Centers for Medicare and Medicaid published an interim final rule on May 5, 2010, that begins implementation of certain provisions of the Patient Protection and Affordable Care Act (PPACA) relating to Medicare and Medicaid program integrity. The regulations, with a comment period ending on July 6, 2010 (the effective date…
The Office of the Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) issued a report this month showing that program safeguard contractors (“PSCs”) have not resulted in significant recoveries to the Medicare program. PSCs are intended to detect and deter fraud and abuse in Medicare, by…
Compliance continues to be a hot topic given the continued increase in enforcement, audits and other aspects of health care reform. On May 7, 2010, the Office of Inspector General (OIG) posted on its website an excerpt from a keynote address that the Inspector General for the Department of Health…
On May 7, 2010, the Office of Civil Rights (OCR) issued guidance on the risk analysis requirement of the HIPAA Security Rule. Many providers have not paid close attention to the actual requirements of the HIPAA Security Rule. In addition to covered entity providers that must comply with the security…
On April 29, 2010, the U.S. Sentencing Commission issued new amendments to the standards for, and criteria included in, an “Effective Compliance and Ethics Program” in the Federal Sentencing Guidelines. These amendments have important implications for all corporate health care providers. For more information on corporate governance and effective compliance…
Despite efforts by the federal government to boost the ranks of primary-care physicians, an overwhelming number of physicians are choosing specialties other than internal medicine, and research has shown that internists leave the field mid-career at a much higher rate than other specialties. As a result, the shortage of primary-care…
The HIPAA Privacy rule currently provides the right of an individual to receive an “accounting of disclosures,” essentially a listing, of occurrences where a HIPAA covered entity has disclosed the individual’s information to others–but this rule has not considered disclosures made for treatment, payment, and health care operations information that…
Effective May 1, 2010, physicians, IDTFs and other Part B Suppliers furnishing Non-invasive Vascular Testing in Michigan must comply with new training and certification requirements. In part, the policy, as set forth in a new LCD, states: A. Training and Certification 1. The accuracy of non-invasive vascular diagnostic studies depends…
The recently passed health care reform bill–known more technically as the Patient Protection and Affordable Care Act–contains a provision bound to increase enforcement regimes for health care providers. For instance, at Section 6401(a)(7), the Act creates mandatory compliance programs for providers enrolled in Medicare and Medicaid. The Secretary of Health…
A recent New York bill, S04998, clarifies the scope of practice for physician assistants. Specifically, it authorizes physician assistants to perform medical services that the physician is otherwise authorized to perform, if the physician is supervising the physician assistant, and if the physician assistant has the necessary training to perform…