On May 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) published final rule CMS-9115-F known as the Interoperability and Patient Access final rule. “This final rule is the first 
phase of policies centrally focused on advancing interoperability and patient access to health information.” 85 Fed. Reg. 25511. CMS states that this rule “puts patients first by giving them access to their health information when they need it most, and in a way they can best use it.” Policies and Technology for Interoperability and Burden Reduction, CMS.gov. The rule requires coordinated communication between patients, providers, and payers. These changes largely require the use of improved and updated technology, and CMS provides implementation support here. Although many of the requirements under the final rule went into effect on January 1, 2021, because of the hardships posed by COVID-19, “CMS will not enforce these requirements until July 1, 2021.” Id.
Payors carry the brunt of this regulatory change. Without detailing all requirements under the rule, a few are as follows. CMS-regulated payors must maintain a secure, standards-based application programming interface (API) that will support the exchange of patient electronic health information (“EHI”). These payers must also maintain a patient-facing API allowing patients to access their EHI, including information about claims and costs, and make provider directory information publicly available through an API. Further, payors are required to implement a process for exchanging data, which is not required until January 1, 2022.
Governed hospitals will soon have a duty to send event notifications of a patient’s hospital “admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner” to “improve care coordination.” Interoperability and Patient Access Fact Sheet, CMS.gov (Mar. 9, 2020). CMS-regulated providers are encouraged to register all interoperability digital contact information through the National Plan and Provider Enumeration System (NPPES). A list of providers who fail to do so will be publicly available as a way to incentivize compliance. Landi, H., CMS’ New Interoperability Rule Requires Major Changes for Payers, Hospitals. Here are 6 Key Elements, Fierce Healthcare (Mar. 9, 2020).
scope of practice for chiropractors in Georgia. As mentioned in the last post, the main rules covering the practice of chiropractors in Georgia are found in Title 43, Chapter 9 of the Georgia Code. To begin to understand the scope of practice of a Georgia chiropractor, there are three main code sections we look to: O.C.G.A. § 43-9-1, 43-9-12.1, and 43-9-16.
chiropractors are not governed by the Georgia Composite Medical Board (“GCMB”). See O.C.G.A. §§ 43-34-22, 43-9-2. Rather, the chiropractic rules are found in Title 43, Chapter 9 of the Georgia Code, which create the Georgia Board of Chiropractic Examiners (“GBCE”). During our 2020 holiday blogging, we blogged about the GCMB (“
adverse licensure
either a state or federal court. Generally speaking, cases begin at the trial court level; in Georgia, that is State or Superior Court or, if federal, District Court. The cases proceed and the judge or a jury makes a decision on the merits of the case. But what happens if the decision is adverse to your position? What is your recourse? The answer generally is to appeal the decision. This post outlines the basic steps and requirements around appealing a decision or ruling from a Georgia Superior Court.
client’s mind when evaluating employment opportunities: “Am I responsible for paying for tail insurance coverage?” As a healthcare and business law firm, we routinely assist physicians in negotiating terms of employment agreements. Through our experience, we have developed tactics for negotiating compromises to the structure of tail insurance coverage agreements, and, herein, we share those tactics.
arisen. 
contracts, it is easy for the entity name to be mistyped, written in an abbreviated or well-known form, or somehow written incorrectly, especially for those individuals operating many similar entities. There is generally no substantial penalty for such an error, however, it can cause unnecessary trouble should a contract dispute arise, including placing the rights, duties, and liabilities under the contract on the individual who signed as the nonexistent entity. This post intends to alert our business readers of this easily avoidable pitfall and provide an overview of how Georgia courts handle such situations.
laboratories. A compliance question faced by many of our clients, particularly those who conduct COVID-19 testing, is how to properly maintain and share patient records. Herein, we note some of the rules around retaining and sharing patient records under Georgia law for clinical laboratories.
outlining the mission and purpose of the business, the next step for our