth modalities is strongly recommended.” Decisions should be” consistent with public health information and … Continue reading
Throughout the COVID-19 pandemic, there have been a multitude of regulatory changes and strategies adopted in an effort to provide the American healthcare system with added flexibilities during this public health crisis. With the stress of these uncertain and isolating times, mental health and substance-use disorder (SUD) patients are particularly at risk. In a recent … Continue reading
The United States Senate has passed a $2 trillion phase three emergency package, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The Senate approved the CARES Act on a unanimous vote of 96-0, with three Senators in self-quarantine and another returning home out of an abundance of caution. The CARES Act, assuming it … Continue reading
On Tuesday February 25, 2020, Nancy Messonnier, director of the U.S. Center for Disease Control’s National Center for Immunization and Respiratory Disease warned in a call with reporters that “[u]ltimately we expect we will see community spread in the United States. It’s not a question of if this will happen, but when this will happen, … Continue reading
On December 21, 2018, CMS issued a mammoth 957 page “Pathways to Success” final rule, which overhauls shared savings/losses tracks for Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) to push ACOs into shared risk models more quickly, among other program changes. Largely consistent with the proposed rule as we summarized here, the final … Continue reading
On November 2, 2018, CMS published its CY 2019 physician fee schedule final rule. The final rule implements a number of significant changes to the way practitioners receive reimbursement for items and services provided to Medicare beneficiaries, including: Eliminating the requirement for a practitioner to document the medical necessity of a home visit in lieu … Continue reading
On July 12, 2018, CMS included three proposed changes to telehealth reimbursements within the CY 2019 Physician Fee Schedule (the “Proposed Rule”). Currently, subject to certain exceptions, Medicare reimbursements for certain telehealth services are statutorily limited by the type of health care professional providing the service, and the geographic location of the patient (namely, the … Continue reading
On August 9, 2018, CMS published the long-awaited Pathways to Success proposed rule. CMS Administrator Seema Verma published a related article on the Health Affairs Blog. The proposed rule would usher in significant changes for Accountable Care Organizations (ACOs). Groups of providers, such as doctors and hospitals, can join together to form an ACO and … Continue reading
While the Senate continues to work on its version of health care reform legislation, the American Health Care Act of 2017 (AHCA), the Centers for Medicare and Medicaid Services (CMS) has been busy streamlining and de-regulating current processes under the Affordable Care Act (ACA). On May 16, CMS released a Checklist for Section 1332 Innovation … Continue reading
On May 11, 2017 the Texas House passed Senate Bill 1107 (“SB 1107”), which greatly expands the telemedicine services physicians can provide in Texas. SB 1107 passed the House with the support of substantially the entire House. Senate Bill 1107 was previously passed unanimously by the Texas Senate on March 29, 2017. SB 1107 must … Continue reading
The Teladoc lawsuit against the Texas Medical Board (the “TMB”) regarding a rule that would require physicians to meet with patients face-to-face prior to prescribing medication will continue to move forward following a federal judge’s denial of the TMB’s request to dismiss the lawsuit. Effective October 2010, the TMB amended its telemedicine regulations, restricting the definition … Continue reading