CMS has released their proposed disclosure requirements for In-Office Ancillary Services (IOAS) Exception. Section 1877 of the Act or the physician self-referral law (Stark) prohibits a physician from making referrals for certain “designated health services” (DHS) payable by Medicare to an entity with which he or she has a financial…
CMS has released the proposed physician fee schedule and other Medicare Part B payment policies to ensure their payment systems reflect the changes in medical practice and relative value services. This update also addresses certain provisions of both the Affordable Care Act and Medicare Improvements for Patients and Providers Act…
The Medicare Payment Advisory Council (MEDPAC) recently delivered its 2010 report to Congress. The report entitled “Report to the Congress: Aligning Incentives in Medicare,” addressed the in-office ancillary services (IOAS) exception to the Stark Law, which allows physicians to provide most DHS services to patients in their own offices under…
On June 14, 2010, CMS published a report entitled, “The Medicare Recovery Audit Contractor (RAC) Program: Update to the Evaluation of the 3-Year Demonstration Program.” This report contains statistics through March 9, 2010 and includes updated appeals data. The new report reveals a much lower number of appeals than had…
The U.S. Food and Drug Administration (the “FDA”) has announced in a press release that the agency and other regulatory representatives will participate in a one day workshop entitled “Indentifying Unmet Public Health Needs and Facilitating Innovation in Medical Device Development.” Dr. Jeffrey E. Shuren, director of the Food and…
Wisconsin Physician Services (an existing Medicare Carrier and Medicare Administrative Contractor) issued a reminder today on its website for providers concerning the new deadlines for Medicare claims submission. The CMS Medlearn matters article dated May 7, 2010 and effective January 1, 2010 on the subject provides specific details relative to…
According to a press release of the Department of Justice dated June 14, 2010, a Texas management physician, Dr Anthony Francis Valdez, was arrested and stands charged with carrying out an estimated $41 million fraudulent health care benefit program billing scheme. Valdez is the owner of the Institute of Pain…
On June 7, 2010, the U.S. District Court for the Western District of Oklahoma held that a Department of Health and Human Services (HHS) regulation, 42 C.F.R. § 418.309(b), implementing a statutory cap on Medicare payments for hospice care was invalid and must be set aside (Compassionate Care Hospice v.…
Detroit and Wayne County leaders are attempting to convince federal authorities to provide $20 million over the next five years to build at least 10 more community health centers. Although Detroit and Wayne County rank among of the nation’s highest poverty and unemployment rates, the area has only 24 federally…
On June 19, 2010, the Senate unanimously passed legislation, known as the “doc fix”, sparing doctors a 21% cut in Medicare payments until November 30, 2010. However, moments after the Senate acted, Medicare announced it would begin processing claims it has already received for June at the lower rate, which…