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Liza Khan practices in the areas of federal-state programs and health care. Ms. Khan helps clients navigate state and federal rules and policies, including those governing the Medicare and Medicaid programs. Ms. Khan regularly counsels clients on the new mandates of the Affordable Care Act, Medicare and Medicaid price reporting issues, coverage and reimbursement of drugs and devices under federal health care programs, Medicaid Section 1115 demonstration waivers, among other issues.

Last week, Senators Cory Gardner (R-CO) and Gary Peters (D-MI) introduced new legislation to test expanded Medicare coverage of telehealth services.  The Telehealth Innovation and Improvement Act requires the Department of Health and Human Services (HHS) to allow selected, eligible hospitals to offer telehealth services in cooperation with the Center for Medicare and Medicaid Innovation

On December 22, 2015, the ONC released the 2016 Interoperability Standards Advisory, which is meant to serve as a “single resource for those looking for federally recognized, national interoperability standards and guidance,” according to ONC’s Director of the Office of Standards and Technology Steven Posnack, MS, MHS, and Director of HIT Infrastructure and Innovation Division Chris Muir. The standards listed in this advisory focus explicitly on clinical health IT systems’ interoperability.  Specifically, the 2016 Advisory lists existing and emerging standards for different interoperability needs and discusses health information exchange related to areas including lab tests, medications, imaging, electronic prescribing, public health reporting, and clinical decision support.
Continue Reading ONC Releases 2016 Interoperability Standards Advisory

Open enrollment for 2016 marketplace exchange plans begins Sunday, November 1. Individuals and families will be able to enroll, re-enroll, or change their health plans from November 1, 2015 through January 31, 2016.

Several new features have been added to HealthCare.gov to ease enrollment for consumers. For the first time, consumers may preview 2016 exchange health plans and premium prices before open enrollment begins. Federal officials from the Department of Health and Human Services (HHS) are encouraging consumers to use this feature to evaluate premium prices in particular, because in many places they may be higher than last year. An online, out-of-pocket expense calculator has also been added to the website to help consumers estimate deductibles and co-payments as well as the monthly premiums.
Continue Reading HealthCare.gov to Launch Open Enrollment for 2016 Plan Year on November 1, 2016

The state of Missouri has promulgated regulations effective July 30, 2015 that formally authorize electronic prescribing of controlled substances in Missouri. With these new regulations, Missouri becomes the final state to allow electronic prescribing of controlled substances. Although the Drug Enforcement Administration implemented changes in 2010 to permit electronic prescribing of such drugs, some states,

The Department of Defense (DOD) is expected to select a contractor sometime this summer to modernize its electronic health records (EHR) system. The DOD’s $11 billion Healthcare Management Systems Modernization Electronic Health Record program will replace the agency’s existing EHR system, which supports more than 9.7 million beneficiaries, including active duty personnel, retirees, and their dependents. This will be the biggest federal IT project since HealthCare.gov, the health insurance website operated by the federal government to facilitate enrollment in Exchange plans.
Continue Reading Department of Defense Contract To Overhaul Electronic Health Records System

The Federal Trade Commission’s (“FTC”) Office of Policy Planning, Bureau of Competition, Bureau of Consumer Protection, and Bureau of Economics recently submitted comments on the Office of the National Coordinator for Health Information Technology (ONC’s) draft Shared Nationwide Interoperability Roadmap (“Roadmap”). As discussed in previous posts, this Roadmap sets forth a ten year plan to develop and implement a nationwide interoperable health information infrastructure. The FTC’s comments focus on (1) creation of a supportive business and regulatory environment that encourages interoperability; (2) shared governance mechanisms; and (3) the advancement of technical standards.
Continue Reading FTC Staff Submit Comments On ONC’s Draft Shared Nationwide Interoperability Roadmap

The Michigan Department of Community Health (MDCH) recently released the nation’s first Medicaid mobile health application, called myHealthButton, and an online portal, myHealthPortal, that allows patients to access their medical information and available health resources remotely and in real-time.  The applications are available to current members enrolled with the Michigan Medicaid program, the Children’s Special

On January 13, 2015, Jocelyn Samuels, director of the Office of Civil Rights (OCR) at the U.S. Department of Health and Human Services, briefed reporters on the agency’s HIPAA enforcement priorities, noting a focus on threats to electronic health information, or ePHI.  Samuels highlighted an increase in infiltration of computer networks reported under the breach notification requirements, explaining that hacking and other cyberthreats are affecting not just covered entities like health care providers, insurers and clearinghouses, but also business associates handling ePHI on behalf of covered entities.  Despite this concern, it is unclear when OCR will launch its HIPAA compliance audits of covered entities and business associates, which were slated to begin in early 2015. 
Continue Reading HIPAA 2015 Enforcement Priorities Highlight Cyber Threats, But Timing of HIPAA Compliance Audits Still Uncertain

On December 2, 2014, the Anchorage Community Mental Health Services (ACMHS) agreed to pay $150,000 under a settlement agreement with the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule.  ACMHS entered the settlement agreement after an OCR investigation revealed that ACMHS had failed to implement adequate security measures to guard against unauthorized access to electronic protected health information (e-PHI).  The settlement underscores the importance of regularly reviewing and addressing risks to e-PHI.
Continue Reading Recent HIPAA Settlement Highlights Need to Address Software Risks

With open enrollment fast approaching, the Obama administration is planning several changes to HealthCare.gov to ease enrollment in insurance plans and avoid last year’s problems, when the site crashed upon launch.  These changes include:

  •  A 16-screen application, reduced from 76 screens in the 2014 enrollment;
  • The addition of a “back button” that will allow enrollees