As a service to our clients and friends in NY, we are reproducing the notice circulated by the Medical Society of the State of New York urging all interested constituents take action to prevent the proposed 21% reduction in Medicare physician reimbursement. “On February 28, the two month extender of the current Medicare > conversion […]
A legal ruling finding that the Red Flag Rules promulgated by the Federal Trade Commission (“FTC”) do not apply to the profession of law has raised new hope that physicians may find a similar exemption. In a final rule published in 2007 under the Fair and Accurate Credit Transaction Act of 2003, the FTC issued […]
A Florida Appeals Court upheld a ruling last month that a hospital-based but non-contracted provider may not balance bill patients for amounts unpaid by the patients’ HMO, when the HMO has accepted liability. The text of the ruling can be found here. In this case, the patients, each a subscriber to one HMO, received pre-authorization […]
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires the Secretary to designate organizations to accredit suppliers, including but not limited to physicians, non-physician practitioners, and Independent Diagnostic Testing Facilities, that furnish the technical component of advanced diagnostic imaging services. Advanced diagnostic imaging services include diagnostic magnetic resonance imaging (MRI), computed tomography […]
HLP is pleased to welcome a new addition to our growing firm, attorney formerly of Hall, Render, Killian, Heath & Lyman, P.C. Kathryn specializes in health care corporate matters, including fraud and abuse, mergers and acquisitions, and private offerings, and has significant experience in federal and state health care law compliance matters. The Health Law […]
CMS rescinded a change order affecting the use of place of service (“POS”) codes used for the interpretation of diagnostic tests. Originally issued on December 11, 2009, the rescinded Change Request (“CR”) led to significant confusion about the POS for reporting the reading of diagnostic tests. MLN Matters 6375, which explained the CR, required providers […]
The home health world has been turned upside down. As many are aware, new regulations have been implemented that affect ownership changes for home health agencies (“HHAs”). On January 21, 2010, CMS published a “Medicare Learning Network Provider Inquiry Assistance.” This publication clearly states that any “ownership change” within 36 months of the Medicare enrollment […]
The American Recovery and Reinvestment Act establishes an incentive program that provides incentive payments to eligible physicians (EP) and eligible hospitals for meaningfully using electronic health records (EHR). While many specialists are learning the conditions under which they can capitalize on these incentive payments, anesthesiologists will learn that they do not qualify as EPs, thus […]
CMS announced new demonstration programs it plans to implement to “identify, develop, test, and disseminate major and multi-faceted improvements to the health care system.” The Medicare Modernization Act requires that Medicare conduct a five-year demonstration program to achieve four main goals: (1) to improve patient safety; (2) to enhance quality; (3) to increase efficiency; and […]
All too often, services provided by hospices are denied by Medicare due to incomplete or inaccurate documentation practices that can easily be prevented. A September report by the HHS Office of Inspector General analyzed some of the most common documentation inadequacies in hospice services provided to beneficiaries at nursing facilities, and the statistics are surprising. […]
Health Law Attorney Blog