Today, the Texas Spine & Joint Hospital and Physicians Hospitals of America jointly filed suit in U.S. Federal Court, Eastern District of Texas, challenging the constitutionality of Section 6001 of the Patient Protection and Affordable Health Care Act. Section 6001 prohibits physician-owned Medicare hospitals from expanding after March 23, 2010, and bans any new physician-owned […]
At this juncture, healthcare providers, to a greater or lesser extent, have begun to acquire at least a basic understanding of the recent federal health reform legislation, commonly known as the Patient Protection and Affordable Care Act (PPACA). At the same time, many in the provider community are looking beyond the contours of the PPACA, […]
In a not surprising turn of events, days before the June 1st deadline, the Federal Trade Commission (“FTC”) announced that it is again delaying the enforcement of the identity theft regulations through December 31, 2010. This latest delay came at the request of certain members of Congress while Congress considers legislation that would affect the […]
On May 21, 2010, CMS issued a new transmittal clarifying the interpretive guidelines for the hospital conditions of participation for anesthesia services. The transmittal serves to revise Appendix A “Survey Protocol, Regulations and Interpretive Guidelines for Hospitals”. Consistent with the CMS December 11, 2009 memorandum, the transmittal confirms that “The administration of medication via an […]
In a long-anticipated maneuver, the American Medical Association (“AMA”), American Osteopathic Association (“AOA”) and the Medical Society of the District of Columbia (“MSDC”) filed a lawsuit last week seeking to block the Federal Trade Commission (“FTC”) from requiring physician practices to implement its “Red Flag” identity theft safeguards. In an ongoing saga that HLP has […]
A False Claims Act lawsuit, sparked by a whistle-blower suit in 2003 filed against the Health Alliance of Greater Cincinnati and then-member Christ Hospital, has been settled, with the Health Alliance and hospital agreeing to pay the government $108 million, despite continuing to deny the allegations of the suit. The U.S. Justice Department joined the […]
Last month, we published a post regarding the new protocols that CMS is requiring RACs to use on Remittance Advice (RAs) when identifying and recouping overpayments. CMS has also issued the additional Transmittal 659, which sets forth the two-step process of utilizing RAs to report amounts to be recovered. Step I: Reversal and Correction to […]
HLP founding partner Robert S. Iwrey, Esq. was quoted in a “Patient Records Legal Primer” article in the award-winning, national publication Physicians Practice. You can read about how to ensure that your record-keeping is well managed by clicking here.
It looks like the days of “voluntary” compliance programs are coming to a close. As we discussed in a recent blog, the health care reform bill contained provisions mandating compliance programs. New York providers receiving Medicaid funds have already experienced mandatory compliance obligations as a result of the New York Office of Medicaid Inspector General […]
On May 7, 2010, CMS promulgated Transmittal 697 to align the requirements governing the timely filing limits (for submitting claims for Medicare Fee-for-Service (“FFS”) reimbursement) with the requirements set forth in the Patient Protection and Affordable Care Act (the “PPACA”). By way of background, a service provider or supplier formerly had been required to submit […]
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