On September 23, CMS released its Voluntary Self-Referral Disclosure Protocol (“SRDP”) pursuant to Section 6409 of the Affordable Care Act (“ACA”), which “requires the Secretary of HHS to inform providers of services and suppliers of how to disclose an actual or potential violation pursuant to the protocol….” The new statutory…
On September 21, The Hill and the American College of Cardiology (“ACC”), hosted a discussion with Sen. Tom Coburn (R-OK), Rep. Brian Baird (D-WA), Dr. Ralph Brindis–the President of ACC–Dr. Jack Lewin, and Dr. John Tooker–the CEO of American College of Physicians (“ACP”) to discuss patient payment reform. While the…
Last week, CMS posted the Preview of the Proposed Rules, which will officially be released in Federal Register format and open for comments on September 23. The proposed rule focuses on implementing the Affordable Care Act (“Act”) that will, in part: • Establish screening procedures for suppliers and providers of…
On September 15, 2010, the US Department of Health and Human Services Inspector General Daniel Levinson testified before the House Subcommittee on Health of the House Committee on Energy and Commerce regarding Medicare’s coverage of DMEPOS suppliers. Stating that DMEPOS expenditures represented 2% of all Medicare expenditures–$10 billion–in 2009, Levinson…
On September 7th, the Joint Commission announced that, commencing in July 2011, the Joint Commission will extend the accreditation process of accrediting ambulatory health care organizations to those who choose the Primary Home option. “A Primary Care Home is a model of care whereby services are provided to patients by…
On September 8, 2010, the OIG released Advisory Opinion 10-14 regarding an arrangement in which a sleep lab management company (the “Requestor”) provides a Hospital sleep lab with all of the equipment, technology, supplies, and staff necessary to operate a sleep testing laboratory. No physicians have any ownership interest in…
Sleep Solutions, Inc. (“Sleep Solutions”)–a Maryland diagnostic service provider of in-home sleep tests–settled with the United States for $500,000 to settle claims that it violated the False Claims Act by submitting false claims to TRICARE and the Federal Employees Health Benefit Program. The United States contends that from February 2003…
The Federal Trade Commission (“FTC”), Centers for Medicare and Medicaid Services (“CMS”), and Department of Health and Human Services Office of Inspector General (“OIG”) have announced their plans to co-host an October 5th workshop on accountable care organizations (“ACOs”). According to a September 8th News Release, the workshop is intended…
CMS recently issued guidance on Section 2302 of the Patient Protection and Affordable Care Act–the 2010 healthcare reform law. “Section 2302 of the law amends sections 1905 (o)(1) and 2110(a)(23) of the Social Security Act to remove the prohibition of receiving curative treatment upon the election of the hospice benefit…
The OIG released Advisory Opinion 10-13 on August 31, 2010, concerning a proposed-arrangement where a hospital would be providing pre-authorization services for diagnostic imaging. Requestor, a non-profit hospital, provides diagnostic imaging services to patients. Because many commercial insurers have begun requiring pre-authorization prior to covering diagnostic imaging services, the hospital…