Electronic health records could become a reality sooner than expected for more users, if a recent bill, introduced by Democratic Senator Jay Rockefeller of West Virginia on April 23, 2009, is passed. The Health Information Technology Public Utility Act of 2009 would facilitate the nationwide adoption of open source-based electronic health records (“EHR”). According to […]
The current legislative initiatives to restrict (or eliminate) the In-Office Ancillary Services Exception (the “IOASE”) under Stark is, by no means, a new phenomenon. Rather, over the years, CMS has received a substantial number of comments from interested groups whose economic interests are adversely affected by the IOASE. In fact, the amendments to the Anti-Markup […]
In an Open Letter to health care providers published March 24, 2009, the Office of Inspector General (“OIG”) refined its Self-Disclosure Protocol (“SDP”) to resolve matters giving rise to civil monetary penalties (“CMPs”) under the federal Stark law and Anti-Kickback Statute, initially addressed by way of Open Letter dated April 24, 2006. In order to […]
The American Recovery and Reinvestment Act (the “Act” or “Stimulus Package”) included important changes to the Consolidated Omnibus Reconciliation Act (“COBRA”). Generally speaking, COBRA allows workers who have lost employer-sponsored health insurance to retain coverage for a period of time. The Stimulus Package includes important provisions related to the cost of health insurance premiums. Generally […]
Recovery Audit Contractors (“RACs”), as other Medicare contractors, are authorized to audit only a small sample of a providers’ or suppliers’ records, and if the RACs find an overpayment, they will extrapolate the overpayment finding to the providers’ or suppliers’ patient population. If RACs engage in statistical sampling and extrapolation, RACs are entitled to keep […]
Generally speaking, the Federal Stark law makes it unlawful for a physician to refer Medicare or Medicaid patients for designated health services (“DHS”) to an entity with which the physician (or an immediate family member) has a financial relationship, unless an exception applies. The Federal Stark law applies only to referrals of DHS. Questions can […]
The Michigan Medical Marijuana Program is set to begin April 6, 2009. Beginning on this date, patients may submit an application to participate in the Michigan Medical Marijuana Program. Applicants must have a “debilitating” illness or condition, such as cancer, glaucoma, positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), hepatitis C, […]
The Centers for Medicare and Medicaid Services (“CMS”) recently published a final rule addressing termination of non-random prepayment complex medical review, which became effective January 1, 2009. The final rule implements Section 934 of the MMA, which required CMS to establish termination dates for non-random prepayment complex medical reviews performed by Medicare Administrative Contractors (“MACs”), […]
On March 31, 2009, Adrienne Dresevic, Esq., one of the founding shareholders of The Health Law Partners, P.C., presented to members of the Radiology Business Management Association (“RBMA”) on the topic of “Regulations Impacting Healthcare Marketing.” The presentation addressed the following healthcare legal topics: • Federal Stark Law; • Federal Anti-Kickback Statute; • Civil Monetary […]
The Medicare Recovery Audit Contractor Program (“RAC”) program has been made permanent and is expanding nationwide, pursuant to Section 302 of the Tax Relief and Health Care Act of 2006. Medicare providers and suppliers in Michigan are some of the first in the country that will experience RAC audits and potential claim denials. Pursuant to […]
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