The Centers for Medicare & Medicaid Services (CMS) has officially requested comments from the physician community regarding policies and standards for accountable care organizations (ACOs) participating in the Medicare program under the Shared Savings Program or in connection with the Center for Medicare and Medicaid Innovation (CMMI). CMS’s request focuses on three areas of interest: […]
Effective January 1, 2011, the new Stark In-Office Ancillary Services Exception (the “IOASE”) provisions will require physicians or group practices relying upon the IOASE (collectively, “Physician Practices”) to furnish the following notice/disclosure to patients receiving MRI, CT, and PET (as identified on the Stark CPT/HCPCS Code list): • Written notice at the time of the […]
For the fourth time this year, the Senate approved a one-month patch that will delay a 23% cut in Medicare payments to physicians until January 1, 2011. The action, passed on Thursday, November 18, is a result of an agreement backed by chairman of the Senate Finance Committee, Max Baucus (D-Montana), and senior Republican Charles […]
Representatives Dingell (D-Mich.), Pete Stark (D-Calif.), and other representatives have introduced legislation to extend the current physician Medicare reimbursement rates for 13 months as well as to provide a 1% update for this year and next year. We will continue to keep our readers apprised of any future developments. Continue Reading →
In its November 3, 2010 release of the final 2011 Home Health Prospective Payment System (“2011 HHPPS”), the Centers for Medicare and Medicaid Services (“CMS”) updated its hospice recertification requirement. Beginning January 1, 2011, the Affordable Care Act requires that physicians and non-physician practitioners attest to a beneficiary’s recertification for hospice eligibility through a documented […]
On November 3, 2010, the Centers for Medicare and Medicaid Service (“CMS”) posted its final 2011 Home Health Prospective Payment System (“2011 HHPPS” or the “Final Rule”). According to CMS, “this final rule reflects CMS’ ongoing efforts to improve quality of care provided by home health agencies to Medicare beneficiaries. The rule is intended to […]
Following The HLP’s submission of numerous written inquiries and phone calls to representatives of CMS, National Government Services, Inc. (“NGS”) (the Medicare Affiliated Contractor), and CGI (the Medicare RAC for Region B), on November 8, 2010, CMS published a response to Frequently Asked Questions related to RAC reviews of Periodic Interim Payments (“PIP”). As described […]
On November 10, 2010, the Centers for Medicare & Medicaid Services (“CMS”) published its much-anticipated Proposed Rule regarding the Medicaid Recovery Audit Contractor (“RAC”) program. Section 6411 of the Patient Protection and Affordable Care Act (“Affordable Care Act”) requires each State to establish a Medicaid RAC program similar to the existing Medicare RAC program. States […]
CMS’s 2011 Final Physician Fee Schedule (the “Fee Schedule”) provides for over 2000 pages of new rules and regulations pertaining to physician reimbursement under Medicare for 2011. With the passing of the Patient Protection and Affordable Care Act (“PPACA”) and the Healthcare and Education Reconciliation Act (collectively referred to as the “Affordable Care Act”), physicians […]
Following upon the heels of September’s first-ever Advisory Opinion on sleep testing, the Office of Inspector General today issued the second and third installments of what appears to be the OIG’s Sleep Opinion Trilogy. These new opinions generally follow the facts of the first opinion – a third party management company provides all of the […]
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