The American Hospital Association (“AHA”) and four hospitals (collectively, the “Plaintiffs”) have filed a lawsuit against the Department of Health and Human Services (“HHS”), alleging that the Centers for Medicare and Medicaid Services (“CMS”, a sub-agency of HHS), through its Medicare RAC Program, has inappropriately refused to pay for Medicare Part B services that it […]

On October 11, 2012, The OIG distributed a questionnaire to hospitals that have received Medicare EHR incentive payments for demonstrating meaningful use of its certified EHR technology. This questionnaire is being sent to hospitals that have received incentive payments between January 1, 2011 and March 31, 2012 which amounts to approximately 830 hospitals nationwide. The […]

On October 18, 2012, the Michigan Department of Licensing and Regulatory Affairs (“LARA”) announced that it will be combining the current Bureau of Health Professions (“BHP”),which governs individual licensed and registered health care providers such as physicians and nurses, and the Bureau of Health Systems (“BHS”), which governs licensed health care entities such as hospitals […]

On October 3, 2012, New York State Governor Andrew Cuomo acted on several health care related bills, including legislation dealing with accountable care organizations and patient referral laws. The Governor approved by signing into law an act to amend the Public Health Law in relation to accountable care organizations (ACOs) (A.8869-B/S.6228-B), which is intended to […]

On October 5, the Office of Inspector General (“OIG”) issued Advisory Opinion 12-13, approving a proposed arrangement allowing a hearing aid supplier to bill Medicare for certain audiometric testing services, while also offering a free hearing exam to potential patients (“Proposed Arrangement”). The requestor owned a chain of hearing aid supply and service locations which […]

On September 28, CMS issued Transmittal 2156 revising and clarifying Place of Service Coding (POS) instructions. The Transmittal rescinds previous Transmittal 2435, extends the implementation date to April 1, 2013 and provides a few clarifications for physicians and other supplier entities when determining the appropriate Point of Service (POS) designation for Physicians and Supplier entities. […]

On October 3, 2012, the OIG released its Work Plan for the FY of 2013. Throughout the week, we will be posting on various aspects of the Work Plan pertinent to our clients and our readers in the following areas: • Hospitals • Home Health Agencies • Hospices • Evaluation and Management Services • Imaging […]

On September 25, Senator Michael Green (31st District) introduced a bill that would expand the definition of the practice of nursing to include “administration of anesthesia by a registered professional nurse who holds a specialty certification as a nurse anesthetist.” Senate Bill 1309 was referred to the Senate Health Policy Committee after two readings. Presently, […]

Within the next month, the Centers for Medicare and Medicaid Services (CMS) is expected to finalize the proposed Medicare Physician Fee Schedule for 2013. In the rule, CMS proposes to expand the definition of CRNA services to include “medical and surgical services that are related to anesthesia and that a CRNA is legally authorized to […]

We are pleased to announce that Abby Pendleton, Esq. and Claudia Hinrichsen, Esq. will be speaking at the upcoming Healthcare Financial Management Association (HFMA) of Western New York education session entitled “Compliance Update: RAC, HIPAA/HITECH, Hospital and Physician Compliance” scheduled for Friday, September 28, from 8:30am-12:00pm EDT. Ms. Pendleton and Ms. Hinrichsen will be speaking […]

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