This month, the Office of Inspector General published its report of the activities and results of the Health Care Fraud and Abuse Control Program for 2009. A few highlights from the report include: 1014 new criminal health care investigations opened, 583 fraud-related convictions concluded, and Continue Reading →
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 for the regulations) include changes […]
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 those tasks. These medical services […]
Meaningful use of electronic health records (EHR) technology has recently been expanded to include physicians providing services in outpatient facilities, according to the Continuing Extension Act of 2010. Initially, Congress had intended that only those physicians who purchased and implemented EHR technology would be eligible for the incentive payments, which would leave hospital-based physicians without […]
The Continuing Extension Act of 2010 was signed into law on April 15. This law reinstates the March 31 Medicare Physician Fee Schedule (Fee Schedule) rates for physicians, postponing, yet again, the anticipated-21.3% cut. The zero percent (0%) update to the Fee Schedule has been extended to May 31 will apply retroactively to claims that […]
Pursuant to the healthcare reform bill that was signed into law by President Obama on March 23, 2010 (“the Patient Protection and Affordable Care Act” or “the Act”), physicians who furnish MRI, CT or PET tests within their practices for their patients are now required to provide their patients with a written disclosure at the […]
The Feds joined a False Claims Act lawsuit against Satilla Regional Medical Center, a Georgia Hospital. The lawsuit, filed by a nurse in 2007, alleges that the hospital allowed an unqualified physician, Najam Azmat, to perform endovascular procedures, leading to the death of at least one patient and injuries to several others. The hospital, which […]
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 1, 2013, a national Medicare […]
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 Final Interim Rule provides practitioners […]
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 because of the program’s cost-effectiveness, […]
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