Archives: Reimbursement

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UK’s NICE releases newly updated Digital Health Technologies (DHT) Evidence Standards Framework

Following on from the Evidence Standards Framework for DHTs published in December 2018 (the Original Standards, as reported in our previous blog post, here), the UK’s National Institute for Health and Care Excellence (NICE) recently published a newly updated version of the standards (the Updated Standards, available here). The Updated Standards were produced following feedback … Continue Reading

NICE adopts evidence standards for the development and assessment of digital health technologies (DHTs)

The UK’s National Institute for Health and Care Excellence (NICE) has recently published an evidence standards framework for DHTs (the Standards), available here.  It did so through a working group led by NHS England, but supported by representatives from Public Health England, MedCity and DigitalHealth.London. The Standards cover DHTs, such as apps, programs and software … Continue Reading

CMS Issues Guidance Encouraging the Use of Commercial Off-the-Shelf Technology and Software-as-a-Service for Medicaid Eligibility and Enrollment Systems

In March, CMS issued a State Medicaid Directors Letter (SMDL) about the availability of enhanced federal funding for state Medicaid programs’ eligibility and enrollment (E&E) systems. This SMDL represents CMS’s most recent effort to encourage States to use commercial “off-the-shelf” technology and “software as a service,” instead of customized electronic systems developed and built specifically … Continue Reading

New CMS Rule Permits Home Health Face-to-Face Encounters to Occur Through Telehealth Technology

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule implementing a provision of the Affordable Care Act (ACA) that requires a Medicaid enrollee seeking coverage for home health services to first meet face-to-face with a practitioner.  The final rule confirms that the face-to-face encounter requirement “may occur through telehealth, as implemented … Continue Reading

CMS Issues New EHR Meaningful Use Rules

Last week, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) finalized new rules for the Electronic Health Records (EHR) meaningful use program.  In response to significant public criticism of the program, the final rulemaking offers some additional flexibility for complying with the program’s requirements.… Continue Reading

Senate Approves Bill to Ease Meaningful Use Requirements In Ambulatory Surgery Setting

Last week, the U.S. Senate unanimously approved a bill that would ease federal requirements that professionals seeing patients at ambulatory surgery centers (ASCs) “meaningfully use” certified electronic health records (EHRs). The measure would sunset after certified EHR technology is applicable to the ASC setting.… Continue Reading

21st Century Cures Act with EHR and Telehealth Provisions Passes Through Committee with Flying Colors

* Jack Lund is a summer associate and student at the University of Virginia School of Law        The “21st Century Cures Act” (Cures) cleared its first major hurdle last month when the House Energy and Commerce Committee voted unanimously in favor of the legislation.  Among other things, Cures helps to modernize Medicare by … Continue Reading

Several States Enact Telehealth Parity Laws in 2015

* Gabriel Kohan is a summer associate and student at Harvard Law School.         States are continuing to debate the role telehealth services should play in the health care system. Thus far in 2015, several States have enacted parity laws requiring that certain telehealth services be reimbursed to the same extent as in-person services. While on … Continue Reading

House Bill Repealing the Medicare SGR Includes Telehealth Provisions

Late last month, the U.S. House of Representatives passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) with broad bipartisan support. MACRA would permanently repeal the Sustainable Growth Rate (SGR) for Medicare physician reimbursement and extend federal funding for the Children’s Health Insurance Program for two additional years. The legislation also includes three … Continue Reading

The Cyber Future of Long-Term Care: Applying Health Care Laws to Aging in Place Technologies

Earlier this month, the National Law Journal published its annual Special Report on Health Care Law. Included in this Special Report is an article written by CovingtonEHealth contributors Caroline Brown, Anna Kraus, and Phil Peisch, entitled, The Cyber Future of Long-Term Care: Applying Health Care Laws to Aging in Place Technologies. This article explores how … Continue Reading

CMS Extends Meaningful Use Attestation Deadline to March 20 for Eligible Professionals

Yesterday, CMS extended the meaningful use attestation deadline for the 2014 reporting year for eligible professionals in the Medicare EHR Incentive Program from February 28 to March 20.  In an email, CMS stated that it “extended the deadline to allow providers extra time to submit their meaningful use data.”  Medicare eligible professionals must attest to … Continue Reading

CMS Estimates that Medicare EHR Incentive Program Will Penalize Hundreds of Thousands of Eligible Professionals

At the ONC’s HIT Committee meeting on February 10, 2015, CMS presented data about the Electronic Health Records (EHR) Incentive Program.  The presentation included CMS’s estimate that over two hundred and fifty thousand professionals participating in Medicare will receive a downward payment adjustment for failing to meet meaningful use standards in 2015, which is the … Continue Reading

Study Identifies Progress and Challenges in E-Prescribing Controlled Substances

At the end of last year, the American Journal of Managed Care published a study — co-authored by researchers at the Office of the National Coordinator for Health Information Technology (ONC) — analyzing the use of electronic prescriptions for controlled substances.  This is the first study on this subject since the Drug Enforcement Agency (DEA) revised … Continue Reading

CMS Submits Proposed Rule on Stage 3 Meaningful Use to OMB

The Centers for Medicare & Medicaid Services (CMS) has submitted to the Office of Management and Budget (OMB) the proposed rulemaking for Stage 3 meaningful use, which is the next stage of compliance for eligible professionals and hospitals in the Electronic Health Records (EHR) Incentive Program.  Stage 3 is scheduled to begin in 2017. The … Continue Reading

CMS Extends Attestation Deadline for Hospitals in Medicare EHR Incentive Program

On November 24, 2014, the Centers for Medicare & Medicaid Services (CMS) announced it would extend the deadline for hospitals and Critical Access Hospitals (CAH) to attest to meaningful use for the 2014 reporting year in the Medicare Electronic Health Records (EHR) Incentive Program.  The deadline was extended for a month, from November 30, 2014 to … Continue Reading

CMS Expands Medicare Telehealth Coverage and Continues Support for Chronic Care Management Coverage; Notes Limitations of Current Law

As part of the October 31, 2014 final rule updating payment polices under the Medicare physician fee schedule, CMS continued its policy of allowing payment for non-face-to-face chronic care management services and also expanded the list of Medicare-covered telehealth services.  However, CMS declined to provide coverage for other proposed telehealth services, and the agency noted the limits … Continue Reading

CMS Reopens Meaningful Use Hardship Exception Application Period

On October 7, 2014, the Centers for Medicare & Medicaid Services (CMS) reopened the submission period for hardship exception applications to allow eligible professionals and hospitals to avoid 2015 meaningful use penalties.  Penalties for failing to demonstrate meaningful use of Certified Electronic Health Record Technology (CEHRT) were applied beginning October 1, 2014 for hospitals, and … Continue Reading

Legislation Introduced to Require CMS to Allow Three-Month EHR Reporting Period in 2015

In September, Congresswoman Renee Ellmers (R-NC) and Congressman Jim Matheson introduced H.R. 5481 — the Flexibility in Health IT Reporting Act of 2014 (“Flex-IT Act”).  This legislation would provide a three-month reporting period, instead of a full year reporting period, for demonstrating meaningful use in the Electronic Health Records (EHR) Incentive Payment Program in 2015.… Continue Reading

ONC Finalizes Changes to 2014 Edition EHR Certification Criteria

On September 11, 2014, the Office of the National Coordinator for Health Information Technology (ONC) published a final rule updating the 2014 Edition Electronic Health Records (EHR) certification criteria.  The certification criteria are technical standards that EHR technology must meet in order for hospitals and health care professionals to achieve meaningful use of EHR (and … Continue Reading

Legal and Practical Challenges Surround Telehealth Implementation

Health care providers and other entities face a host of legal and practical challenges as they implement telehealth and telemedicine initiatives. For example, providers of telehealth services, and the entities creating or hosting telehealth platforms, must determine which federal and state privacy and security laws apply to them.  These laws, such as the federal Health … Continue Reading