Business Associates of Business Associates - Partners Pointer

Caitlin Riccobono, Esq., Counsel at Nixon Law Group, develops these routine “Partners Pointers” for the Virginia-based healthcare organization Partners in Healthcare.

Topic: Business Associates of Business Associates

I was asked to address two main questions regarding a Business Associate that is a subcontractor of another Business Associate (we will call this a “Sub-BA”). First, to what extent is a Sub-BA permitted access to PHI? Second, what are the Sub-BA’s obligations with respect to safeguarding PHI?

PrivacyCait RiccobonoJune 19, 2017HIPAA, healthcare business

CLIENT ALERT: Remedial Measures for eClinicalWorks Customers Under the Corporate Integrity Agreement

On May 31, 2017, the U.S. Department of Justice announced that electronic health records (EHR) vendor eClinicalWorks (ECW), along with certain individual officers and employees, have agreed to pay a total of $155 million to settle a lawsuit under the False Claims Act (FCA). In its Complaint-in- Intervention, the government alleged ECW falsified compliance with certification requirements for EHR under the Meaningful Use program. The programming shortcuts ECW allegedly took in developing its software, along with inadequate post-market support and patches, could expose providers to increased risk of errors and jeopardize patient care. If you or your practice uses the eClinicalWorks software, you should be aware of ECW’s obligations and your rights under the Corporate Integrity Agreement (CIA).

Fraud and AbuseCait RiccobonoJune 13, 2017AKS, EMR, Health IT, healthcare vendor, fraud and abuse

Nixon Law Group, a leading boutique healthcare law firm, welcomes Caitlin Riccobono, Esq.

VIRGINIA, June 5, 2017/Nixon Law Group, PLLC/- Nixon Law Group, a Virginia-based boutique law firm representing clients in the healthcare industry exclusively, begins Summer 2017 by welcoming Caitlin Riccobono, Esq. as Counsel with the firm. Cait will be based in Nixon Law Group’s Richmond office. Prior to beginning her career as a healthcare lawyer, Cait spent five years in skilled nursing/long-term care facilities as a social worker.

Physician Employment Contracts: The Compensation Package

Before signing an employment contract, it is crucial to understand the details of your compensation package. Often, things are not as straightforward as they may appear, and small details may make a big difference to your take-home bottom line and your lifestyle. Before you sign on the dotted line, consider both the cash and non-cash components and evaluate what is most important to you.

Is Telemedicine Right for My Healthcare Practice?

Before you dismiss telemedicine as an unnecessary complication and investment for your business, consider the changes in technology, customer preference, trend toward value-based care, and aging population.

For many businesses, telemedicine is a way to increase patient care options, raise the quality of care, increase reimbursements, and grow business.

Interested? Then let’s take a look at why telemedicine might be right for your practice.

Five New Safe Harbors to the Fraud and Abuse Statutes: What do they mean for healthcare providers?

Five new safe harbors have been added to the Anti-Kickback Statute (AKS) in the final rule, issued on December 17, 2016 by the Health and Human Services Office of the Inspector General (OIG). In addition, existing safe harbors have been revised to grant further protections to providers from criminal prosecution and civil damages. What these changes mean for providers: The trend in healthcare is to move from volume-based care to value-based care.

MACRA for Physicians, Part Three

In Part Three of the MACRA series, you’ll learn about Advanced Alternative Payment Models (APMs) and the requirements for participating in this track, along with how doing so will affect your Medicare payments for 2017 and beyond.

Care Management ServicesCarrie NixonDecember 21, 2016MACRA, APM

MACRA for Physicians, Part Two

Have you decided which MACRA participation option your practice will choose in the 2017 transition year? What you choose now (and how you implement) determines your payment adjustment for Medicare Part B billings in 2019 and beyond. In the second blog post of our MACRA series, we talk about the Merit Based Incentive Payment System (MIPS), and what it means for physicians.

Care Management ServicesCarrie NixonNovember 23, 2016MACRA, Physicians, Medicare

MACRA for Physicians, Part One

The Final MACRA Rule relaxed the more stringent proposed requirements for 2017, so whether you choose to dip your toe in the water or take the full-on MACRA plunge, now is the time to get MACRA-ready and avoid reimbursement penalties. What does MACRA mean for your practice? That's a question we can help answer.

Care Management ServicesRebecca GwiltOctober 27, 2016MACRA, Physicians, Medicare

Nursing Homes and the CMS Rule Barring Arbitration Clauses

It just got easier to sue nursing homes. How do you protect your facility and your patients while still maintaining a profit?

This article is a high-level overview of the proposed changes by the Centers for Medicare and Medicaid Services (CMS), as well as the main points you as an Administrator need to know now.

Top Changes to 2017 Medicare Physician Fee Schedule (MPFS)

Last week, Nixon Law Group attended the Virginia Medical Group Management Association (VMGMA)‘s fall meeting in Williamsburg, and we were lucky enough to sit in on a session by the dynamic and talented Elizabeth Woodcock (of Woodcock & Associates). It was a whirlwind session on the key changes in the 2017 MPFS Proposed Rule, and we wanted to pass along all of the juicy details.

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

Increase Medical Practice Revenue with Ancillary Services

As physician revenues decline, and medical practices are feeling the pressure of the shift to value-based payment, more physicians are choosing to add ancillary services to their practices to boost revenue. Ancillary services are healthcare services provided by a clinician that are in addition to or complementary to basic medical or surgical services. Examples include medication dispensing, radiography, weight-loss services, in-office diagnostic testing, nutrition counseling, alternative treatments, such as acupuncture and massage, physical therapy, immunotherapy, mental health counseling, urgent care, cosmetic (“med spa”) services, and many more.

OCR ramping up HIPAA Enforcement for "Small" Breaches

We often advise our clients that one of the criteria separating a “high risk” breach from a “low risk” breach is whether the breach affects more or fewer than 500 individuals. This is because the HHS Office of Civil Rights (which is the HIPAA enforcement arm of HHS) has historically prioritized investigation of and corrective action following breaches affecting in excess of 500 individuals—OCR’s Regional Offices investigate all reported breaches involving the PHI of 500 or more individuals. However, OCR recently announced that it would be teaming up with its regional office staff to more widely investigate HIPAA breaches affecting fewer than 500 individuals—sending a strong signal to covered entities and business associates that no one is “safe” from repercussions emanating from a HIPAA breach.

PrivacyRebecca GwiltAugust 19, 2016HIPAA, OCR

How Should My Practice Respond to a Breach?

Despite the risk of experiencing a HIPAA breach exceeding 89%, fewer than half of healthcare organizations have formal incident response plans and procedures. When an actual or suspected breach occurs, it is vital for covered entities and business associates to have a simple, streamlined, and expeditious plan to respond. These breaches can be anything from a lost thumb drive or laptop to a sophisticated cyber-attack, but a good breach response plan will be flexible enough to work in a variety of circumstances. There are standard responses that the Department of Health and Human Services’ (HHS) Office of Civil Rights (the government entity that polices HIPAA compliance) (OCR) expects to see when health data has been compromised. These include protocols for investigation, mitigation, and notification of affected individuals.

PrivacyRebecca GwiltAugust 8, 2016HIPAA, breach, breach response, security incident, privacy and security

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.

NLG in the News: How to be Efficient with Vendor Relations

In the latest article in Diagnostic Imaging, NLG Partner Rebecca E. Gwilt offers advice on how medical practices can manage vendor relations. Read the full article here: http://www.diagnosticimaging.com/partnerships/how-be-efficient-vendor-relations

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

Hot Topic: CMS' Comprehensive Primary Care Plus (CPC+) Initiative

The CMS Center for Medicare and Medicaid Innovation (CMMI) has spent the last 6 years testing out a variety of models for value-based care and payment--the Medicare Shared Savings Program (MSSP) and other ACO models, the Bundled Payments for Care Improvement (BPCI) Initiative, the Comprehensive Care for Joint Replacement Model, and various Medicaid and CHIP initiatives. As the Administration doubles down on its commitment to shift payments away from fee-for-service (FFS), it continues to innovate, building programs to align incentives to person-centered, comprehensive, high quality health care. In that vein, in July of this year, CMS will begin taking applications from practices for participation in a new CMMI program: the CPC+ program.

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216 Apple Blossom Court, Suite 200
Vienna, VA 22181

What You Need To Know

Nixon Law Group216 Apple Blossom Court, Suite 200Vienna, VA 22181

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