Mid-Atlantic Health Law TOPICS

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Did You Know?

Teletherapy: Did you know that the Maryland Health Care Commission has awarded a grant for school-based teletherapy for special education services to Charles County Public Schools? A maximum of $200,000 in funding will be provided to Charles County Public Schools to increase access to qualified service providers via teletherapy. Charles County Public Schools plans to partner with a technology vendor to connect middle and high school students with special education needs to Maryland-licensed, speech-language pathologists via teletherapy.

PRRB Rules: Did you know that the Provider Reimbursement Review Board (PRRB) has announced changes to the rules governing its appeals (Rules), effective immediately for existing and future appeals. The PRRB is an independent panel to which a Medicare Part A provider may appeal if dissatisfied with a final determination by a medicare administrative contractor after its review of the provider’s annual cost report. The most significant changes to the Rules include: (1) the implementation of electronic filing; (2) the requirement to file a complete preliminary position paper; and (3) legal authority and guidance for appealing issues that were included as protested amounts on a provider’s cost report.

Radiology Documentation: Did you know that effective January 1, 2020, ordering professionals must consult applicable appropriate use criteria when ordering imaging services, and furnishing professionals must report applicable use criteria (AUC) consultation information, on Medicare claims? AUC are defined as evidence-based criteria that assist ordering and furnishing professionals in making the most appropriate treatment decision for a specific clinical condition. The AUC information will be communicated to professionals through clinical decision support mechanisms (CDSMs). CDSMs are interactive, electronic tools available through electronic health record technology. The year 2020 will be an educational and operations testing period, meaning AUC consultation information is expected to be reported on claims, but claims will not be denied for failure to include proper AUC consultation information.

Barry Rosen
410-576-4224 • brosen@gfrlaw.com


June 17, 2019




Rosen, Barry F.


Health Care