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 [...]
Imminent Withholding of Medicare Physician Payments Appears Likely
As of today, there still has not been a resolution of the threatened reductions to the Medicare payment rate which are scheduled to go into effect ten (10) days from now . As you are aware, the Medicare Sustainable Growth Rate will require reducing payments by over 27% as of January 1, 2012.
While the news [...]
POLST Act Signed into Law
On December 21, 2011, Governor Christie signed the Physician Orders for Life-Sustaining Treatment Act (“POLST Act”). The POLST Act is designed to provide a mechanism for patients who (1) have advanced chronic progressive illness; or (2) a life expectancy of less than five years; or (3) who otherwise wish to further define their preferences for [...]
UPDATE OF SUSTAINABLE GROWTH RATE
As you are aware, the recent publication of the Medicare fee schedule updating the Sustainable Growth Rate (SGR) formula, which limits the Physician Fee reduction from approximately a 30% reduction to approximately a 27% reduction, is not a permanent solution to the problem.
Physicians need to be considering their options in regard to their Medicare patients. [...]
OIG Exclusion List Updated
Earlier this month, the Office of the Inspector General (“OIG”) of the U.S. Department of Health and Human Services updated its List of Excluded Individuals and Entities (LEIE). This announcement should serve as a reminder to all Medicare providers to check their employees and contractors against the LEIE database to make sure they have not [...]
Sustainable Growth Rate (SGR)
Both the American Hospital Association and the American Medical Association (together with numerous physician specialty organizations) , have submitted letters to the Medicare Payment Advisory Commission (MedPAC) in response to a “Proposal” which MedPAC adopted yesterday, on various issues. MedPAC Proposal freezes payments for certain primary care services and reduces reimbursement for all other “specialist [...]
“The New Frontier: How Accountable Care Organizations (ACOs) May Impact Your Business,” October 12, 2011
This education program will focus on issues to consider when deciding whether to participate in an
ACO. Medicaid, Medicare and private insurance companies all have different ideas of what
constitutes an ACO.
For more information and to RSVP, please click here.
OIG Issues Advisory Opinion 11-11 Regarding Discounts
The HHS Office of Inspector General has published Advisory Opinion 11-11, which deals with a financial relationship between an entity furnishing supplies, equipment and other items to a skilled nursing facility. In order to enhance its likelihood of becoming the successful bidder in response to the skilled nursing facility’s RFP, the medical supplier offered to [...]
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