As the Federal Communications Commission repeals the Open Internet Order—more commonly known as the net-neutrality rules—health care consumers and providers have been left wondering how this change will affect their ability to receive and deliver health care using digital health tools. In this On the Subject, we outline how changes in internet access will affect digital health and what the regulatory landscape will look like in the coming months and years.
China’s new data protection framework clearly creates a requirement for local storage and conducting a security assessment before personal information or important data is shared with other jurisdictions, but it is currently much less clear what types of entities fall under this requirement.
Localization and Transfer Assessment Requirements Related to CII Operators
Under the People’s Republic of China Network Security Law, also known as the Cybersecurity Law, personal information and important data collected and generated in the operation of critical information infrastructure operators (CII operators) is required to be stored in China and, before providing that information abroad, a security assessment is required to be passed. This new requirement caused a significant amount of concern for entities that fall within the category of CII operators because of the need to potentially restructure their data systems, but there was also a general appearance of acceptance within the business community due to the relatively targeted scope of the definition of CII operators and acknowledgement that critical infrastructures require elevated protections. (more…)
Disruption of traditional health care is inevitable and poses a central challenge for health care governance. While the size and complexity of the health care industry have slowed the process of business disruption, its high costs and lack of convenience make it highly vulnerable to innovative, nontraditional competitors.
To make sure boards are well-prepared to address this challenge, McDermott Will & Emery and Kaufman Hall have partnered on a new thought leadership series designed to help you identify the signs of disruption, learn how to prepare your organization, and understand the implications for health care governance.
Get critical insights on how to spot, prepare for and manage disruption in your organization now:
Subscribe to the Surviving Disruption podcast on iTunes, SoundCloud and Pocket Casts, and keep an eye on the Resource Center for Episode 2: The Path Through Disruption and Episode 3: A Governance Foundation, being released on December 27 and January 10.
The Centers for Medicare & Medicaid Services (CMS) reiterated its commitments to expanding access to telehealth services and paying “appropriately” for services that maximize technology in the Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program Final Rule published on November 15, 2017 (the Final Rule). Among many other developments, the Final Rule expands allowable telehealth reimbursement under the calendar year (CY) 2018 Physician Fee Schedule, List of Medicare Telehealth Services (list) and permits virtual sessions in certain circumstances under the Medicare Diabetes Prevention Program Expanded Model (MDPP, or the Program). The regulations are effective January 1, 2018.
“New” and “Add-On” Telehealth Services Slated for Reimbursement
CMS evaluates requests for the addition of telehealth services on the basis of two categories: (1) services that are similar to services already on the list and (2) services that are not similar to services already on the list. An evaluation of a category (2) service requires CMS to assess, based on the submission of evidence, whether the use of a telecommunications system to furnish the service “produces demonstrated clinical benefit to the patient.” (more…)
Although the Illinois Biometric Information Privacy Act has been on the books for almost 10 years, a recent surge in lawsuits has likely been brought on by developments in biometric scanning technology and its increased use in the workplace. At least 32 class action lawsuits have been filed in recent months by Illinois residents in state court challenging the collection, use and storage of biometric data by companies in the state. This could potentially cause a reevaluation of company strategies and development of new defenses in the use of advancing biometric technology.
Read “To Scan or Not to Scan: Surge in Lawsuits under Illinois Biometrics Law.”
In September, the Office of the National Coordinator for Health Information Technology (ONC) announced that it is scaling back requirements for third-party certification of criteria related to certified electronic health record (EHR) technology (CEHRT). Going forward, ONC will allow health developers to self-declare their products’ conformance with 30 of the 55 certification criteria.
ONC will also exercise discretion and not enforce the requirement that certification bodies conduct randomized surveillance of two percent of the health IT certifications they issue.
Read “ONC’s De-Regulatory Announcement Aims at Enticing Industry to Adopt 2015 Edition Criteria.”
Copyright 2017, American Health Lawyers Association, Washington, DC. Reprint permission granted.
The Electronic Health Records (EHR) Incentive Program run by Centers for Medicare and Medicaid Services (CMS) garnered attention again last week following the release of a report by the Office of Inspector General of the US Department of Health and Human Services (OIG) describing inappropriate payments to physicians under the program. The report follows on the heels of a high-profile settlement under the False Claims Act between the US Department of Justice and an EHR vendor related to certified electronic health record technology (CEHRT) used in the EHR Incentive Program (which we’ve previously discussed in-depth).
The OIG reviewed payments to 100 eligible professionals (EPs) who received EHR incentive payments between May 2011 and June 2014 and identified 14 inappropriate payments. OIG extrapolated the results of the review to the 250,470 total EPs who received incentive payments during that time period and estimated that CMS made approximately $729 million in inappropriate EHR incentive payments out of a total of just over $6 billion in such payments during the review period. (more…)
On March 23, 2017, the New York Attorney General’s office announced that it has settled with the developers of three mobile health (mHealth) applications (apps) for, among other things, alleged misleading commercial claims. This settlement highlights for mHealth app developers the importance of systematically gathering sufficient evidence to support their commercial claims.
After three government agencies collectively created an online tool to help developers navigate federal regulations impacting mobile health apps, McDermott partner Jennifer Geetter was interviewed by FierceMobileHealthcare on the need for mobile health development tools.
At a recent public workshop, Dr. Janet Woodcock, director of the U.S. Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research (CDER), announced plans to expand the agency’s use of the Sentinel infrastructure to conduct post-market effectiveness studies.
Sentinel is an electronic surveillance system that aggregates data from electronic medical records, claims and registries that voluntarily participate and allows the agency to track the safety of marketed drugs, biologics and medical devices. As of August 2015, the Sentinel database includes information from 193 million individuals, 4.8 billion instances of prescription dispensing, 5.5 billion unique encounters and 51 million acute inpatient stays.
The FDA currently uses the system to assess post-market safety issues. However, in a February 3, 2016, workshop, Dr. Woodcock announced that the FDA is in the early stages of adapting the Sentinel infrastructure to develop the “Guardian” system, which the agency intends to use to “actively gather information about the performance of regulated medical products” used in health care. At the same workshop, Dr. Steven Anderson of the FDA’s Center for Biologics Evaluation and Research (CBER) described the Guardian system as a parallel system to Sentinel that will rely on the Sentinel infrastructure to assess product effectiveness. According to Dr. Anderson, the FDA is currently assessing the feasibility of using Sentinel to perform effectiveness studies, and over the next five years, intends to develop the system to support a range of clinical trial designs.
The FDA envisions that the Guardian system will help the agency and external researchers quickly and less inexpensively answer questions about the performance of medical products that would otherwise require expensive, time-consuming clinical investigations to assess. The FDA did not specifically address how the agency intends to use the effectiveness data developed using the Guardian system.
The proposed Guardian system represents the FDA’s latest attempt to harness the power of “big data” and to participate in the changes precipitated by digital health strategies and tools to address FDA priorities. In 2014, the FDA launched its openFDA initiative, which gives the general public access to several of the agency’s public data sets (e.g., adverse event reports). Moreover, in December 2015, the FDA launched a beta version of its precisionFDA platform, which is an online, cloud-based platform that is intended to allow scientists from the public and private sectors to test, pilot and validate existing and new bioinformatics approaches for processing the large amounts of data collected using next-generation sequencing (NGS) technology.
The FDA’s efforts to launch the Guardian system mirror “big data” initiatives by other private and public stakeholders seeking to leverage data capture and data mining to pursue important public health, quality improvement, research and cost-containment efforts.
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