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Resource Material

COVID-19 Public Health Emergency (PHE)

Based on current COVID-19 trends, the Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19, declared under Section https://www.hhs.gov/coronavirus/covid-19-public-health-emergency/index.html319 of the Public Health Service (PHS) Act, to expire at the end of the day on May 11, 2023.

https://www.hhs.gov/coronavirus/covid-19-public-health-emergency/index.html

Fact Sheet:  Covid-19 Public Health Emergency Transition Roadmap

https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html

Creating a Roadmap for the End of the COVID-19 Public Health Emergency

https://www.cms.gov/blog/creating-roadmap-end-covid-19-public-health-emergency

HHS Office for Civil Rights Announces the Expiration of COVID-19 Public Health Emergency HIPAA Notifications of Enforcement Discretion

OCR is providing a 90-calendar day transition period for covered health care providers to come into compliance with the HIPAA Rules with respect to their provision of telehealth. The transition period will be in effect beginning on May 12, 2023 and will expire at 11:59 p.m. on August 9, 2023

https://www.hhs.gov/about/news/2023/04/11/hhs-office-for-civil-rights-announces-expiration-covid-19-public-health-emergency-hipaa-notifications-enforcement-discretion.html?utm_source=newsletter&utm_medium=email&utm_campaign=name_ocr_cms_updates_auditing_for_compliance&utm_term=2023-04-11

CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency

https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf

https://www.cms.gov/files/document/frequently-asked-questions-cms-waivers-flexibilities-and-end-covid-19-public-health-emergency.pdf

 

COVID-19 CPT coding and guidance | American Medical Association (ama-assn.org)

Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19 | AHA

PPP Loans

SBA and Treasury Announce PPP Re-Opening; Issue New Guidance | U.S. Department of the Treasury


Physician Self-Referral

https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/index?redirect=/physicianselfreferral/

Self-Referral Disclosure Protocol

Changes Effective March 1, 2023

On December 28, 2022, the Office of Management and Budget approved revisions to the SRDP Disclosure Form and related forms that providers of services and suppliers must use in order to utilize the SRDP. The updated forms can be found here. Providers of services and suppliers must use the updated forms for disclosures submitted on or after March 1, 2023. The updated forms may be used for disclosures submitted prior to March 1, 2023.

https://www.cms.gov/medicare/fraud-and-abuse/physicianselfreferral/self_referral_disclosure_protocol


Quality Payment Program – MIPS/MACRA

MIPS Extreme and Uncontrollable Circumstances (EUC) exception application deadline extended until March 3, 2023

https://qpp.cms.gov/mips/traditional-mips

https://documents.cap.org/documents/2022-mips-clinical-quality-measures-guide.pdf

http://2022 Summary of Cost Measures – cms.gov

2020 Extreme and Uncontrollable Circumstances Fact Sheet.pdf

Quality Payment Program – MIPS

CMS Releases 2018 Quality Payment Program Performance Data

Posted 1/6/2020

Today, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 performance data for the Quality Payment Program. We announced the preliminary data earlier this year, and now we have released additional data elements that show significant success and participation in both the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) paths

We heard from you that this program was a big change for many clinicians and we worked with you to improve the program. Therefore, we are pleased to announce that clinician participation rates and success in QPP increased from 2017 to 2018.

2018 Performance Highlights

The final 2018 performance feedback data revealed:

  • 98% of eligible clinicians participated in MIPS in 2018— up from 95% in 2017
  • 98% of eligible clinicians exceeded the performance threshold score of 15 points to receive a positive payment adjustment— up from 93% in 2017
  • 356,353 clinicians participated in MIPS through APMs— up from 341,220 in 2017

Moving Forward

We continue with our commitment to building a program that is fully transparent and provides accurate information. We are also committed to continuing to provide the MIPS performance data points that, based on your feedback, will be most useful to you right now. Additionally, we plan to provide a comprehensive 2018 MIPS Experience Report in the coming months that documents national trends for MIPS eligibility, participation, and reporting.

For a complete breakdown of the 2018 performance data, please see our blog post and 2018 Quality Payment Program Performance Year Data Infographic.


Telehealth

Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

On May 9, 2023, ahead of the expiration of the COVID-19 Public Health Emergency (PHE), the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued the “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” —a temporary rule that extends telemedicine flexibilities adopted during the COVID-19 PHE.

Federal Register :: Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

DEA, SAMHSA Extend COVID-19 Telemedicine Flexibilities for Prescribing Controlled Medications for Six Months While Considering Comments from the Public | SAMHSA

 

New HIPPA Telehealth Regulations in 2023

Bottom Line: what does the May 11 end of HHS’s Telehealth HIPAA enforcement discretion mean?

Federal Register/Vol. 85. No. 77/Tuesday, April 21, 2020/Rules and Regulations

Under this Nonfiction, covered health care providers may use popular applications that allow for video chats, including Apple Face Time, Facebook Messenger video chat, Google Hangouts video, zoom, or Skype to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency. 1.       Since March 2020, providers have been allowed to use non-HIPAA compliant video chat applications to deliver telehealth services

2.       On May 11, 2023 this policy of “enforcement discretion” will end & HHS’s Office of Civil Rights (OCR) will resume enforcement of penalties on providers for noncompliance with HIPAA rules for telehealth technology use.

 

https://www.hipaajournal.com/new-hipaa-regulations/

OCR is providing a 90-calendar day transition period for covered health care providers to come into compliance with the HIPAA Rules with respect to their provision of telehealth. The transition period will be in effect beginning on May 12, 2023 and will expire at 11:59 p.m. on August 9, 2023

https://www.hhs.gov/about/news/2023/04/11/hhs-office-for-civil-rights-announces-expiration-covid-19-public-health-emergency-hipaa-notifications-enforcement-discretion.html?utm_source=newsletter&utm_medium=email&utm_campaign=name_ocr_cms_updates_auditing_for_compliance&utm_term=2023-04-11

 

 

Telehealth policy changes after the COVID-19 public health emergency

https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/policy-changes-after-the-covid-19-public-health-emergency/

https://www.cchpca.org/michigan/

MLN Booklet – Telehealth Services

Telehealth Qualification Area Link

List of Telehealth Services for Year 2022

http://www.cms.gov/Medicare/Medicare-general-information/telehealth/telehealth-codes

 


Human Resources

Two new laws are taking effect this year that protect pregnant employees at work, the PUMP for Nursing Mothers Act (otherwise known as the Pump Act) and the Pregnant Workers Fairness Act.

The Pump Act went into effect on December 29, 2022, providing additional protections for employees who need to express breastmilk. PUMP requires the vast majority of employers to provide a nursing employee with reasonable time to express breastmilk in a private location (other than a restroom) for up to one year after the nursing child’s birth.

https://www.dol.gov/agencies/whd/pump-at-work

https://www.eeoc.gov/wysk/what-you-should-know-about-pregnant-workers-fairness-act

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Transitional/Chronic Care Management

MLN Fact Sheet – Transitional Care Management Services

MLN Booklet – Chronic Care Management Services