Federal Regulation news
Written by Editor   
Monday, July 25, 2016 12:00 AM

On the morning of the tragic mass shooting in Orlando, a tweet by CNN stated, “The White House waived HIPAA regulations so that hospitals could talk with family members of shooting victims, says Orlando Mayor Buddy Dyer."  HIPAA [the Health Insurance Portability and Accountability Act] had previously been waived during Hurricane Katrina. Despite rumors to the contrary about 9/11, Katrina was the only time a HIPAA waiver has ever been issued.

Regarding Orlando, the White House never issued a HIPAA waiver.  HIPAA has provisions stating patient information can be shared without consent in an emergency if a physician feels that there is a need. The least understood provision of HIPAA concerns the sharing of information between providers. Obtaining information from another physician or a hospital is often hindered by an erroneous belief that a signed consent must be obtained from a patient before protected health information can be exchanged. Here is what the Department of Health and Human Services has to say: "The Privacy Rule allows covered health care providers to share protected health information for treatment purposes without patient authorization, as long as they use reasonable safeguards when doing so. These treatment communications may occur orally or in writing, by phone, fax, e-mail, or otherwise."

Family Physicians, Geriatricians Could See 30% Medicare Increases
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Friday, July 22, 2016 12:00 AM

Primary care is the watchword for 2017 when it comes to the Medicare physician fee schedule proposed by the Centers for Medicare & Medicaid Services (CMS).

“In the United States, we have historically invested far more in treating sickness than we do in maintaining health," CMS acting administrator Andy Slavitt said. “The result of this imbalance is not only poorer health, but more money spent in institutions, hospitals, and nursing homes. The road to a better health care system means correcting this imbalance," he continued. "We should reinvest in what we value."

Under the proposed rule, Medicare would:

  • Increase primary care provider payments for routine office visits involving patients with mobility-related disabilities, raising the payment from $73 to $119 per visit.

  • Increase payments to geriatricians and family physicians. "We anticipate that these clinicians could receive a 2% increase in their payments for providing the care we propose to recognize under the Physician Fee Schedule," Slavitt said. "Over time, if all of the practitioners that can provide these services provide them to all eligible patients, we estimate that the payment increase could be as much as 30% and 37%, respectively, to these specialties."

Senate Told CMS May Put Off Implementing MACRA
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Thursday, July 21, 2016 12:00 AM

The Centers for Medicare & Medicaid Services (CMS) might be open to delaying the implementation of parts of the SGR repeal law dealing with physician payment, CMS acting administrator Andy Slavitt told the Senate Finance Committee. ”We remain open to multiple approaches. Some things on the table include alternative start dates, looking at whether shorter [reporting] periods could be used, and finding other ways for physicians [to get used to] the program before the impact really hits them."

Several committee members expressed concerns about how MACRA will impact small and rural practices. "We recognized the inherent challenges of these types of practices when we crafted MACRA," said committee chairman Orrin Hatch. "I know CMS is aware of the issue but we need to make sure ... these practice settings remain viable options for Medicare beneficiaries."

"Our focus on small independent practices and their ability to practice independently is a very high priority for us," Slavitt said. " And any practice that practices in a rural location has a very different set of dynamics than other practices do. Often in small practices you'll find it's a physician and their spouse and that's all the work they do ... So additional paperwork [time] comes out of patient care.”  CMS is looking at issues such as "How do we compare the performance of small physician practices? How do we lessen the burden?" he continued. He noted that the agency just adjusted the way it reimburses physicians who participate in the Medicare Advantage program to account for these types of differences. 

ACA Petitions HHS on Chronic Pain
Written by Editor   
Wednesday, July 20, 2016 12:00 AM

At the end of June the American Chiropractic Association (ACA) petitioned the U.S. Department of Health and Human Services (HHS) to amend one of its recent rules.  Read the entire letter here.

The American Chiropractic Association (ACA) requests that the Secretary of the HHS amend the recently released “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016" as published in Morbidity and Mortality Weekly Report, Early Release / Vol. 65 March 15, 2016 ("CDC Guideline").

The draft proposal of the above referenced CDC Guideline made reference to the effectiveness of nonpharmacologic therapies including manipulation therapy in the treatment of chronic pain:  “Based on contextual evidence, many nonpharmacologic therapies, including physical therapy, weight loss for knee osteoarthritis, complementary and alternative therapies (e.g., manipulation, massage, and acupuncture), psychological therapies such as CBT, and certain interventional procedures can ameliorate chronic pain.”  However, no mention is made of manipulation therapy under the heading “Effectiveness of Nonpharmacologic and Nonopioid Pharmacologic Treatments" on page 12 of the final CDC Guideline nor anywhere else in the final rule.

The ACA therefore respectfully requests that the HHS restore the above referenced comment from the draft proposal to the final CDC Guideline. In addition, ACA requests that the portions the CDC Guideline pertaining to “Effectiveness of Nonpharmacologic and Nonopioid Pharmacologic Treatments” on page 12 and "Determining When to Initiate or Continue Opioids for Chronic Pain" p.17, be revised to reference the effectiveness of manipulation therapy in the treatment of chronic care by adding the following language: “Patients should be informed of non-pharmacological therapies for low back pain before seeking opioids. Manual-thrust manipulation, such as performed by a doctor of chiropractic, often achieves a greater short-term reduction in pain compared with common medical treatments.”

New Food Nutrition Labels, Coming Soon
Written by Editor   
Thursday, June 16, 2016 12:00 AM

The nutrition facts panel on the back of food packages -- that box many of us check to see how many calories and how much fat, protein, and fiber are in the foods we eat -- is getting a new look.

Among the key changes:
  • A new line will tell people how much sugar has been added to a processed food.
  • Serving sizes will be updated to more closely reflect the amount of a food people actually eat. A serving of ice cream, for example, will be increased to two-thirds of a cup instead of one-half cup. A serving of soda will go from 8 to 12 ounces.
  • Calories will be larger and bolder.
  • Daily values will be updated to reflect the most recent science. The daily value for fiber has been increased from 25 grams to 28 grams, for example.

  • New vitamins and minerals will get some space. Potassium and vitamin D, two nutrients that Americans tend not to get enough of, will now be featured on food labels.

These are the first updates to nutrition labels in 2 decades. Food manufacturers will have between 2 and 3 years, depending on their size, to comply.

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