Medicare Publishes Proposed Rule Regarding Reporting and Return of Overpayments
Last week, the Centers for Medicare and Medicaid Services (“CMS”) published in the Federal Register notice of a proposed rule concerning the reporting and return of overpayments to the Medicare program. The proposed rule will require providers and suppliers to report and return Medicare overpayments by the deadlines specified. Providers will need to be very [...]
No Valentine to Physicians from Congress as SGR Issue Remains Unresolved
Physicians may need to gear up again for a potential 27.4% cut in Medicare reimbursement if Congress does not address the sustainable growth rate issue by the February 29th deadline. As you may recall from reviewing our earlier blog post, Congress averted a January 2012 reduction, which was enacted together with an extension of the [...]
OIG Issues Alert to Physicians Regarding Medicare Reassignment
The Office of Inspector General (OIG) today issued an alert to physicians regarding their potential liability on claims submitted by entities to whom the physician has reassigned the right to bill for Medicare payments. The OIG gives an example in which the OIG reached a settlement with eight physicians under the Civil Monetary Penalties Law. [...]
Ambulatory Surgery Facility Inspection Reports Now Available On Line
As we have reported in a January 16th, January 18th, and January 30th blog post, legislation which would require the licensure of surgical practices by the Department of Health and Senior Services is currently pending in the New Jersey Legislature. On February 1, 2012, the Department of Health and Senior Services published an update to [...]
Bill to License Single ORs is Reintroduced
As we reported two weeks ago, Governor Chris Christie pocket vetoed a bill passed by the Legislature in the last legislative session, which would amend the law governing surgical practices and require them to be licensed by the Department of Health and Senior Services. Following a pocket veto, a bill cannot go back to the [...]
Supreme Court Upholds Ruling: PAs Cannot Administer EMGs
This week the New Jersey Supreme Court issued an opinion in a case of first impression in New Jersey regarding the scope of practice for physician assistants (PAs). In this case, Selective Insurance Co. of America v. Rothman, M.D., the Court held that a PA cannot, under the scope of his/her license, perform electromyography (EMG) [...]
Update Re: State to License One Room ORs
As we reported the other day, last week the New Jersey legislature adopted a bill that would require licensure by the Department of Health and Senior Services of “surgical practices” or single operating rooms within physician private practices. Yesterday, Governor Christie “pocket vetoed” the bill. The ability to “pocket veto” a bill arises out of [...]
OIG’s Most Wanted List
The Office of the Inspector General in the United States Department of Health and Human Services has long maintained a website listing their “most wanted” health care fugitives. The individuals contained on this list are wanted on charges related to health care fraud and abuse, ranging from billing the Medicare program for services that were [...]
State to License One Room ORs
Last week the legislature adopted S-2780, which amends the law governing surgical practices and will require them to be licensed by the Department of Health & Senior Services. A surgical practice consists of one operating room with one or more post-anesthesia care units or a dedicated recovery area, established by a physician or a physician [...]
Medicare Physician Pay Reduction Averted…Temporarily
President Obama signed the Temporary Payroll Tax Cut Continuation Act of 2011 into law on December 23rd . Among other things, the legislation will avert the imposition of the 27.4% reduction in the Medicare physician fee schedule that was due to go into effect on January 1, 2012. The reprieve is only temporary, however. The [...]
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