HHS Delays Stark Law Reforms One Year
By John Commins | August 27, 2020
The much-anticipated final rule updating physician self-referral and anti-kickback laws has been pushed back for one year, the Department of Health and Human Services announced this week.
“We are still working through the complexity of the issues raised by comments received on the proposed rule,” HHS Deputy Executive Secretary Wilma M. Robinson wrote in a public notice, “and therefore we are not able to meet the announced publication target date.”
Ins The news was a disappointment for the American Hospital Association, which earlier this month had urged the Office of Management and Budget for an “expeditious review and release of the Physician Self-Referral and Anti-Kickback Statute final regulations” that the Centers For Medicare & Medicaid Services had submitted in July.
The AHA has long complained that the Stark Law prohibiting physician self-referrals is a major hindrance in the transition to value-based care, and that the proposed reforms would “provide space for the types of innovative arrangements among hospitals and physicians that can enhance care coordination, improve quality and reduce costs.”
The proposal would create new and permanent exceptions to the 30-year-old Stark Law for value-based arrangements, permitting physicians and other providers to try innovating solutions without fear that their legitimate efforts to coordinate care might violate the law, according to an agency fact sheet.
To read more, go to HealthLeaders Media.
CMS to Require COVID-19 Test Results for 20% Medicare Add-on Payment
By Tara Bannow | August 26, 2020
Starting next week, CMS is requiring hospitals have positive COVID-19 laboratory tests in patients’ records to qualify for Medicare’s 20% add-on payment.
The new rule, which CMS said seeks to address “potential Medicare program integrity risks,” applies to admissions beginning Sept. 1. Until now, CMS guidance has said a provider’s documentation—but not necessarily a positive test result—is sufficient to receive the 20% higher Medicare reimbursement for inpatient COVID treatment.
CMS will continue to automatically apply the 20% add-on payment for COVID-19 claims after the rule takes effect. The agency will enforce the requirement through post-payment audits, with the extra 20% being recouped if no test results are found.
To read more, go to Modern Healthcare.
CMS Threatens to Withhold Funds From Providers Skirting COVID-19 Requirements
By Ginger Christ | August 25, 2020
CMS on Tuesday strengthened its COVID-19 testing and reporting requirements for nursing homes, hospitals and labs, warning the providers could get fined or have funding withheld if they don’t comply.
Under the interim rule, nursing homes need to routinely test staff and test residents whenever there is an outbreak. The frequency of staff testing will be tied to the rate of community spread in an area and will be outlined in guidance expected to be announced soon, CMS Administrator Seema Verma said.
Facilities that do not comply with the new requirements will be cited for noncompliance and could face fines of $400 per day or more than $8,000 for a case of noncompliance, CMS said. Facilities also could be denied payment for new admissions.
“These new rules represent a dramatic ramp up in our effort to track and control COVID-19 in nursing homes,” Verma said. “While we’ve had good compliance across the country, we want to make sure every single nursing home is doing this. If not, they’re going to face sanctions.”
Nursing homes will be aided in compliance by the 15,000 rapid point-of-care testing devices CMS previously announced it would send to nursing homes over the next few months and $5 billion in funding from the Provider Relief Fund, which was announced in July. CMS also earlier Tuesday launched a staff training program on infection control and prevention for CMS-certified nursing homes.
Under Tuesday’s rule, hospitals and critical access hospitals are now required to report COVID-19 related data daily. The data will include the number of confirmed or suspected COVID-19 positive patients, ICU beds occupied, and availability of supplies and equipment like ventilators and PPE, CMS said.
The agency will warn hospitals that miss a day and give them a few weeks to come into compliance before Medicaid and Medicare payments are withheld, Verma said. After that point, the hospitals could be terminated from the Medicare and Medicaid program.
To read more, go to Modern Healthcare.
New Liability Concerns Emerge for Radiologists Who have Used Patient Images in Presentations
By Marty Stempniak | August 21, 2020
Recent updates to search engines such as Google and Bing may expose patient imaging data previously thought to be anonymous.
That’s according to an update shared by the American College of Radiology, RSNA and the Society for Imaging Informatics in Medicine on Thursday. Radiologists and other providers
often use patient images in educational presentations or online PDFs and, until recently, search engine spiders could not pinpoint any unique patient identifiers. However, advances in web-crawling and content processing are increasingly allowing for large-scale info extraction from previously stored files thought to be safe.
Physicians and other health professionals must pay special attention to this concern or open themselves up to potential privacy breaches and liability risk, the three groups advised.
“Healthcare providers frequently create presentations containing medical imaging for many worthwhile purposes,” according to an Aug. 20 ACR news update. “Patient privacy guidance including the Health Insurance Portability and Accountability Act and General Data Protection Regulation may extend to these situations. Providers may be responsible for protecting their patients’ privacy in this context just as they are in routine clinical operations.”
ACR gave the hypothetical example of a patient punching her name into a search engine and turning up a diagnostic imaging study from four years ago. Clicking through, she’d be directed to the website of a professional association, which has housed the presentation, unaware that it contains protected health information.
To avoid this concern, the societies suggest only using images that are free of any identifiers in educational presentations. They also recommend utilizing screen-capture tools to grab only the relevant portions, disabling patient information overlays, or using an anonymization algorithm in the PACS. Cropping out protected info or inserting a black box over it is insufficient to protect a patient and their imaging practice, the trio stressed.
“Specific functions are available in some software to permanently delete cropped, obscured or hidden information in presentation files. As a final quality control check, it is recommended that these ‘sanitization’ functions be run on all presentations prior to being made public,” the societies advised.
Trump Taps Board-certified Radiologist as New COVID-19 Advisor
By Matt O’Connor | August 13, 2020
A new face walked out with President Trump during his daily coronavirus briefing on Monday: Scott Atlas, MD, a board-certified radiologist.
“He’s working with us and will be working with us on the coronavirus,” Trump said during the Aug. 10 meeting. “And he has many great ideas. And he thinks what we’ve done is really good, and now we’ll take it to a new level.”
Atlas is a senior fellow at Stanford University’s Hoover Institution, a conservative think tank, according to Forbes. He served as a professor and chief of neuroradiology at Stanford University Medical Center from 1998 to 2012, according to his online university profile.
Additionally, his Stanford bio states that he has served as a senior healthcare advisor to a number of presidential candidates and has counseled Congress members on national
healthcare issues. He’s the editor of Magnetic Resonance Imaging of the Brain and Spine, a “leading” textbook in the field, now in its fifth edition.
CNN has reported that his official title is adviser to the president, and noted that he has made a handful of recent appearances on Fox News, calling for schools to reopen and college football to resume this fall.
“We have to become rational here,” Fox quoted him as saying during a Monday night interview on one of the channel’s programs. “The risk for people that age is less than seasonal influenza,” Atlas said referring to college students. “I mean, you have to really look at the data…You can’t say it’s all about the science and then act contrary to science.”
Many news outlets have reported that Atlas’ views on COVID-19 appear to more directly align with the president’s, with Rush Limbaugh praising the new adviser during his radio show this week, saying “he is countering Fauci.” In late July, Trump called Anthony Fauci, MD, the longtime director of the National Institute of Allergy and Infectious Diseases, “a little bit of an alarmist.” Fauci responded by saying, “I consider myself more of a realist.”
In an op-ed published by The Hill in April, Atlas shared his opinions on the coronavirus, promoting herd immunity until a vaccine is available.
To read more, go to Health Imaging.