In addition to the Information Blocking updates we discussed in a recent blog post, the 21st Century Cures Act Final Rule also requires use of Cures Act Edition certified software. This will include some new and revised certification criteria. Providers will need to have their EHR updated with these new requirements in time for the 2022 reporting period. Is your EHR provider ready?

The information blocking requirements of the Cures Act Final Rule will take effect on November 2, 2020. This means healthcare providers have barely a month to ensure they are in compliance or risk financial penalties. When it comes to allowing proper access to information as required by HIPAA, commonly called “Right of Access,” regulatory entities have already begun cracking down on violators. In 2019, the Office for Civil rights (OCR) at HHS had announced its intention to more aggressively enforce the rights of patients to have prompt access to medical records without being overcharged for it.

The American Medical Association (AMA) recently released a broad update to CPT codes for 2021, including guidance for several new codes related to COVID-19. This update to the CPT code set was reviewed and approved by the CPT Editorial Panel convened by the AMA. This is seen as a rather significant event because it is the first AMA overhaul of office visit and outpatient E/M coding in more than 25 years. These new code changes range from 99201 to 99215 and are proposed to be adopted by CMS on January 1, 2021.

The Centers for Medicare and Medicaid Services (CMS) recently released its proposed 2021 Medicare Physician Fee Schedule. Among the proposed items are a number of significant changes to the Quality Payment Program (QPP) for next year. To make sure your practice knows what to expect with these new changes, here is a list of just some of the more notable items:

Starting today, August 3, 2020, CMS is resuming suspended medical reviews as well as initiating new audits. While this should merely be a return to business as usual for MIPS providers, it is important to note that this resumption of CMS audits will now continue regardless of the status of the current public health emergency. To help our readers get ready, we thought this would be a good time to offer a quick refresher on preparing for and surviving a MIPS audit. For reference, check out our new eBook Winning the Game: Surviving a MIPS Audit.

In a recent blog, we discussed the new CMS proposed rules intended to make permanent many of the telehealth flexibilities initiated in response to the COVID-19 outbreak. Since that time, two additional and very significant pieces of telehealth legislation have been introduced. First, on July 16, 2020, a group of bipartisan lawmakers introduced the Protecting Access to Post-COVID-19 Telehealth Act to the U.S. House of Representatives. The very next day, July 17, Senators Ted Cruz (R-Texas) and Marsha Blackburn (R-Tennessee) introduced the Equal Access to Care Act to the U.S. Senate.

At the close of June 2020, the Centers for Medicare & Medicaid Services (CMS) released a new proposed rule that would make some of the recent flexibilities for telehealth permanent. Many of these changes are already in place, though temporarily for now, in response to the COVID-19 Public Health Emergency. If finalized, this rule would make several of these new telehealth flexibilities permanent. This blog will provide you with a summary of the proposed rule so that you can stay informed on what it could mean for you and your practice.

On June 9, 2020, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced new redistributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers who participate in those programs. As a result, HHS plans to distribute approximately $15 billion to Medicaid and CHIP program participants who have not received a payment from the Provider Relief Fund General Allocation.