CMS published its 1,250 page 2018 Physician Fee Schedule Final Rule (“PFS”) on November 2, 2017.[1] In addition to the finalized changes to payment for non-excepted off-campus provider-based departments (discussed in detail here), the following are other important PFS changes, effective January 1,…
340B covered entities are facing major changes in the way the discount drug program is reimbursed and administered. On November 1, 2017, CMS made available its 2018 Outpatient Prospective Payment System Final Rule (“Final Rule”).[1] The Final Rule implements, in total, drastic reimbursement cuts to…
On November 1, 2017, CMS published its 2018 Outpatient Prospective Payment System OPPS Final Rule (“Final Rule”).[1] In addition to numerous changes to the 340B Discount Drug Program, the Final Rule finalizes other important rule changes requiring providers’ close consideration. Barring unexpected…
In May 2017, the Texas Senate passed Senate Bill 1107,[1] which cleared a path for the State’s various heath care professional boards, including the Texas Medical Board (“TMB”) and Texas State Board of Pharmacy (“TBP”), to offer greater, easier access to telemedicine services. On September 15,…
The State Medical Board of Ohio recently issued a Frequently Asked Questions Guidance Document (“FAQ”) on Rule 4731-11-09 of the Ohio Administrative Code, which governs when a physician or physician assistant can prescribe medication to a patient that they have not conducted an in-person…
On September 7, 2017, the Health and Human Services Office of Inspector General (“OIG”) published Opinion 17-05 (“Opinion”) that allowed a retail pharmacy to include Medicare and Medicaid beneficiaries in the pharmacy’s discount benefit program. The OIG determined that the program design did not…
The Joint Commission is enhancing provider Element of Performance (“EP”) protocols regarding patient medications in response to the nation’s ongoing opioid crisis. Specifically, the Joint Commission has revised its Medication Management (MM) EPs “to assure the standards continue to reflect…
The Interim Study Committee on Public Health, Behavioral Health, and Human Services (“Committee”) met on September 28, 2017, to discuss the following topics: 1) Potential improvements to the INSPECT program; and 2) the shortage of health care providers in Indiana.
With regard to the first topic, the…
Hurricanes Harvey and Irma have devastated our nation in recent weeks and significantly impacted health care facilities in the affected areas. To better address preparedness for disasters such as Hurricanes Harvey and Irma, the Centers for Medicare and Medicaid Services (“CMS”) issued the Emergency…
A July 21, 2017 letter from CMS approves Indiana’s State Plan Amendment (“SPA”) 17-0002, which “proposes to bring Indiana into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment.”[1] In review of the approved SPA, one notable change emerges, and…
A quick peek at CMS’ FY 2018 budget (and beyond) indicates that CMS is investing heavily in rules enforcement.[1] Encouraged by a Fraud Prevention System return on investment of $11.50 for every $1.00 spent[2], CMS sees enhanced enforcement as a critical means of keeping (and returning) financial…
As part of the August, 14, 2017 Inpatient Prospective Payment System (“IPPS”) Final Rule[1], the Centers for Medicare and Medicaid (“CMS”) revised the public notice requirements for Medicare provider agreement terminations.
Previously, a Rural Health Clinic (“RHC”), Federally Qualified Health…
