In Notice 2010-44, the Internal Revenue Service (IRS) outlined the tax credit for employee health insurance expenses available to certain small businesses under Section 45R of the Internal Revenue Code. Effective for taxable years beginning in 2010, the 45R credit is available to an employer when (1) the employer has fewer than twenty-five full-time equivalent […]

On June 9, 2010, the Office of Inspector General (OIG) published a report regarding inpatient rehabilitation facility (IRF) payments made in 2006 and 2007. According to this report, over half of the claims reviewed (i.e., 113 out of 200 claims) resulted in overpayments, because the providers failed to submit patient assessment instruments within the requisite […]

On May 28, the Centers for Medicare and Medicaid Services (CMS) issued Transmittal 128, which clarifies CMS policies regarding physician supervision of diagnostic and therapeutic services provided to hospital outpatients. The transmittal, effective on July 1, 2010, updates the Hospital Outpatient Prospective Payment System (OPPS). In the transmittal, CMS specifies that “[d]irect supervision is the […]

On May 26, 2010, CMS published a proposed rule revising the Medicare Conditions of Participation (CoPs) to give hospitals and critical access hospitals (CAHs) more flexibility in credentialing and privileging telemedicine physicians and practitioners (while not prohibiting hospitals from continuing to use traditional credentialing and privileging process if they please). The proposed CAH CoP requirements […]

Today, the Texas Spine & Joint Hospital and Physicians Hospitals of America jointly filed suit in U.S. Federal Court, Eastern District of Texas, challenging the constitutionality of Section 6001 of the Patient Protection and Affordable Health Care Act. Section 6001 prohibits physician-owned Medicare hospitals from expanding after March 23, 2010, and bans any new physician-owned […]

At this juncture, healthcare providers, to a greater or lesser extent, have begun to acquire at least a basic understanding of the recent federal health reform legislation, commonly known as the Patient Protection and Affordable Care Act (PPACA). At the same time, many in the provider community are looking beyond the contours of the PPACA, […]

In a not surprising turn of events, days before the June 1st deadline, the Federal Trade Commission (“FTC”) announced that it is again delaying the enforcement of the identity theft regulations through December 31, 2010. This latest delay came at the request of certain members of Congress while Congress considers legislation that would affect the […]

On May 21, 2010, CMS issued a new transmittal clarifying the interpretive guidelines for the hospital conditions of participation for anesthesia services. The transmittal serves to revise Appendix A “Survey Protocol, Regulations and Interpretive Guidelines for Hospitals”. Consistent with the CMS December 11, 2009 memorandum, the transmittal confirms that “The administration of medication via an […]

In a long-anticipated maneuver, the American Medical Association (“AMA”), American Osteopathic Association (“AOA”) and the Medical Society of the District of Columbia (“MSDC”) filed a lawsuit last week seeking to block the Federal Trade Commission (“FTC”) from requiring physician practices to implement its “Red Flag” identity theft safeguards. In an ongoing saga that HLP has […]

A False Claims Act lawsuit, sparked by a whistle-blower suit in 2003 filed against the Health Alliance of Greater Cincinnati and then-member Christ Hospital, has been settled, with the Health Alliance and hospital agreeing to pay the government $108 million, despite continuing to deny the allegations of the suit. The U.S. Justice Department joined the […]

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