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CMS Delays PECOS

On November 23, 2009, CMS sent a notice delaying implementation of its registration requirements for the Medicare Provider Enrollment, Chain and Ownership System (PECOS) which affects physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers, providing…

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2010 Home Health PPS Final Rule Addresses Program Integrity Issues

On November 10, 2009, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Home Health Prospective Payment rates for the 2010 calendar year (the “Final Rule”). The Final Rule continues with the previously promulgated 2.75 percent reduction to the home health prospective payment…

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Physician Tax? No, Thank You

Governor Granholm’s proposal to impose the Quality Assurance Assessment Program (“QAAP”) fee (A.K.A tax) on physicians–HB 5386–was defeated in the Michigan Senate by a 32-4 vote on Wednesday, October 28. The bill proposed that “the Department shall assess and collect a quality assurance assessment on physicians…at a rate of 3%…

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Part B Physicians Must Sign Dictated Medical Records

Wisconsin Physician Services (WPS) issued guidance yesterday clarifying the importance of physician signatures on dictated notes, which emerged as a national issue identified by the Comprehensive Error Rate Testing Program (CERT). Regardless of whether dictation is given directly to a scribe, or via an electronic recording that is then transcribed,…

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Red Flags Exceptions Passed in House

Representative John Adler’s proposed Red Flags exceptions–H.R. 3763–passed in the House on October 23. Passing with a 400-0 vote, the bill exempts small businesses with 20 or fewer employees that meet certain requirements. The bill will next be sent to the Senate for vote. Notwithstanding this legislation, the Red Flags…

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Bill Introduced to Exempt Category of Small Businesses from Compliance with Red Flags Rule

Representative John Adler introduced H.R. 3763 on October 8 to amend the definition of “creditor” in the Fair Credit Reporting Act to reflect the following exclusions: (A) a health care practice with 20 or fewer employees; (B) an accounting practice with 20 or fewer employees; (C) a legal practice with…

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$8.3 Million Settlement between University of Medicine and Dentistry of New Jersey Alleging Stark and Anti-Kickback Violations

Alleging False Claims Act, Stark Law, and Anti-Kickback violations, the University of Medicine and Dentistry of New Jersey (UMDNJ) settled with the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) for $8.3 million–double what Medicare paid for the allegedly improper referrals. UMDNJ is licensed as…