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BILLING

Newly proposed Medicare Part B Physician Fee Schedule contemplates Making COVID-19 telehealth changes permanent

On July 13, 2021, CMS published its proposed physician fee schedule rule for FY 2022. One of the key items is the proposal to make the temporary change allowing Medicare providers to deliver healthcare services via telehealth a permanent part of Medicare Part B. The Proposed Medicare Changes During the public health emergency (PHE), Congress added the home of the beneficiary as a permissible originating site for telehealth services for the purposes of diagnosis, evaluation or treatment of a mental health disorder. In addition to updating the fee schedule, the proposed CY2022 rule would allow certain services added to the Medicare telehealth list to remain on the list until the end of December 2023. This would allow CMS to continue to evaluate whether the temporary expansion of telehealth services adopted… . . . read more.

BILLING

New federal rule to protect consumers from surprise medical bills

The Biden-Harris Administration has announced a rule to protect consumers from surprise medical bills. The U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing happens when people unknowingly get care from providers that are outside of their health plan’s network and can happen for both emergency and non-emergency care. Balance billing, when a provider charges a patient the remainder of what their insurance does not pay, is currently prohibited in both Medicare and Medicaid. This rule will extend similar protections to Americans insured through employer-sponsored and commercial health plans. “No patient should… . . . read more.

EMPLOYMENT LAW UPDATE

Disability discrimination and lookism in the workplace

By Mike O’Brien EEOC sues a work placement agency on behalf of disabled workers for disability discrimination The EEOC announced this week that it has filed suit under the Americans with Disabilities Act (ADA) against a Hawaii work placement agency for disabled workers. The suit alleges that the agency refused to provide sign language interpreters for deaf employees, despite repeated requests by several deaf individuals. The workers had asked for interpreters to be present at staff meetings where matters such as work safety, protocols, and assignments were discussed. Despite these requests for accommodation, the agency declined to provide interpreters and instead gave the deaf workers written notes and handouts, or asked a deaf employee to interpret for other deaf employees. The EEOC asserts that these accommodations were ineffective and that as a… . . . read more.

GETTING PAID

Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act

Like most cliches, the one about the COVID-19 pandemic’s transformation of medicine forever is laden with truth. Telemedicine is Exhibit A. Of course, telemedicine goes back decades. But the pandemic accelerated the breakdown of resistance on the parts of providers, regulators and above all, patients. It was supposed to be just temporary. But to use still one more cliché, now that the toothpaste is out of the tube, it becomes a matter of figuring out how to regulate it effectively. Ironically, but hardly unexpectedly, one of Congress’ first attempts to impose systematic regulation involves recycling a piece of legislation that falabiled to gain support in pre-pandemic times but may make it into law this time. Here’s a quick overview of the so-called CONNECT for Health Act and what medical office… . . . read more.

CMS

Updated 2021 CMS QRDA III Implementation Guide final rule available

The Centers for Medicare & Medicaid Services (CMS) has released an update to the 2021 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG) for Eligible Clinicians and Eligible Professionals to support Calendar Year (CY) 2021 reporting. The update includes the list of electronic clinical quality measures (eCQMs) finalized by CMS for the CY 2021 Performance Period based on the CY 2021 Physician Fee Schedule Final Rule released on Dec. 1, 2020. It also includes information for Improvement Activity Identifiers, Promoting Interoperability Objectives and Measures, and Promoting Interoperability Attestation Statement Identifiers finalized by CMS for the CY 2021 Performance Period based on the CY 2021 Physician Fee Schedule Final Rule. The updated 2021 CMS QRDA III IG outlines requirements for eligible clinicians and eligible professionals to report eCQMs, Improvement Activities, and… . . . read more.

EMPLOYMENT LAW UPDATE

Who’s an independent contractor? DOL explains

By Mike O’Brien bio DOL tries to clarify independent contractor definition The US Department of Labor (DOL) has proposed what it believes is a simplified definition of independent contractor (IC) for purposes of applying wage provisions of the Fair Labor Standards Act (FLSA), which applies only to employees. The new DOL proposal still focuses on the factors of economic reality, but tries to clarify how to apply them. DOL says employers first should focus on two core factors: (1) the nature and degree of the worker’s control over the work and (2) the worker’s opportunity for profit or loss based on initiative and/or investment. If both factors point to either employee status or IC status, that probably is the right classification. If not, DOL says three additional factors must be… . . . read more.

COVID-19

So, your employee wants to stay on unemployment

By Paul Edwards bio It’s been a few of months of COVID chaos and business owners across America are thinking about what it’s going to take to reopen their businesses—and the economy, in general. Of course, the first piece of that equation involves recalling your employees who have been temporarily furloughed or laid off. And, since one portion of the CARES Act included an additional $600 per week to anyone collecting unemployment benefits, one common question we’re hearing is, “What if my employees refuse to come back to work because they want to keep collecting unemployment?” Usually, this question seems to be based on a misunderstanding of how unemployment benefits work. Generally speaking, if your employees refuse work in favor of collecting unemployment benefits, they will likely not be eligible for… . . . read more.

EMPLOYMENT LAW UPDATE

Supreme Court ruling extends workplace protections to LGBTQ workers

By Mike O’Brien bio SEXUAL ORIENTATION AND TRANSGENDER STATUS NOW ARE PROTECTED CLASSES NATIONALLY: Federal civil rights law protects gay, lesbian, and transgender employees, the United States Supreme Court announced June 15 in a landmark ruling. The historic decision will extend workplace anti-discrimination and anti-harassment protections to about 8 million LGBTQ workers nationwide. The ruling also vindicates a position long taken by the federal Equal Employment Opportunity Commission (EEOC). It is a defeat, however, for the Trump administration, which opposed the EEOC. President Trump instructed the Department of Justice to argue that the provision of Title VII of the Civil Rights Act that bars discrimination based on sex did not extend to claims of gender identity and sexual orientation bias. This led to the odd circumstance where two parts of the same government argued for opposite… . . . read more.

COMPLIANCE

5 tested ways to make your billing and coding more profitable

The health of your medical practice depends on good quality coding and billing work. One of the most important roles in the medical office that…


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COMPLIANCE

Job interviews: how to ask personal questions without committing discrimination

The job interview process is a breeding ground for discrimination complaints. One common mistake: asking job applicants…


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