Under the proposed Medicare physician fee schedule rule (the “Proposed MPFS”) released by the Centers for Medicare and Medicaid Services (CMS) on June 25th, physician reimbursement rates would decrease by 6.1% as of January 1, 2011. On the day that CMS issued the Proposed MPFS, the 21% cut in physician reimbursement was deferred until at […]
Last year, Governor Arnold Schwarzenegger requested exemption from the federal supervision requirement of nurse anesthetists. After unsuccessfully seeking a rescission of the opt-out, on June 3, 2010, the California Society of Anesthesiologists (CSA) and California Medical Association (CMA) filed a lawsuit against the governor. Medicare required a physician to supervise a nurse anesthetist until 2001, […]
The Office of Inspector General (“OIG”) today published a report regarding overpayments identified made to inpatient rehabilitation facilities (“IRFs”) from 2004 through 2007. According to the report, of the claims reviewed by the OIG, the vast majority (i.e., 213 out of 220) of transfers from an IRF to another facility were improperly coded as discharges. […]
It looks like the days of “voluntary” compliance programs for the health care industry are coming to an end. Specifically, Section 6401(a)(7) of the Patient Protection and Affordable Care Act (“PPACA” or the “health care reform bill”) included provisions mandating compliance programs as part of the Medicare enrollment process. According to the health care reform […]
CMS has released their proposed disclosure requirements for In-Office Ancillary Services (IOAS) Exception. Section 1877 of the Act or the physician self-referral law (Stark) prohibits a physician from making referrals for certain “designated health services” (DHS) payable by Medicare to an entity with which he or she has a financial relationship, unless an exception applies. […]
CMS has released the proposed physician fee schedule and other Medicare Part B payment policies to ensure their payment systems reflect the changes in medical practice and relative value services. This update also addresses certain provisions of both the Affordable Care Act and Medicare Improvements for Patients and Providers Act of 2008. Additionally, the proposed […]
The Medicare Payment Advisory Council (MEDPAC) recently delivered its 2010 report to Congress. The report entitled “Report to the Congress: Aligning Incentives in Medicare,” addressed the in-office ancillary services (IOAS) exception to the Stark Law, which allows physicians to provide most DHS services to patients in their own offices under certain conditions. In recent years, […]
On June 14, 2010, CMS published a report entitled, “The Medicare Recovery Audit Contractor (RAC) Program: Update to the Evaluation of the 3-Year Demonstration Program.” This report contains statistics through March 9, 2010 and includes updated appeals data. The new report reveals a much lower number of appeals than had previously been reflected. Specifically, the […]
The U.S. Food and Drug Administration (the “FDA”) has announced in a press release that the agency and other regulatory representatives will participate in a one day workshop entitled “Indentifying Unmet Public Health Needs and Facilitating Innovation in Medical Device Development.” Dr. Jeffrey E. Shuren, director of the Food and Drug Administration’s Center for Devices […]
Wisconsin Physician Services (an existing Medicare Carrier and Medicare Administrative Contractor) issued a reminder today on its website for providers concerning the new deadlines for Medicare claims submission. The CMS Medlearn matters article dated May 7, 2010 and effective January 1, 2010 on the subject provides specific details relative to the topic. For example, Section […]
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