The Centers for Medicare and Medicaid Services (“CMS”) has released the final version of its 2014 Medicare Physician Fee Schedule (“MPFS”) that determines physician reimbursement for services furnished to Medicare beneficiaries. In addition to adjusting the various formulas that are used to determine payment amounts, the MPFS includes a number of changes to policies and […]
On December 2, 2013, the Office of Inspector General (“OIG”) published an advisory opinion in which it considered whether a charitable organization’s (the “Requestor”) proposal to provide monetary assistance, including Medicare premium assistance, to financially needy patients suffering from a rare genetic disorder (the “Disorder”) violated the Anti-Kickback Statute (“AKS”) or the prohibition on beneficiary […]
On November 21, 2013, the Office of Inspector General (“OIG”) published its Strategic Plan for 2014-2018. The Plan outlines the OIG’s vision for achieving its mission to protect the Department of Health and Human Services (“DHHS”) through a number of goals and priorities. The OIG intends to use the Plan as a guide when determining […]
On November 12, 2013, the Office of Inspector General (the “OIG”) released an unfavorable Advisory Opinion in response to an anesthesiology practice’s (the “Requestor”) inquiry. Specifically, the OIG found that a psychiatry group’s (the “Psychiatry Group”) proposal to pay the Requestor a per-diem rate for anesthesia services while keeping any difference from the amount billed […]
On Wednesday, October 23, 2013, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services released a report detailing its findings from a study it completed on the prevalence and use of devices supplied by physician owned distributors (“PODs”). The report, issued in response to a congressional request, used data […]
Michigan Attorney General Bill Schuette along with Steve Arwood, Director of the Michigan Department of Licensing and Regulatory Affairs, and State Senator Joe Hune, recently announced their plan to collaborate on a bill designed to strengthen Michigan’s regulation and oversight of compounding pharmacies. Compounding pharmacies have been under increased scrutiny in Michigan and nationally following […]
Jessica Gustafson, Esq. and Abby Pendleton, Esq., co-chairs of the firm’s Medicare and RAC department authored an ABA Health eSource article titled “The Latest Development in Medicare Audits: Supplemental MEdical Review Contractor (“SMRC”) Audits.” To view this article click here. The article discusses the Center for Medicare and Medicaid Services’s (“CMS’s”) recent addition of Supplemental […]
Abby Pendleton, Esq., Adrienne Dresevic, Esq., Carey Kalmowitz, Esq., Robert Iwrey, Esq., and Jessica Gustafson, Esq. were named Attorneys of The Month by Attorney At Law Magazine and were featured on the front page and on page 16 in, “Healthy Growth: The Health Law Partners Has Rapidly Become One Of The Industry’s Premier Health Care […]
Sleep testing is clearly on the Office of Inspector General’s radar. A recently released report by the agency identified nearly $17 million in questionable billing for PSG services. A lawyer analyzes the OIG’s report and provides recommendations you can implement today. In a report issued last week, the Office of Inspector General of the US […]
On October 15, 2013, the Office of Inspector General for the U.S. Department of Human Services (“OIG”) issued an Advisory Opinion favorable to a non-profit health services organization’s (“Requestor’s”) proposal to provide free dental screenings and services to uninsured children while billing Medicaid for the same services provided to children who were Medicaid beneficiaries. The […]
Health Law Attorney Blog