Category: Current Affairs

CMS Provides Billing Instructions for Opioid Treatment Programs (OTP) Telecommunications Add-On Codes

February 18, 2025

CMS Provides Billing Instructions for Opioid Treatment Programs (OTP) Telecommunications Add-On Codes

In the 2025 Final Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) finalized important updates for Opioid Treatment Programs (OTPs) aligning with regulations previously adopted by the Substance Abuse and Mental Health Services Administration (SAMHSA). These changes aim to enhance access to care for individuals with opioid use disorder (OUD) by expanding telehealth options.

Key Updates include:

  • Periodic assessments may now be conducted via audio-only technology on a permanent basis if live video is unavailable, as long as they meet all applicable SAMHSA and DEA requirements.
  • The OTPs intake add-on code (G2076) can now be billed when using live video for the initiation of methadone treatment.

As a result of these changes, CMS has updated its Opioid Treatment Program (OTP) webpage to reflect proper billing practices. OTPs should use the following HCPCS add-on codes when treating eligible patients:

  • G2076 – Used to initiate buprenorphine or methadone treatment via two-way interactive audio-video or audio-only technology when video is unavailable.
  • G2077 – covers periodic patient assessments via audio-only technology when video is unavailable.
  • G2080 – Applies to additional counseling or therapy provided via audio-only technology when video is unavailable.

For more details on the finalized policy, review the 2025 Final Physician Fee Schedule.

To learn more about billing and G-codes for OTPs, visit the CMS Opioid Treatment Program webpage.

Click Here to go to 2025 Final Physician Fee Schedule

Click Here to go to CMS Opioid Treatment Program webpage.

HHS Proposes Major Updates to HIPAA Security Rule to Strengthen Cybersecurity, Comments due March 7

February 18, 2025

HHS Proposes Major Updates to HIPAA Security Rule to Strengthen Cybersecurity, Comments due March 7

For the first time in two decades, the Department of Health and Human Services (HHS) has proposed significant updates to the HIPAA Security Rule to better protect electronic protected health information (ePHI) from increasing cyber threats. The Notice of Proposed Rulemaking (Proposed Rule) seeks to modernize security safeguards in response to a significant increase in large-scale healthcare breaches caused by hackers and ransomware between 2018 and 2023.

If enacted, the rule would require all HIPAA-regulated entities to:

  • Enhance cybersecurity practices, including maintaining an up-to-date inventory of technology assets,
  • Conducting annual risk analyses,
  • Implementing stronger patch management policies, and
  • Using multi-factor authentication.

Additionally, covered entities would be obligated to:

  • Encrypt ePHI,
  • Perform vulnerability scans and penetration testing, and
  • Ensure more rigorous oversight of business associates handling sensitive health data.

As remote care platforms manage vast amounts of ePHI, these new cybersecurity rules could significantly impact telehealth services.

The Proposed Rule also emphasizes stricter compliance documentation and monitoring, including mandating a 72-hour disaster recovery plan, annual compliance audits, and stronger incident response protocols. Notably, business associates would be required to notify covered entities of any contingency plan activation within 24 hours.

The proposed rule also seeks comments on emerging technologies such as artificial intelligence, quantum computing, virtual and augmented reality, and HIPAA’s role in regulating these emerging technologies.

Comments are due by March 7, 2025 and can be submitted through the federal register.

Click Here to Read More

New Fact Sheets from USDA

February 18, 2025

New Fact Sheets from USDA

The Economic Research Service (ERS) at the U.S. Department of Agriculture (USDA) regularly updates data on population, income, poverty, food security, education, employment/unemployment, farm characteristics, farm financial indicators, and agricultural exports for all states and includes breakouts for rural and metropolitan areas.

County-level Data Sets include poverty estimates, unemployment, and median household income. A separate ERS report examines the Trends and Patterns of Job Quality in the United States, including wages, employer sponsored health insurance coverage, and retirement benefits between 2000 and 2022.

Click Here to see County-level data sets

Click Here to see Trends and Patterns of Job Quality in the United States

DEA, HHS Finalize Expansion of Buprenorphine Treatment via Telemedicine

February 18, 2025

DEA, HHS Finalize Expansion of Buprenorphine Treatment via Telemedicine

The Drug Enforcement Administration (DEA) and the U.S. Department of Health & Human Services (HHS) are amending their regulations to expand the circumstances under which practitioners registered by the DEA are authorized to prescribe schedule III-V controlled substances approved by the FDA for the treatment of opioid use disorder via telemedicine, including an audio-only telemedicine encounter.

Under these new regulations, after a practitioner reviews the patient’s prescription drug monitoring program data for the state in which the patient is located, the practitioner may prescribe an initial six-month supply of such medications (split amongst several prescriptions totaling six calendar months) through audio-only means.

Click Here to Learn More

HIPAA Security Rule Notice of Proposed Rulemaking to Strengthen Cybersecurity for Electronic Protected Health Information, Comment by March 7

January 10, 2025

HIPAA Security Rule Notice of Proposed Rulemaking to Strengthen Cybersecurity for Electronic Protected Health Information, Comment by March 7

On January 6, 2025, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a proposed rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule to strengthen cybersecurity protections for electronic protected health information.

The proposal will strengthen the Security Rule’s standards and implementation specifications with new proposals and clarifications. This rule will impact hospitals, providers, health plans, and any other entity that use or transmit electronic protected health information. Comments are due by March 7, 2025.

Click Here to Read More and Make Comment

Application Now Open for Rural Community Hospitals to Participate in Demonstration Program

January 3, 2025

Application Now Open for Rural Community Hospitals to Participate in Demonstration Program

The Centers for Medicare & Medicaid Services (CMS) is now accepting new applications for the Rural Community Hospital Demonstration. The demonstration tests cost-based reimbursement for Medicare inpatient services for small rural hospitals with fewer than 51 beds that are not eligible to be Critical Access Hospitals.

As part of a broader rural strategy initiative, CMS hosted a Rural Health Hackathon in August 2024 to collaboratively produce creative, actionable ideas to address health care challenges facing rural communities. This Request for Applications (RFA) is one effort to help address these challenges.

The RFA is open and available on Rural Community Hospital Demonstration webpage. Hospitals interested must apply by 11:59 Eastern Standard Time on March 1, 2025. Hospitals currently participating in the demonstration do not need to complete a new application.

For the latest information on the demonstration, visit the Rural Community Hospital Demonstration webpage.

If you have questions about the demonstration, please email RCHDemo@cms.hhs.gov.

Public Comment Period Now Open: Screening for Cervical Cancer USPSTF Draft Recommendation, Draft Evidence Review, and Draft Modeling Report, Comment by January 13

January 3, 2025

Public Comment Period Now Open: Screening for Cervical Cancer USPSTF Draft Recommendation, Draft Evidence Review, and Draft Modeling Report, Comment by January 13

The U.S. Preventive Services Task Force recommends that women ages 21 to 65 get screened regularly for cervical cancer and seeks comments on the following documents:

  • Draft Recommendation statement
  • Draft Evidence Review, and
  • Draft Modeling Report.

Note the public comment period has been expanded from the standard four weeks to five weeks to account for the holidays. Comment by January 13, 2025.

To comment, click on the title of the draft document Here

Stroudwater Releases Physician Compensation Survey Results

December 31, 2024

Stroudwater Releases Physician Compensation Survey Results

The 2024 Rural Provider Compensation Report by Stroudwater Associates Principal Opal H. Greenway in partnership with the National Rural Health Association (NRHA) and the National Organization of State Offices of Rural Health (NOSORH) offers critical insights to help rural hospitals address these issues thoughtfully and strategically.

This report reflects input from 199 organizations across 42 states, representing more than 2,800 providers. The data highlights areas where rural hospitals must adapt to remain competitive and sustainable.

Click Here to Access the Full Report

Click Here to Sign up to Participate Next Year

Article: Why Hospital Violence is a Public Health Emergency

December 31, 2024

Article: Why Hospital Violence is a Public Health Emergency

A distressing 80 percent of emergency room doctors say violence has impacted patient care and safety where they work. Half of emergency physicians note they have witnessed harm to patients in the emergency department, and 47 percent report they themselves have been assaulted at work.

Since the pandemic, 44 percent of nurses report an increase in physical violence and 68 percent report an increase in verbal abuse. Additionally, health care violence prevention expert Kimberly Urbanek recently discussed ways to reduce violence, protect workers, and empower staff.

Click Here to Read Article: Hospital Workplace Violence is a Public Health Emergency

Click Here to Read Article: Taking a Proactive Approach to Reducing Violence in Healthcare

Medicare Advantage Value-Based Insurance Design (VBID) Model to End after Calendar Year 2025

December 20, 2024

Medicare Advantage Value-Based Insurance Design (VBID) Model to End after Calendar Year 2025

The Centers for Medicare & Medicaid Services (CMS) announced the Medicare Advantage (MA) Value-Based Insurance Design Model (VBID) is ending on December 31, 2025.

CMS is ending the model due to negative financial performance. Through the model, participating MA plans have had greater flexibility in serving high needs and underserved beneficiaries, and many of the lessons learned from the model have been incorporated into the MA program as a whole. Upon the model’s end, some beneficiaries in VBID MA plans may need to select a new MA plan or go back to traditional Medicare in 2026.

Click Here to Learn More