Posts in Corporate Healthcare Law
What You Need to Know About the Revised Virginia Assisted Living Regulations: STAFFING (Part 1 of 2)

The revised Virginia assisted living regulations go into effect February 1, 2018.  This is the latest summary in Nixon Law Group’s series highlighting key changes under the new regulations.  This summary is the first of two that will focus on some of the new staffing requirements, including qualifications, training, and records.

Read More
What You Need to Know About the Revised Virginia Assisted Living Regulations: Private Duty Personnel and Volunteers

NLG continues its series of posts on certain key changes in the new Virginia assisted living regulations, scheduled to take effect February 1, 2018.  In this installment, we review new requirements for the use of private duty personnel and volunteers.  Keep reading THE LATEST from Nixon Law Group more information on the new ALF regulations and other healthcare happenings!

Read More
What You Need to Know About the Revised Virginia Assisted Living Regulations: Records & Reports

In this third installment of NLG posts summarizing the new Virginia assisted living regulations, we cover notable changes to requirements for Electronic Records and eSignatures, Incident Reporting, and Reports of Abuse, Neglect, or Exploitation.  These regulations are scheduled to take effect February 1, 2018, so keep checking back for THE LATEST from Nixon Law Group! 

Read More
What You Need to Know About the Revised Virginia Assisted Living Regulations: Infection Control

This is the second NLG summary in our series on the revisions to Virginia’s Standards for Licensed Assisted Living Facilities, scheduled to take effect February 1, 2018.  The new regulations include changes to the timing for submitting incident reports, a new section addressing electronic records and electronic signatures, substantial revisions to requirements for infection control programs, and changes to the required content of the Disclosure Statement and admission agreements.  This summary focuses on changes to Infection Control regulations. 

Read More
CLIENT ALERT: Revisions to Virginia Assisted Living Regulations

Final regulations that comprehensively revise Virginia’s Standards for Licensed Assisted Living Facilities are scheduled to take effect February 1, 2018.  The new regulations include changes to the timing for submitting incident reports, a new section addressing electronic records and electronic signatures, substantial revisions to requirements for infection control programs, and changes to the required content of the Disclosure Statement and admission agreements.  This is the first in a series of summaries on key changes under the new assisted living regulations, so stay tuned! 

Read More
The MACRA 2018 Proposed Rule: What does it mean for you?

Last week, CMS issued a Proposed Rule suggesting changes for Year 2 of the Quality Payment Program ("QPP"), established under the Medicare Access and CHIP Reauthorization Act of 2015. The changes are aimed at reducing administrative and financial burdens of the QPP on physician practices, particularly small independent practices and practices serving rural communities. Per CMS, the Proposed Rule "continues the slow ramp-up of the Quality Payment Program by establishing special policies for Program Year 2 aimed at encouraging successful participation in the program while reducing burden, reducing the number of clinicians required to participate, and preparing clinicians for the CY 2019 performance period."

Read More
Stuck in the Middle Again: Protected Workplace Recordings Must Coexist with Patient Privacy

Healthcare providers are highly sensitive to the risks introduced by recordings in the workplace—not the least of which are potential violations of federal and state laws regarding the privacy of their patients and residents.  We have often advised our healthcare clients to enact restrictions on recordings that could introduce unnecessary risk, but a National Labor Relations Board (NLRB) decision, recently upheld by the U.S. Court of Appeals for the Second Circuit, indicates that those same restrictions on recordings might, in and of themselves, introduce compliance risk.  In its decision, the NLRB had to determine whether no-recording policies maintained by employer Whole Foods were overly broad by prohibiting all recordings by Whole Foods employees without prior management approval.  The NLRB’s position seems clear: Policies reasonably read as prohibiting all employee workplace recordings violate the National Labor Relations Act.

Read More
Compliance Alert: ACA Section 1557 Nondiscrimination Requirements for Medical Practices

Beginning on October 17, 2016, medical practices (and other Covered Entities) who serve Medicare, Medicaid, VA, or TRICARE beneficiaries will be required to implement new practices related to nondiscrimination. The Final Rule, nearly 6 years in the making, is commonly called “Section 1557”--it implements Section 1557 of the Affordable Care Act, the purpose of which is to prevent discrimination based on race, color, national origin, sex, age, or disability

Read More
Six Things to Watch Out for in Physician Employment Agreements

Healthcare reform and the shift from fee-for-service to value-based reimbursement has brought a host of new complexities to the day-to-day practice of medicine.  As a result, more and more physicians are choosing to be employed by a hospital or health system, rather than owning and running their own practice.

While physician employment is not a new concept, the relationship between employed physicians and their employers is shifting as the model for healthcare reimbursement shifts.  Employers not only expect their physician employees to meet or exceed RVU (“Relative Value Unit”) production goals, but also to move the needle on certain quality metrics that reflect the overall health of the patient population. This new paradigm creates unique challenges and risks for employed physicians, and is all the more reason for physicians considering employment to pay close attention to what their employment contracts actually require of them.

Read More
Physician's Guide to the New DOL Overtime Pay Law

On May 23, 2016, the Department of Labor passed long-awaited overtime pay rules, modifying the Fair Labor Standards Act (FLSA) for the first time in 12 years. The overtime rules apply to all industries across the country, but will like have a major impact on the healthcare industry, especially independent physician and other clinician employers. The rule significantly increases the amount of money an employee must be paid for that employee to qualify as exempt from the overtime pay rules. This means a much larger pool of employees that now qualify for overtime pay (an additional 4.2 million Americans), and likely significant cost increases for employers. Some healthcare employers will be hit harder than others.

Read More
ALERT: MACRA and the Quality Payment Program (QPP) Proposed Rule

The biggest takeaway from this proposed Rule? Physicians should start planning for this change IMMEDIATELY to best position their practice for financial sustainability. This rule establishes the new Quality Payment Program (QPP) framework, which consists of two new pathways for provider evaluation and payment—the Merit-based Incentive Payment System (MIPS) and participation in Advanced Alternative Payment Models (APMs). The QPP stems from the changes passed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), passed in April of last year. Participation in one of the QPP pathways will form the new basis for the level of payment for services Medicare Part B providers will receive. CMS will begin collecting data beginning in 2017. They will analyze the data for one year, and then use the data to adjust Medicare payments for eligible providers starting January 1, 2019.

Read More
Payer Contract Negotiation Nuts and Bolts

Contracts are long and complicated, often missing or obscuring key information a provider needs to make an informed decision about whether to agree to the contract’s terms. In addition, insurance companies are incredibly resistant to modifying their contracts. Contract negotiation employees often say “no” to even minor changes, expecting that the provider will back down. It takes a significant amount of pushing back to gain access to the staff with the power to make changes. Many providers, we know, simply negotiate the fee schedule, and sign the payer contract without a full understanding of its content. We think that is a mistake—these contracts can have legal and financial impacts unrelated to the fee schedule rates, which outlive the contract itself. But, it's not always clear what parts of these gargantuan documents medical practices should be looking for to reduce their risk. In this post, we describe specific types of provisions to read carefully and consider, how easy it will be to change them, and why you may be agreeing to more than the language inside the contract:     

Read More
Buying Professional Liability (Malpractice) Insurance

One of the key elements of any healthcare provider’s risk management plan is securing professional liability (also known as “medical malpractice”) insurance coverage. But, all professional liability policies are not created equal. When considering which policy to purchase, physicians and other healthcare providers should thoroughly examine and understand who the policy covers, how coverage is triggered, and the types of patient claims that are eligible for coverage. . . .

Read More