Genesys Health System in Genesee County settled a claim by the U.S. Department of Justice that it violated the False Claims Act by billing Medicare at higher rates for evaluation and management services than were actually provided to cardiology patients. The fraud allegations, which were initiated by a whistleblower lawsuit, resulted in a nearly $670,000 […]
In a recent survey by the American College of Physician Executives, 97% of respondents–doctors and nurses–reported behavior problems between doctors and nurses. This disruptive behavior, which over 55% of respondents reported happens at least monthly, included degrading comments or insults, inappropriate joking, and refusing to speak to or work with each other. The startling prevalence […]
Medicare published the 2010 Fee Schedule in the Federal Register today. This new final rule reflects changes to the physician fee schedule and other Medicare Part B payment policies. The full text of the rule can be found here. For more information on how these changes might affect you, contact Adrienne Dresevic, Esq. at (248) […]
Health Net became the latest company that lost data containing personal, financial and medical information of hundreds of thousands of Connecticut residents. The data disappeared from Health Net in May, but the company never informed consumers (or authorities) about the breach of privacy until about two weeks ago (a six-month delay). A spokeswoman for Health […]
On November 23, 2009, CMS sent a notice delaying implementation of its registration requirements for the Medicare Provider Enrollment, Chain and Ownership System (PECOS) which affects physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers, providing them additional time to enroll […]
On November 10, 2009, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Home Health Prospective Payment rates for the 2010 calendar year (the “Final Rule”). The Final Rule continues with the previously promulgated 2.75 percent reduction to the home health prospective payment rates in calendar year 2010 […]
Governor Granholm’s proposal to impose the Quality Assurance Assessment Program (“QAAP”) fee (A.K.A tax) on physicians–HB 5386–was defeated in the Michigan Senate by a 32-4 vote on Wednesday, October 28. The bill proposed that “the Department shall assess and collect a quality assurance assessment on physicians…at a rate of 3% of the gross revenue of […]
Representative John Adler’s proposed Red Flags exceptions–H.R. 3763–passed in the House on October 23. Passing with a 400-0 vote, the bill exempts small businesses with 20 or fewer employees that meet certain requirements. The bill will next be sent to the Senate for vote. Notwithstanding this legislation, the Red Flags Rule is still set to […]
Representative John Adler introduced H.R. 3763 on October 8 to amend the definition of “creditor” in the Fair Credit Reporting Act to reflect the following exclusions: (A) a health care practice with 20 or fewer employees; (B) an accounting practice with 20 or fewer employees; (C) a legal practice with 20 or fewer employees; or […]
The OIG released its Work Plan for the 2010 fiscal year (FY) this week, to be effective beginning October 2009. The OIG’s Work Plan “describes the specific audits and evaluations that [the OIG has] underway or plan[s] to initiate in the FY ahead….The Work Plan also provides focus areas for [the OIG’s] investigative, enforcement, and […]
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