Some Helpful Managed Care Guidance Provided in Advisory Opinion 18-11

Granston Memo

Practitioners in the Medicare or Medicaid managed care space place heavy reliance on the protection of the Anti-Kickback Statute (AKS) Safe Harbor found at 42 C.F.R. § 1001.952(t), generally known as the “EMCO [eligible managed care organization] Safe Harbor,” as they look at incentive arrangements between providers and managed care plans. Although the language of the regulation is generally understood, there has not been any guidance from HHS’s Office of the Inspector General (OIG) since the publication of the final rule containing the safe harbor.

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FDA’s Response to HHS’ Revised Common Rule: Four Things to Know

drug testing

In a final rule published on January 19, 2017, HHS and several federal departments and agencies made revisions to the Common Rule, the federal policy for the protection of human subjects applicable to human subject research conducted or supported by participating federal departments and agencies.[1]  Compliance with the revised Common Rule is expected on January 21, 2019.[2]

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Understanding Medicare’s New Remote Evaluation of Pre-Recorded Patient Information (Asynchronous Telemedicine)

medicaid

Starting January 1, 2019, the Medicare program will cover certain medical services delivered via asynchronous telemedicine technologies. The Centers for Medicare and Medicaid Services (CMS) just published the final rule for the 2019 Physician Fee Schedule, introducing a new code, officially titled Remote Evaluation of Pre-Recorded Patient Information” (HCPCS code G2010). This article provides the top 10 things to know about the new code and explains how it will work.

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Top 10 FAQs on Medicare’s Virtual Check-In Codes: The New Brief Communication Technology-Based Service

medicaid

Telemedicine providers rejoice: Medicare will cover new virtual care services starting January 1, 2019.  The Centers for Medicare and Medicaid Services (CMS) just published the final rule for the 2019 Physician Fee Schedule, introducing a new code: Virtual Check-Ins, officially titled “Brief Communication Technology-Based Service” (HCPCS code G2012).  This article discusses the new code and explains how it will work.

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Medicare Remote Patient Monitoring Reimbursement FAQs:   Everything You Need to Know About Chronic Care Remote Physiologic Monitoring Codes 

monitoring

Remote Patient Monitoring (RPM) is the next big thing in medical care; patients just don’t know it yet.  And, it seems, neither do many physicians.  On Thursday, CMS published the final rule on its new RPM codes, officially titled “Chronic Care Remote Physiologic Monitoring.”  There are three new RPM codes, all of which will go live starting January 1, 2019.  These codes incentivize providers to effectively and efficiently use RPM technology to monitor and manage patient care needs.  

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