The Continuing Extension Act of 2010 was signed into law on April 15. This law reinstates the March 31 Medicare Physician Fee Schedule (Fee Schedule) rates for physicians, postponing, yet again, the anticipated-21.3% cut. The zero percent (0%) update to the Fee Schedule has been extended to May 31 will apply retroactively to claims that […]
Yesterday, the U.S. House of Representatives proposed a bill that ups the ante on Medicare fraud. The bill, the Medicare Fraud Enforcement and Prevention Act, will double prison sentences from 5 to 10 years and fines from $25,000 to $50,000 for Medicare fraud-related crimes, and creates a new crime for illegally distributing patients’ Medicare and […]
The New York state attorney general’s office announced yesterday that it recovered more than $283 million and obtained a record of 148 Medicaid fraud convictions in 2009. This information is detailed in an Annual Report submitted to the Secretary of the U.S. Department of Health and Human Services. The report highlights the cases, settlements, and […]
Pursuant to the healthcare reform bill that was signed into law by President Obama on March 23, 2010 (“the Patient Protection and Affordable Care Act” or “the Act”), physicians who furnish MRI, CT or PET tests within their practices for their patients are now required to provide their patients with a written disclosure at the […]
On Monday, April 6, 2010, CMS updated its RAC website by announcing a series of nationwide calls as detailed below: April 28, 2010, 1:00pm – 2:30pm EST: Nationwide RAC 101 Call, 1-877-251-0301 May 4, 2010, 1:00pm – 2:30pm EST: Nationwide RAC 101 Call for Home Health and Hospice Providers, 1-877-251-0301 May 5, 2010, 1:00pm – […]
The Feds joined a False Claims Act lawsuit against Satilla Regional Medical Center, a Georgia Hospital. The lawsuit, filed by a nurse in 2007, alleges that the hospital allowed an unqualified physician, Najam Azmat, to perform endovascular procedures, leading to the death of at least one patient and injuries to several others. The hospital, which […]
Today, John Muir Health began notifying its 5,450 patients about a possible breach of their personal and health information. The notifications came two months after two laptop computers were stolen from the John Muir Physician Network Perinatal office in Walnut Creek, California. Although the laptops were password protected, and there is no evidence that the […]
The Internal Revenue Service (the “IRS”) recently published News Release IR-2010-25 (the “Release”) announcing that it made an administrative determination to accept the position that medical residents are excepted from FICA taxes based on the student exception for tax periods ending before April 1, 2005 (the “4/1/05 Rule Change Date”), when new IRS regulations went […]
In a recent development for the anesthesia community, HealthDataInsights (“HDI”), the RAC for Region D, removed the anesthesia care package issue from its approved issues list. In January of 2010, the RAC vendor posted the following issue: Under NCCI Edit rules, the anesthesia care package consists of preoperative evaluation, standard preparation and monitoring services, administration […]
Effective March 15, 2010, pursuant to CMS’s update to the Medicare Claims Processing Manual addressing “Payment to Physician or Other Supplier for Diagnostic Tests Subject to the Anti-Markup Payment Limitation”, among other actions, The Centers for Medicare and Medicaid Services (“CMS”) has effectively eliminated an Independent Diagnostic Testing Facility’s (“IDTF’s”) or radiology group’s ability to […]
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