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Showing 23 posts from 2018.

On Friday, December 21, 2018, CMS issued a final rule, referred to as “Pathways for Success,” that makes significant changes the Medicare Shared Savings Program. Issued just before the holidays, various stakeholders will likely have varying opinions about whether this final rule constituted an early gift or lump of coal. Among other things, the final rule overhauls the current track system for participating accountable care organizations, or ACOs, and requires a more rapid transition to assumption of downside risk. The two new tracks available to participating ACOs will go into effect for agreement periods commencing on or after July 1, 2019. Read More ›

With an implementation date of July 1, 2019 for updates to the Accreditation Council for Graduate Medical Education’s (ACGME) Common Program Requirements (the basic set of standards for training resident and fellow physicians), teaching hospitals should be proactively reviewing and making appropriate changes to their graduate medical education (GME) programs over the next several months to ensure compliance moving forward. Read More ›

On October 26, 2018, the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration released an update to the National Practitioner Data Bank (NPDB) Guidebook, a manual that provides guidance on the requirements established by the laws governing the NPDB. The Guidebook is not updated on any set schedule - the previous amendments to the Guidebook occurred in April 2015 and were the first updates since 2001. While most of the 2018 revisions can be categorized as minor changes, the 2018 NPDB Guidebook does contains a number of new sections and clarifications that Medical Staffs and other peer review bodies should be aware of. We will be following up on the effect of the revisions on an on-going basis, but want to give clients and friends a preliminary summary of some of the key revisions affecting peer review bodies. Read More ›

On October 24, 2018, President Trump signed into law the bipartisan SUPPORT for Patients and Communities Act (H.R. 6 or the “Act”), which aims to combat opioid abuse with increased attention to treatment. The wide-reaching compromise legislation combines elements from a number of opioid bills, addressing issues from access to treatment and prevention programs to expanded law enforcement efforts to curtail drug trafficking. The Act, however, does omit several items that have been part of the national dialogue on opioid abuse. For example, it does not include amendments to 42 U.S.C. § 290dd-2 and the associated regulation at 42 C.F.R. Part 2 (“Part 2”) that would align the Part 2 substance use treatment privacy law with the Health Insurance Portability and Accountability Act (“HIPAA”) privacy rules to better facilitate the sharing of a patient’s substance use disorder information among providers. In addition, the Act does not provide for a significant increase in spending for the opioid crisis. Read More ›

Last week, California’s Governor, Jerry Brown, signed into law AB 2861, which expands access to behavioral health and substance use providers via telehealth for Medicaid patients.  AB 2861 will expand Medi-Cal reimbursement for services provided via telehealth technology by certain licensed practitioners and certified substance use disorder (“SUD”) counselors. Read More ›

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