As reiterated in the WPS Medicare Part B Legacy eNews, Medicare beneficiaries who elect hospice care, forego their rights to Medicare Part B payments for services related to treating and managing their terminal conditions, unless the services are provided by an attending physician. An “attending physician” is defined as a…
Health and Human Services (HHS) announced that it launched its new HealthCare.gov Facebook page. According to HHS Secretary, Kathleen Sebelius, “HealthCare.gov on Facebook offers Facebook users a new tool to understand and stay informed about the Affordable Care Act…This new page is another resource that people can use to learn…
On September 22, 2010, the Office of Inspector General (“OIG”) released its Memorandum Report: Questionable Billing for Physician Services for Hospice Beneficiaries addressing a hospice billing vulnerability that cost CMS $566,000 in 2009. The OIG noted that there are instances of billing a single service under both Medicare Parts A…
On September 22, 2010, the House passed HR 6130: Strengthening Medicare Anti-Fraud Measures Act of 2010 (the “Bill”), introduced by Reps. Pete Stark (D-CA) and Wally Herger (R-CA). The Bill provides for an expanded “permissive exclusion from participation in Federal health care programs to individuals and entities affiliated with sanctioned…
On September 23, CMS released its Voluntary Self-Referral Disclosure Protocol (“SRDP”) pursuant to Section 6409 of the Affordable Care Act (“ACA”), which “requires the Secretary of HHS to inform providers of services and suppliers of how to disclose an actual or potential violation pursuant to the protocol….” The new statutory…
On September 21, The Hill and the American College of Cardiology (“ACC”), hosted a discussion with Sen. Tom Coburn (R-OK), Rep. Brian Baird (D-WA), Dr. Ralph Brindis–the President of ACC–Dr. Jack Lewin, and Dr. John Tooker–the CEO of American College of Physicians (“ACP”) to discuss patient payment reform. While the…
Last week, CMS posted the Preview of the Proposed Rules, which will officially be released in Federal Register format and open for comments on September 23. The proposed rule focuses on implementing the Affordable Care Act (“Act”) that will, in part: • Establish screening procedures for suppliers and providers of…
On September 15, 2010, the US Department of Health and Human Services Inspector General Daniel Levinson testified before the House Subcommittee on Health of the House Committee on Energy and Commerce regarding Medicare’s coverage of DMEPOS suppliers. Stating that DMEPOS expenditures represented 2% of all Medicare expenditures–$10 billion–in 2009, Levinson…
On September 7th, the Joint Commission announced that, commencing in July 2011, the Joint Commission will extend the accreditation process of accrediting ambulatory health care organizations to those who choose the Primary Home option. “A Primary Care Home is a model of care whereby services are provided to patients by…
On September 8, 2010, the OIG released Advisory Opinion 10-14 regarding an arrangement in which a sleep lab management company (the “Requestor”) provides a Hospital sleep lab with all of the equipment, technology, supplies, and staff necessary to operate a sleep testing laboratory. No physicians have any ownership interest in…