The appeals backlog has taken a toll not only on appellants, but also the Office of Medicare Hearings and Appeals (OMHA), tasked to adjudicate the appeals. The appeals submission and document management processes are overdue for an upgrade in order to keep up with OMHA’s substantial workload. The new system to be put into place […]
On Thursday, April 24, 2015, the Michigan House of Representatives’ Insurance Committee passed a bill to reform Michigan’s No-Fault law and sent it to the House floor for a vote. The bill (SB 248) will have significant negative changes for No-Fault reimbursements for health care providers in Michigan. As currently proposed, the bill will cap […]
Section 1128J(d) of the Social Security Act (the “Act”) requires providers and suppliers who have received an overpayment from the Federal health care programs to report and return the overpayment within 60 days of identifying the overpayment or by the date any corresponding cost report is due, whichever is later. The Centers for Medicare and […]
House Speaker John Boehner and Minority Leader Nancy Pelosi announced yesterday that they agreed to advance a bill to permanently fix the payment system for Medicare physicians. Details of the bill have yet to be released, but multiple news agencies are reporting that Boehner and Pelosi agreed to a $210 billion deal that would replace […]
In an effort to combat and draw attention to the seriousness of Bullying, OCMS partnered with Marlene Seltzer, MD, Director of the Beaumont Children’s Hospital NoBLE Anti-Bullying Program and Rob Iwrey, Esq. (and staff) at The Health Law Partners, P.C., to develop informational materials that would assist physicians in recognizing the signs of bullying and […]
On January 22, 2015, in the case of Barrows v. Burwell, No. 3:11-cv-1703, 2015 WL 264727 (2nd Cir., January 22, 2015), the United States Court of Appeals for the Second Circuit ruled that Medicare beneficiaries be granted the opportunity to demonstrate a Constitutionally-protected property interest to challenge their patient status designations as hospital outpatients rather […]
Health care providers across the country are still adapting to the unprecedented disclosure of health care information that is associated with the government’s effort create a more transparent health care system. As many providers recall, in April, 2014, the Centers for Medicare & Medicaid Services (“CMS”), which administers the Medicare program, publicly released detailed data […]
The government recently took the unusual step of filing an amicus brief in a civil case involving Stark Law and Anti-Kickback Statute (“AKS“) issues. See, Ameritox, Ltd. v. Millennium Laboratories, Inc., Case No. 14-14281 (U.S. Court of Appeals for the 11th Circuit). The amicus brief provides insight into – and clarification of – the government’s […]
On January 20, 2015, the Food and Drug Administration (“FDA”) published two draft guidance documents that revealed its way of thinking on the regulation of low risk general wellness products and regulation of medical device accessories. Broadly speaking, the proposed guidance indicates that the FDA will not regulate low risk products intended only for general […]
According to a new report from the Office of Inspector General (“OIG”) published on January 13, 2015, the OIG is concerned with the financial incentives created by the current Medicare payment system with regard to hospice beneficiaries in assisted living facilities. For example, hospices received significantly higher Medicare payments for beneficiaries in assisted living facilities […]
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