Reimbursement and Practical Considerations for House Call Practices

Are you thinking about starting a new house call practice? There will be things you need to prepare for (and budget for), so Nixon Law Group compiled this information. Note that major concerns include whether commercial clients can reimburse, what kinds of safety needs there are, and Medicare requirements for a “practice location.” Read more below and feel free to contact us with questions!

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New HHS Fact Sheet on Direct Liability of Business Associates under HIPAA

As all health care providers know, the HIPAA Privacy Rule applies to their practice. But because many providers outsource some of their health care activities and/or functions, the HIPAA Privacy Rule also applies to these “business associates".” It is important that providers have assurances in writing that all business associates are appropriately safeguarding patient information and following all HIPAA provisions. The HHS Office for Civil Rights has issued a new fact sheet that lays out all provisions where the business associate would be held directly liable for HIPAA Rule violations.

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Carrie Nixon on the latest in Remote Patient Monitoring in Digital Health Today

Remote patient monitoring providers have known the benefits of RPM, including better outcomes for patients and lower overall cost of care, for awhile now. But with innovations in technology and CMS’ move to allow separate reimbursement for RPM bring incredible opportunities for health care technology companies and providers alike. Read more on Digital Health Today.

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NLG's Medical Cannabis Practice and Leadership Role in Virginia's Cannabis Industry Association

Nixon Law Group represents clients whose businesses are on the leading edge of healthcare and technology. We represent healthcare providers, healthcare technology companies, and other businesses that sell to the healthcare industry, including businesses in the medical cannabis industry.

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Prepare Against Phishing Attacks!

We like to find interesting tips and tricks to help our clients improve their health data security. This infographic from Inspired eLearning on "phishing" schemes covers the most common types of phishing attacks, including via email, phone call, text message, or USB baiting.  Read on to learn about how these attacks can occur, common statistics, and prevention tips.

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Virginia's Cannabis Industry: A 2019 Legislative Session Rundown

In Virginia’s 2019 General Assembly (GA) Session, five of six proposed cannabis-related bills passed and will soon reach the desk of the Governor, ushering in some significant changes to the Commonwealth’s medical cannabis program. Among them, allowing full therapeutic-strength medical cannabis preparations, and the addition of physician assistants and nurse practitioners to the list of providers permitted to make medical cannabis recommendations.

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CMS issues Technical Correction regarding "Incident To" Billing for Remote Patient Monitoring

On March 14, 2019, CMS issued “Technical Corrections” to address errors in the 2019 Final Medicare Physician Fee Schedule (“MPFS”) published on November 23, 2018. One of these corrections addresses “incident to” billing by clinical staff, and has important implications for Remote Patient Monitoring under CPT Code 99457.

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Considerations for Clinician Contracting – An Employer Perspective

Having written a series of posts over the years addressing employment contracting from the physician perspective, one of our readers reached out to let us know that Nixon Law Group should, likewise, address physician/clinician employment contracting from the perspective of the healthcare employer.  Considerations for Clinician Contracting – An Employer Perspective…

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7 Common Mistakes Physicians Make When Signing a Physician Employment Contract (and How to Avoid Them)

Smart physicians are not immune from making highly regrettable mistakes when it comes to employment contracts. And unlike in medicine, you don't get the option of trying a new treatment plan if the first one doesn't work. Physicians are educated, and intellectually sophisticated. This means that, even though you weren’t trained to read legal contracts in medical school, courts expect that you have read and fully understand the terms of the contracts you sign. That means that, both during and even after your employment, you're stuck with the contract you sign, so make sure you avoid these common pitfalls.

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Proposed Healthcare Legislation in the 2019 Virginia General Assembly

On January 9, the 2019 General Assembly Session will convene, and there are several bills that are set to be introduced that may have an impact on Virginia healthcare providers. We will update this post with additional legislation as session progresses.

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Congress Votes to Legalize Low-THC Cannabis (Hemp)

On December 12, 2018, Congress passed the 2018 Farm Bill (The “Agriculture Improvement Act of 2018” or the “Bill”), which includes provisions that exempt Cannabis plants with lower than 0.3% THC content (also called “Hemp”) from the Controlled Substances Act (CSA). Once signed into law, the Farm Bill effectively legalizes the production, commercialization, and interstate shipment and sale of hemp and hemp-derived products like cannabidiol or “CBD”. Each state (including Indian Tribes and U.S. Territories) will eventually be able to regulate hemp production like any other agricultural commodity, as long as the U.S. Department of Agriculture (USDA) approves its plan to monitor and regulate the plant’s production.

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How to Get Paid for Remote Interprofessional Consultation between Physicians

Beginning January 1, 2019, physicians and other Qualified Healthcare Providers (“QHCPs”) eligible to independently bill for E/M services can obtain standalone reimbursement for Interprofessional Internet Consultations using CPT Codes 99446-99449, 99451, and 99452.

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CMS introduces CPT Codes 99453, 99454, and 99457 to reimburse for Chronic Care Remote Patient Monitoring

The final 2019 Medicare Physician Fee Schedule (the “Rule”), released on November 1st, creates three new codes in the category of Chronic Care Remote Physiologic Monitoring (“CCRPM”) for (1) initial set-up and patient education, (2) initial device supply, and (3) monitoring data and interacting with patients or caregivers.

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HCPCS Code G2010 reimburses for Remote Evaluation of Patient-Submitted Images and Video

The final 2019 Medicare Physician Fee Schedule, released by CMS on November 1, 2018, includes a new code that physicians may use to bill for remote evaluation of images to determine whether or not an in-person office visit is necessary. Learn more about HCPCS Code G2010 and how it can be used in medical practices.

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How to get Reimbursed for Virtual Check-ins under HCPCS Code G2012

In its Final Rule for the 2019 Medicare Physician Fee Schedule released on Friday, CMS introduced a new code, HCPCS G2012, allowing physicians and other qualified healthcare professionals (“QHCPs”) to be reimbursed for “virtual check-ins” with patients who aren’t sure whether or not their symptoms warrant an in-office visit. Learn more about virtual check-ins and how they can be used by practices.

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Should I Self-Disclose a Stark or AntiKickback Violation?

On September 27, 2018, the Department of Justice (“DOJ”) for the first time announced its own “road map” guiding voluntary self-disclosures and cooperation with government investigations of fraud and abuse in the healthcare industry. By encouraging self-disclosure, the government is incentivizing healthcare entities to come forward early with reports of violations in the hope of negotiating reasonable settlements, avoiding exclusion from Federal healthcare programs, and reducing the severe civil and criminal penalties that would otherwise be imposed for such violations.

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When Do I Need a Healthcare Attorney? Responding to an Investigation by the Virginia Department of Health Professions

Do I really need a healthcare attorney? The Board is simply asking me to answer some questions and provide some documentation. Of course, a Board complaint is a big deal, but this part seems harmless/easy enough. I will just respond and tell them what happened, right?” The reality is that an effective response is not as straightforward as it may seem. Hiring a healthcare attorney to assist in the preparation of your response to a complaint investigation can improve your chances of resolving the complaint at the investigation stage, incidentally saving you money in the long run.

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Evolution of Cannabis Law and Regulations in Virginia

On September 25, 2018, the Virginia Board of Pharmacy met in closed session for more than five hours before awarding five conditional permits to five separate companies who will likely become the first Pharmaceutical Processors of Medical Cannabis in Virginia. Following this exciting announcement, these conditional license permittees will undergo background checks and, upon satisfactory results, will begin the arduous process of creating Virginia’s first vertically integrated Medical Cannabis cultivation, manufacturing and retail facilities. The state’s program started in earnest in 2015, and due to the advocacy of Virginia patients, caregivers, legislators, and healthcare providers, expanded to its current state in just three short years.

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