Weiss Zarett Brofman | Sonnenklar & Levy, P.C. | Attorneys At Law

High Quality Services And Personal Attention

StatLaw – August 2014

On Behalf of | Aug 1, 2014 | New York StatLaw

The Cost of High Deductibles on Patient Care: Rather than addressing patient questions about the benefits of procedures, tests, drugs and specialist referrals, doctors are now beginning to field questions about the cost and inherent necessity of procedures. Recent trends in healthcare coverage require patients to bear financial responsibility for more of their medical bills. That’s because a growing number of health plans have high deductibles that can exceed $5,000.00, high coinsurance rates, and limited or no coverage when patients seek care outside the plans’ narrow provider networks. Patients are becoming increasingly vocal about their out-of-pocket medical costs, which is one of the policymakers’ goal of making healthcare consumers more cost-conscious and potentially slowing the nation’s medical spending growth. This increased scrutiny, however, has a potential chilling effect on patient care. Doctors warn that too much cost sensitivity among patients can compromise their ability to provide the appropriate medical care, with potential harmful consequences if patients delay or skip necessary treatment for purely financial reasons.

CMS Reactivates Open Payments Website Registration: The CMS announced last week that its Open Payments website registration for physicians is back up after it had temporarily taken down registration the previous week after finding errors in its data. Currently, the website is intended to allow physicians to check payments data attributed to them and contest any perceived erroneous data. Doctors complained that the registration process was overly onerous, as the CMS has apparently reused a registration tool from HealthCare.gov despite the tool’s apparent failure there. The agency since has reportedly scrapped the tool. The website also was apparently not user-friendly once registered, with error messages and counterintuitive methods for challenging payments data. The agency has said the registration-and-dispute period will be adjusted by one day for each day the website was suspended. That means providers will now have an additional week to register and review this year’s tranche of data, with a 15-day correction period following that. That would push the new registration deadline to September 3, 2014. Notwithstanding the recent deactivation, the CMS is still on schedule to release data concerning medical device and pharmaceutical manufacturer payments to doctors available to the public September 30, 2014.

Effective March 27, 2015 electronic prescribing of controlled substances and non-controlled substances will be mandatory for all physicians and prescribers: According to regulations of the NYS Department of Health, the Commissioner of Health may grant a waiver from the requirement to use electronic prescribing upon a showing by the physician that his or her ability to issue an electronic prescription is unduly burdened by (a) economic hardship; (b) technological limitations that are not reasonably within the control of the physician or (c) other exceptional circumstances in support of the waiver. Any waiver granted by the Commissioner may not exceed one year. A physician would then need to apply for a renewal of a previously granted waiver. It is expected that NYS DOH will begin considering waiver applications later this year.

Effective March 27, 2015, physicians may issue electronic prescriptions for controlled substances in Schedules II through V: According to the NYS Department of Health, physicians may issue electronic prescriptions for controlled substances when (a) computer applications used by the practice meet federal security requirements; and (b) computer applications meeting federal security requirements are registered with the Department of Health, Bureau of Narcotics.