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 […]
As reported in the May 14th HLP blog, the Departments of Justice (DOJ) and Health and Human Services (HHS) recently released the Health Care Fraud and Abuse Control Program (HCFAC) Annual Report for Fiscal Year 2009, which reflects that $2.51 billion was deposited to the Medicare Trust Fund in 2009, as a result of more […]
On May 6, 2010 the Office of Inspector General (the “OIG”) posted Advisory Opinion 10-04, which approved a program conducted by several imaging centers to provide free pre-authorization services to patients and referring physicians (the “Pre-Authorization Arrangement”). This approval was somewhat unexpected in light of the OIG’s prior issuance of several advisory opinions and other […]
This month, the Office of Inspector General published its report of the activities and results of the Health Care Fraud and Abuse Control Program for 2009. A few highlights from the report include: 1014 new criminal health care investigations opened, 583 fraud-related convictions concluded, and Continue Reading →
Health Law Attorney Blog