By Allison Shelton and Beth Anne Jackson, Brown & Fortunato, P.C. . Recent pronouncements from the Centers for Medicare and Medicaid Services (CMS) produced considerable uncertainty regarding Medicare coverage of shared and split evaluation and management (E/M) visits in the hospital setting. Effective May 9, 2021, CMS removed manual provisions setting forth a billing and payment policy that has been in place for nearly twenty years. Subsequently, on May 26, 2021, CMS issued a notice...

By Rossanna Howard and Allison Shelton, Brown & Fortunato, P.C. In 2018, the Centers for Medicare & Medicaid Services introduced new CPT Codes for remote physiologic monitoring (RPM).  The purpose of the RPM codes, generally, is to allow providers to bill for time spent monitoring and managing patients using medical devices that are capable of storing and transmitting physiologic data.  Such data may include the patient’s blood pressure, weight, pulse oximetry, and respiratory rate flow....

By Allison Shelton and Beth Anne Jackson, Brown & Fortunato, P.C. Physician supervision of certified registered nurse anesthetists (CRNAs) was the topic of a recent opinion from the Texas Attorney General (AG). In Opinion No. KP-0353, AG Ken Paxton addressed whether the Texas Medical Practice Act requires a physician to supervise a CRNA to whom the physician delegated the administration of anesthesia. The Texas Medical Practice Act governs the practice and license of physicians and...

By Beth Anne Jackson and Allison Shelton, Brown & Fortunato, P.C.   In its January opinion in Aguiluz v. Univ. of Tex. Health Sci. Ctr. at San Antonio, the United States District Court for the Western District of Texas, denied the motions of the University of Texas Health Sciences Center – San Antonio (UTHSCSA) to dismiss the retaliation and other claims of Dr. Cesar Aguiluz, a graduate of its surgical residency program.  The court’s opinion...

By Allison L. Davis and Brittany K. Hinton, Brown & Fortunato, P.C. On December 16, 2020, the United States Equal Employment Opportunity Commission (EEOC) published new guidance concerning mandatory vaccinations in an updated version of What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. In the article, the EEOC analyzes potential disability discrimination implications of employers requiring their employees to receive SARS-CoV-2 (“COVID-19”) vaccinations as a condition of...

By Allison Shelton and Beth Anne Jackson, Brown & Fortunato, P.C. On December 29, 2020, the D.C. Circuit Court of Appeals issued a decision that effectively upholds the Hospital Price Transparency Rule.  Meanwhile, the Centers for Medicare and Medicaid Services (CMS) signaled its intent to actively enforce the rule. Accordingly, as of January 1, 2021, hospitals are expected to have a public website that displays pricing information for inpatient and outpatient items and services furnished...

By Beth Anne Jackson and Allison Shelton, Brown & Fortunato, P.C. In the December 2, 2020 issue of the Federal Register, the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) published significant changes to the Physician Self-Referral Law (Stark) and Anti-Kickback Statute (AKS) rules. These changes added protections for value-based care arrangements and altered some fundamental tenets of the rules. The revised rules will affect a wide variety of...

By Beth Anne Jackson and Allison Shelton, Brown & Fortunato, P.C.   Since the Office for Civil Rights (OCR) announced its first enforcement action under the Right of Access Initiative in September 2019, nine providers have settled allegations that they failed to provide patients with copies of their medical records in a timely manner. Seven of those settlements have been announced since September 2020, indicating that the COVID pandemic will not stop OCR’s enforcement efforts....

By Allison Shelton and Beth Anne Jackson, Brown & Fortunato, P.C. On September 2, 2020, the Texas Court of Appeals for the Fourth District in San Antonio issued an order protecting a surgeon’s email from disclosure in a civil suit against a hospital. The appellate court determined that the email was protected by the peer review privilege and was, therefore, not subject to discovery. The peer-review privilege is designed to allow for candid and frank...

By  Beth Anne Jackson and Monique Pena, Brown & Fortunato, P.C. The Public Health and Social Services Emergency Fund for provider relief (the Provider Relief Fund) of the CARES Act is currently concluding its second phase of General Distribution funding. The deadline to apply had been extended to September 13, 2020. As most providers are aware, after each payment from the Provider Relief Fund, providers must attest to compliance with the terms and conditions of...