June 7, 2011, the Departments of Justice and Health and Human Services (“HHS”) announced that Reynel Betancourt, a 51 year-old Miami resident, was sentenced for his involvement in a $9 million Medicare fraud scheme originating in metro Detroit. His penalty includes 77 months in prison and three years of supervised release. Betancourt was also ordered […]
The Health Law Partners, P.C. (“The HLP”) is pleased to announce that founding partner Adrienne Dresevic was recently appointed to serve as Chair, ABA Health eSource; Vice Chair, Publication Committee; Vice Chair, Stark Toolkit Editorial Board; and Judge, Law Student Writing Competition. The appointment is for the 2011 – 2012 Bar Year (September 1, 2011 […]
In February, the Centers for Medicare and Medicaid Services (“CMS”) settled the first Stark matter since the publication of the CMS Voluntary Self-Referral Disclosure Protocol (“SRDP”). Although CMS spokesperson, Ellen Griffith, would not provide additional details, she confirmed that a settlement was reached. According to other sources, however, the first Stark case involved Saints Medical […]
The patient-centered medical home (“PCMH”) concept, in which a primary care physician and an interdisciplinary team coordinate the provision of patient services, continues to gain support. In April, New York State Health Commissioner Nirav Shah, M.D. promoted the state’s new initiative to increase access to PCMHs during his National Public Health Week visit to Urban […]
On May 31, 2011, the Department of Health and Human Services (“HHS”) issued a notice of proposed rulemaking (“Proposed Rule”) in relation to the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule (“Privacy Rule”). The Proposed Rule concerns changes to the accounting disclosures requirement of the Privacy Rule. The Proposed Rule intends to divide […]
On Friday, June 3, the American Medical Association (AMA) submitted its comments to Donald Berwick of the Centers for Medicare and Medicaid Services (CMS) regarding CMS’ proposed rule for Accountable Care Organizations (ACOs). In its opening remarks, the AMA states the following: The AMA is pleased to provide our views and recommendations for revising the […]
CMS has proposed a new rule that would grant organizations that meet certain qualifications access to patient-protected Medicare data, in order to produce public reports on physicians, hospitals and other healthcare providers. These reports would be a combination of Medicare claims data and private-sector claims, identifying which physicians and hospitals provided the highest quality, cost-effective […]
The Centers for Medicare & Medicaid Services (“CMS”) is taking steps in anticipation of its Medicare Part D RAC program release; this component of the RAC program is expected to begin in the third quarter of 2011. The director of the Medicare Program Integrity Group, John Spiegel, announced that CMS selected a vendor for the […]
On May 24, 2011, the Joint Commission announced that the new Primary Care Medical Home (“PCMH”) option for commission accredited ambulatory care organizations, by which a primary care clinician and an interdisciplinary team render patient services, will launch in July 2011. Applications from entities that are prepared for survey are currently being accepted. According to […]
On May 26, the American Medical Association (AMA) submitted a letter to Donald Clark–the Federal Trade Commission (FTC) Secretary–in response to the proposed FTC and Department of Justice (DOJ) Statement of Antitrust Enforcement Policy regarding accountable care organizations (ACOs). The AMA opened its letter by urging the FTC to consider its comments insofar as “the […]
Health Law Attorney Blog