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IRS To Honor Medical Resident FICA Refund Claims

The Internal Revenue Service (the “IRS”) recently published News Release IR-2010-25 (the “Release”) announcing that it made an administrative determination to accept the position that medical residents are excepted from FICA taxes based on the student exception for tax periods ending before April 1, 2005 (the “4/1/05 Rule Change Date”),…

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RAC Vendor For Region D Removes Anesthesia Care Package Issue from Approved List

In a recent development for the anesthesia community, HealthDataInsights (“HDI”), the RAC for Region D, removed the anesthesia care package issue from its approved issues list. In January of 2010, the RAC vendor posted the following issue: Under NCCI Edit rules, the anesthesia care package consists of preoperative evaluation, standard…

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CMS’s Deletion of “Purchased Interpretations” Causes Problems for Certain Out-of State teleradiology arrangements: Imaging Centers Billing for out-of-State interpretations can Expect Claim Denials

Effective March 15, 2010, pursuant to CMS’s update to the Medicare Claims Processing Manual addressing “Payment to Physician or Other Supplier for Diagnostic Tests Subject to the Anti-Markup Payment Limitation”, among other actions, The Centers for Medicare and Medicaid Services (“CMS”) has effectively eliminated an Independent Diagnostic Testing Facility’s (“IDTF’s”)…

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Impact of the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872)

On March 23, 2010, President Barack Obama signed the Health Care and Education Affordability Reconciliation Act of 2010 (the “Act”) into law. As is evident, barring any legal challenges that require a reconfiguration of the law, the Act will have a profound effect upon the business of medicine. By January…

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Final Interim Rule: Electronic Prescriptions for Controlled Substances

The DEA recently published its Final Interim Rule regarding Electronic Prescriptions for Controlled Substances. This Rule comes almost two years after the DEA published a Notice of Proposed Rulemaking to revise its regulations to allow the creation, signature, transmission, and processing of controlled substance prescriptions electronically (73 FR 36722). The…

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Get Ready: The RAC Program Soon May Be Expanding

As Medicare providers and suppliers are acutely aware, the Centers for Medicare and Medicaid Services (“CMS”) has determined that the use of Recovery Audit Contractors (“RACs”) is a “cost-effective” way to identify and correct improper payments, in part as a result of the contingency-fee-based structure of using these auditors. Primarily…