New Rule for Substance Abuse Records: Confidentiality and Disclosures

On January 2, 2018, the Substance Abuse and Mental Health Services Administration (“SAMHSA”) issued a Final Rule, amending 42 C.F.R Part 2 (“Part 2”), creating new changes to the federal rules governing confidentiality and disclosures of patient substance use disorder (“SUD”) records for the first time since 1987. Part 2 protects the confidentiality of SUD records, which are subset of protected health information (PHI). This means that these records are subject to HIPAA, but are also protected by Part 2, which contains additional (and more stringent) federal protections. These overlapping standards can make the storage and disclosure of patient records administratively burdensome for healthcare providers, patients and their families. It is also a challenge for technology companies that store, analyze, and transmit patient records on behalf of providers and patients.

What You Need to Know About the Revised Virginia Assisted Living Regulations: STAFFING (Part 2)

This is the latest Nixon Law Group summary in our series on the new Virginia assisted living regulations, which go into effect on February 1, 2018. In this summary, we continue to focus on key changes to the regulations related to staffing.

Corporate Healthcare LawCait RiccobonoJanuary 31, 2018assisted living, post-acute, staffing, personnel, regulations, Virginia, ALF

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.

Corporate Healthcare LawCait RiccobonoJanuary 15, 2018assisted living, post-acute, staffing, regulations, ALF, Virginia, personnel

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!

Corporate Healthcare LawCait RiccobonoDecember 18, 2017assisted living, post-acute, regulations, ALF, Virginia, personnel, volunteers

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!

Corporate Healthcare LawCait RiccobonoOctober 27, 2017assisted living, Virginia, regulations

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.

Corporate Healthcare LawCait RiccobonoOctober 26, 2017Virginia, assisted living, regulations

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!

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."

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.

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

Corporate Healthcare LawRebecca GwiltSeptember 19, 2016Section 1557, medical practice, nondiscrimination, covered entity, LEP, OCR, HHS

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.

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.

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.

Corporate Healthcare LawRebecca GwiltMay 12, 2016Physicians, Medicare, MACRA

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:

6 Key Things Medical Practices Should Consider When Negotiating Payer Contracts

Learn what kinds of questions you and your medical practice team should be asking when negotiating insurance contracts

Alphabet Soup! Physician Quality Reporting and Reimbursement

PQRS… VPM... MU… MIPS. These letters represent a complex world of quality reporting requirements that physicians must adhere to if they want to maximize their reimbursement and ensure the sustainability of their practice.

Corporate Healthcare LawCarrie NixonJanuary 25, 2016PQRS, MACRA, MIPS, quality reporting, Meaningful Use

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. . . .

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216 Apple Blossom Court, Suite 200
Vienna, VA 22181

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Nixon Gwilt Law216 Apple Blossom Court, Suite 200Vienna, VA 22181

Nixon Gwilt Law
216 Apple Blossom Court, Suite 200
Vienna, VA 22181