CMS announced on December 30th a new feature to enhance its Physician Directory tool, called Physician Compare, which expands and updates the existing Healthcare Provider Directory. The new site, www.medicare.gov/find-a-doctor, was mandated by the Patient Protection and Affordable Care Act. In the first phase of the roll-out, the categories of…
With the onslaught of the new Patient Protection and Affordable Care Act (PPACA) provisions making it a false claim to retain known overpayments and the new CMS guidance on the newly-reinstated Voluntary Self-Referral Disclosure Protocol (SRDP), Wisconsin Physician Services (WPS)–the Medicare Part B Contractor for Illinois, Michigan, Wisconsin, and Minnesota–released…
For over a year, the Health Law Attorney Blog has reported on many of the electronic health records (EHR) incentive payment updates (the most recent entry from July 13, 2010). Beginning today, eligible professionals, hospitals and critical access hospitals may begin registering for incentive payments for demonstrating meaningful use of…
On December 28,2010, the Office of Inspector General (“OIG”) published Advisory Opinion 10-26, wherein the OIG concluded that an ambulance provider offering discounted rates to skilled nursing facilities (“SNFs”) could violate the Anti-Kickback Statute (“AKS”). In Advisory Opinion 10-26, Requestor is a nonprofit Medicare and Medicaid certified ambulance supplier providing…
Last week, a lawsuit was filed in the Northern District of Texas federal court, challenging the validity of the aggregate annual cap for hospice reimbursement. Medicare provides reimbursement for hospice services rendered on a per beneficiary, per diem basis, subject to an aggregate annual cap. This cap is based upon…
When advising clients regarding the legal risks potentially implicated by the health care transactions into which they contemplate entering, we at The Health Law Partners have consistently articulated the mantra that “there is substantially heightened scrutiny in the regulatory arena.” It is not uncommon for clients to inquire, upon hearing…
The days are counting down to December 31 where certain New York providers and suppliers must certify that they have adopted and implemented “effective compliance programs” to be eligible to receive Medicaid payments (for a more detailed explanation of the requirements under the Medicaid Provider Compliance Programs can be found…
Passed in the House and Senate and awaiting signature by the President, the Red Flag Program Clarification Act of 2010 limits the definition of “creditor” to include only those that use consumer reports, furnish information to consumer reporting agencies or advance funds to a person. Importantly, the definition does not…
Identical bills passed by both House and Senate. Building upon the fifth 1-month extension patch this year that delayed a steep 23% Medicare provider pay cut, the U.S. House and Representatives (by a vote of 409-2) and the U.S. Senate (unanimously) both passed another pay cut delay. This delay will…
$2.5 billion in settlements in crackdown against fraud. The federal government has announced the largest settlement amounts in the history of the False Claims Act for fiscal 2010. The $2.5 billion amount received from healthcare False Claims Act cases remarkably does not include hundreds of millions of dollars that the…