“Red Flag Rules” enforcement has been delayed by the Federal Trade Commission (“FTC”) until August 1, 2009. On the eve of the scheduled May 1, 2009 enforcement date for the Red Flag Rules, the FTC announced that it is delaying the enforcement date until August 1, 2009. The purpose of…
The Office of the Inspector General (the “OIG”) posted new Advisory Opinion 09-03 on April 30, 2009, which concerns an arrangement whereby three municipalities reciprocally waive the otherwise applicable cost-sharing obligations of individuals residing within each other’s borders when providing backup emergency medical services transportation. Based on the facts presented,…
The new Secretary of the Department of Health and Human Services (“HHS”) has been confirmed. On Tuesday, April 28, 2009, by a vote of 65-31, the Senate confirmed Kansas governor Kathleen Sebelius as the new Secretary of HHS. Just hours later, in an Oval Office ceremony, Sebelius was sworn in.…
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…
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…
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…
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,…
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…
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…
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…