Posts in Medicare
No Significant Fraud: CMS findings relieve concerns over Medicare Telehealth during COVID
No Significant Fraud: CMS findings relieve concerns over Medicare Telehealth during COVID

Discover what the OIG found when investigating telehealth billing fraud, what they recommend regarding future CMS oversight, and four takeaways for businesses billing Medicare telehealth services.

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Digital Health, Fraud and Abuse, Medical Practice, Medicare, OIG, Physician Fee Schedule, Regulations, Reimbursement, Remote Monitoring, Telehealth, Virtual Care, Virtual Care ManagementFaisal Khantelehealth, virtual care managemet, remote monitoring, oig, cms, fraud, Medicare claims, billing, risk management, audits, investigations, regulation
The 2023 Medicare Physician Fee Schedule Proposed Rule: Everything You Need to Know Now [video]
The 2023 Medicare Physician Fee Schedule Proposed Rule: Everything You Need to Know Now [video]

Whether you are building a business aimed at facilitating RTM for healthcare providers or growing a direct-to-consumer RTM practice, you know that reimbursement requirements significantly impact several of your most important business decisions.

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Behavioral Health, Digital Health, Medical Practice, Medicare, Physician Fee Schedule, Physicians, Provider, Reimbursement, Remote Monitoring, Remote Patient Monitoring, Regulations, Telehealth, Telemedicine, Virtual Care Management, WebinarNixon Gwilt Law2023 MPFS, reimbursement, behavioral health, chronic pain management, RTM, telehealth
2022 Trends and Opportunities for Healthcare and Life Sciences Businesses and Investors
2022 Trends and Opportunities for Healthcare and Life Sciences Businesses and Investors

Find out what Healthcare and Life Sciences businesses and investors anticipate for the healthcare industry in 2022.

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Digital Health, FDA, Legislation, Life Sciences, Medicare, OIG, Pharmacy, Remote Patient Monitoring, Telehealth, TelemedicineNixon Gwilt Lawtelepharmacy, contracts, RTM, SaMD, FDA, wearables, FTC, hospital at home, tele-phlebotomy, tele-radiology, data analytics, femtech, hipaa, DEA
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Medicare Physician Fee Schedule for Calendar Year 2022 (the “Final 2022 MPFS” or the “Final Rule”). As we noted in our July article discussing the Proposed 2022 MPFS, CMS made some significant proposed changes to allow for audio-only telehealth in some limited circumstances. In addition, the agency also proposed to enable remote “direct supervision,” which would allow practitioners to supervise clinical staff billing incident to their services as long as they could be available by audio/video communication as necessary.

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Behavioral Health, CMS Programs, Healthcare Reform, Medicare, OIG, Physician Fee Schedule, Regulations, Reimbursement, Telehealth, TelemedicineRebecca GwiltTelemedicine, telementalhealth, 2022 Medicare Physician Fee Schedule, 2022, MPFS, Medicare, telemedicine, CMS, 99441, 99442, 99443, CPT, 93797, 93798, G0422, G0423, G2252
Biden Administration Requires Vaccination for Medicare and Medicaid Certified Providers/Suppliers by January 2022: CMS Issues its Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule
Biden Administration Requires Vaccination for Medicare and Medicaid Certified Providers/Suppliers by January 2022: CMS Issues its Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule

The Centers for Medicare and Medicaid Services (CMS) issued its Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (IFR) on November 4, 2021, the same day the Department of Labor’s Occupational Safety and Health Administration (OSHA) issued its COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS). The IFR and ETS complement each other, with both aimed at furthering the Biden Administration’s goal of vaccinating the entire United States healthcare workforce to ensure capacity to serve local and national healthcare needs, the safety of the workforce and patients, and to reduce the risk of continued COVID-19 transmission. Both rules are effective November 5, 2021.

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COVID-19, Employment, Medicare, RegulationsFaisal KhanCOVID-19, vaccine, medicaid, Medicare
Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS
Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS

In the Final Medicare Physician Fee Schedule (“MPFS”) for 2022 (the “Final Rule”) issued on November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) added five new CPT codes in the categories of Chronic Care Management (“CCM”) and Principal Care Management (“PCM”) and increased reimbursement for already existing codes in the same categories. Despite stakeholder feedback, CMS refrained from making any changes to the existing rules for obtaining beneficiary consent for CCM and PCM.

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CMS Programs, Digital Health, Healthcare Reform, OIG, Medicare, Physician Fee Schedule, Reimbursement, Telemedicine, TelehealthKaitlyn O'Connor and Reema TanejaCCM, PCM, Chronic Care Management, Principal Care Management, MPFS, 2022, 2022 Medicare Physician Fee Schedule, medicare physician fee schedule, 99437
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2022 (the “Final 2022 MPFS”), revising certain payment policies for services provided to Medicare beneficiaries by healthcare practitioners. These policies take effect on January 1, 2022.

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Healthcare Reform, Legislation, Medicare, OIG, Physician Fee Schedule, Physicians, Reimbursement, Telehealth, TelemedicineCarrie Nixon and Casey Pappphysician coverage, MPFS, 2022, medicare physician fee schedule
New Reimbursement for Remote Therapeutic Monitoring in the Final 2022 Medicare Physician Fee Schedule
New Reimbursement for Remote Therapeutic Monitoring in the Final 2022 Medicare Physician Fee Schedule

This article examines the new CPT codes for Remote Therapeutic Monitoring as finalized for reimbursement in the 2022 Medicare Physician Fee Schedule, discussing key takeaways and implications for digital health and remote patient monitoring companies.

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Digital Health, Medicare, Physician Fee Schedule, Regulations, Reimbursement, Remote Patient Monitoring, TelehealthCarrie NixonRemote Therapeutic Monitoring, Remote Monitoring, Remote Patient Monitoring, Reimbursement, MPFS, 2022 Medicare Physician Fee Schedule, CPT Code 98975, CPT Code 98976, CPT code 98977, CPT code 98980, CPT code 98981, RPM, RTM, CPT