Health Law

Published on: March 12, 2013 | by The Health Law Partners

CMS Updates Manual Regarding Payment for Medical or Surgical Services Furnished by CRNAs

On March 8, 2013, the Centers for Medicare and Medicaid Services (“CMS”) issued Transmittal 2668 (Change Request 8180) to Publication 100-04 (Medicare Claims Processing), rescinding and replacing Transmittal 2634 (January 11, 2013). Transmittal 2634 provided clarifications in the manual language to reflect revisions to 42 C.F.R. § 410.69. The newly-released Transmittal 2668 maintained all changes […]

Continue Reading →

Published on: March 12, 2013 | by The Health Law Partners

HHS Slightly Increases Interest Rate on Overpayment Debts/Underpayments Owed Providers

The Department of Health and Human Services (“HHS” or the “Department”) has marginally raised the interest rate on overpayment debts owed to the Department. HHS published notice of the newly certified interest rate for the quarter ended December 31, 2012 in the Federal Register on March 5, 2013. The new rate, 105/8%, represents a ¼% […]

Continue Reading →

Published on: March 7, 2013 | by The Health Law Partners

Abby Pendleton, Esq to Speak at The American Academy of Orthopaedic Surgeons Annual Meeting

Abby Pendleton, Esq. will be co-speaking with Jack Bert, M.D. and Ranjan Sachdev, M.D. MBA, CHC on March 19, 2013 at the American Academy of Orthopaedic Surgeons Annual Meeting in Chicago. They will be presenting on the topic “Compliance 2013- What You Need to Know”. Continue Reading →

Continue Reading →

Published on: February 26, 2013 | by The Health Law Partners

Highlights From Leon Rodriguez, Executive Director of OCR’s, Speech at ABA’s EMI Conference in Miami

To view this article, please click here. Continue Reading →

Continue Reading →

Published on: February 25, 2013 | by The Health Law Partners

OIG Report Discusses Inadequacy of CMS’ Collection of Medicaid Overpayments

On February 19, 2013, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) published OIG Report A-05-11-00071 (the “Report”), detailing the results of an audit to determine the adequacy of CMS’ collection of Medicaid overpayments identified in certain OIG audit reports. Under federal regulations (specifically 42 C.F.R. § 433.304), the Secretary […]

Continue Reading →

Published on: February 4, 2013 | by The Health Law Partners

Michigan Pharmacist Sentenced to 17 years for Medicare Fraud

On February 1, 2013, 50-year-old Canton pharmacist, BABUBHAI “Bob” PATEL, was sentenced today to 17 years in prison for his 26 convictions for health care fraud conspiracy, drug conspiracy, and related fraud and drug violations. During his 6-week trial which ended in August 2012, Mr. Patel’s pharmacies were found to have billed Medicare, Medicaid and […]

Continue Reading →

Published on: February 1, 2013 | by The Health Law Partners

New Jersey Hospital Settles Anti-Kickback Qui Tam Case for $12.5 Million; Case Alleged Cardiologists Were Compensated $18,000 Per Year to Serve on Advisory Board That Was Actually Tied to Patient Referrals

On January 24, 2013, the U.S. Attorney’s Office for the State of New Jersey unsealed a $12.5 Million Dollar settlement with Cooper Health System, headquartered in the Camden, New Jersey area, but serving regions of New Jersey, Pennsylvania and Delaware. The settlement was the result of cardiologist Nicholas DePace’s whistleblower qui tam lawsuit, which alleged […]

Continue Reading →

Published on: February 1, 2013 | by The Health Law Partners

Michigan Podiatrist Sentenced to over 4.5 years for Medicare Fraud

On January 15, 2013, Richard Behnan, DPM., a 56 year old podiatrist from Fenton, MI was sentenced by a federal judge to 55 months in prison and ordered to pay over $1.4 million in restitution to Medicare and nearly $200,000 to BCBSM for his participation in a $1.6 million fraudulent medical billing scheme. Dr.Behnan previously […]

Continue Reading →

Published on: January 17, 2013 | by The Health Law Partners

The Office for Civil Rights has just released the long awaited HIPAA “Omnibus Rules”

Stay tuned for many further developments – The Health Law Partners will be providing numerous valuable educational resources for its clients. The announcement and links are below. January 17, 2013 The U.S. Department of Health and Human Services (HHS) has announced a new rule to strengthen the privacy and security protections for health information established […]

Continue Reading →

Published on: January 15, 2013 | by The Health Law Partners

CMS Transmittals: Medicare Claims Processing Manual, 100-04, Trans. No. 2634, January 11, 2013–Internet Only Manual (IOM) Update to Payment for Medical or Surgical Services Furnished by CRNAs. This CR rescinds and fully replaces CR 8027, (Jan. 15, 2013)

CMS released Transmittal No. 2634 to update the Medicare Claims Processing Manual in connection with the changes to payment for medical and surgical services furnished by CRNAs. In particular: 140.4.3 – Payment for Medical or Surgical Services Furnished by CRNAs (Rev.2634, Issued: 01-11-13, Effective: 01-01-13, Implementation: 02-12-13) B3-16003.H Payment shall be made for reasonable and […]

Continue Reading →