On November 1, 2007, the Centers for Medicare and Medicaid Services ("CMS") released its final Medicare Physician Fee Schedule Rule for calendar year 2008. In addition to announcing CMS' payment rates for 2008, the final rule includes a new definition of physical therapist assistant and sets forth certain personnel standards for the provision of physical therapy services.
Continue Reading...The California Supreme Court has agreed to hear the appeal of Mileikowsky vs. West Hills Hospital and Medical Center. The question to be heard on appeal is:
“Does the presiding officer in a medical review proceeding have the authority to terminate the hearing as a sanction for a party’s failure to cooperate in discovery, or must that decision be made by the hearing committee in power to decide the case on the merits?”
During medical staff proceedings, in which Dr. Mileikowsky was appealing the hospital’s denial of clinical privileges, the hearing officer terminated the medical staff proceeding on grounds that Dr. Mileikowsky essentially failed to cooperate during the proceedings. The termination effectively affirmed the hospital’s denial of Dr. Mileikowsky’s application, which result was affirmed by the hospital’s governing board.
Dr. Mileikowsky filed a state proceeding known as a petition for a writ of mandate, challenging the hospital board’s decision. The trial court denied the petition, again effectively affirming the denial of Dr. Mileikowsky’s application. However, on appeal, the state appellate court held that the hearing officer had exceeded his statutory authority in California and ordered a new medical staff hearing. The hospital has appealed this decision to the California Supreme Court.
This case was the subject of a Med Law Blog post on September 20, 2007.
In continuing coverage from yesterday's briefing, Bloomberg (12/20, Goldstein, Johnston) reports that a "scheduled cut in Medicare payments to doctors will be postponed," and the State Children's Health Insurance Program (SCHIP) "will be extended at its current enrollment under legislation the U.S. House sent to the President" on Wednesday. By a vote of 411 to 3, the House passed the bill, which the Senate approved unanimously on Tuesday. According to press secretary Dana Perino, "President George W. Bush is expected to sign the compromise legislation." Under this bill, physicians who treat Medicare patients will "get a 0.5 percent increase through June 30, rather than a 10.1 percent cut on Jan. 1."
Conrgress is working on an unusual solution to the yearly Medicare update. The SGR formula mandates a fee decresase, projected to be about 10%. In past years, Congress has overidden the fee reduction with a modest increase. Of course, since the sustainable growth reate formula is never changed, the chasm gorws every year. This year, instead of an override, Congress is merely proposing a 6 month delay in the decrease. Below id the report from the Kaiser Daily Health Policy Report.
Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) on Monday agreed on a Medicare package that would delay for six months a scheduled 10% reduction in Medicare physician fees, a Republican committee aide said, CQ Today reports. The fee cut is scheduled to take effect on Jan. 1, 2008. The lawmakers previously called for a one- or two-year fix of the physician fee cut, but "difficulty in finding ways to pay for the legislation, along with Senate Republican leadership's demand that the package be able to pass by unanimous consent, forced them to scale back their ambitions," according to CQ Today (Armstrong, CQ Today, 12/17).
The package would cost about $6 billion, but lawmakers, looking to attract Republican support and avoid a presidential veto, will not propose "anything close to the billions of dollars in cuts in payments to Medicare Advantage insurers that many Democrats have backed," the Wall Street Journal reports (Lueck, Wall Street Journal, 12/18).
A. Refinement of Work Relative Value Units.
Since the physician fee schedule is first established in 1992, it has been composed of three categories of relative value units, i.e., work, malpractice expense, and overhead. Each of these units is assigned a value and the sum of those units is multiplied by the dollar conversion factor to establish the Medicare reimbursement for each particular CPT code. The system includes a process for refining the work relative value units, i.e., a re-evaluation of the value of the work units assigned to each CPT code. CMS uses a standard five year review cycle based upon input by the AMA/Specialty Society Relative Scale Update Committee (RUC). For 2008, CMS has revised the work units for comprehensive hearing tests (92557), visual audiometry (92579), doppler color flow (93325), and 14 home visit codes (99336 through 99350). The values, which are contained in Table 14 of the proposed physician fee schedule, is attached below at the link entitled Table 14: Work RVU Revisions.
www.medlawblog.com/Table 14 Work RVU Revisions(1).pdf
Continue Reading...Posted By: Lisa Ventresca lventresca@tuckerlaw.com
Foreign nationals traveling abroad will need reentry visas. The attached memo from Lisa Ventresca highlights the documents requirements for H1Bs.
The 2008 Medicare Physician Fee Schedule also includes revised performance standards for Independent Diagnostic Testing Facilities (IDTFs). The revisions are promulgated via 42 CFR § 410.33. The link below is the text of the regulations with the new provisions "boxed" for easy identification. Following is a description of these new IDTF performance standards beginning January 1, 2008:
Continue Reading...Pennsylvania law states that medical providers and hospitals must provide copies of patients’ medical records upon request, but may charge a fee for copying and producing the medical records. That fee is addressed annually.
The link below is the announcement by the Pennsylvania Department of Health, entitled “Amendments to Charges for Medical Records,” which was published on the Pennsylvania Bulletin on December 1, 2007, which fees will be in effect for 2008.
Posted by: Lisa Ventresca
As posted previously, Tucker Arensberg is now offering immigration law services. As such, our firm strongly believes that the 2008 H1B Temporary Worker Visa Cap will be closing in early April 2008, shortly after the United States Citizenship and Immigration Service (USCIS) begins accepting petitions on April 1, 2008. If your organization desires to hire a foreign national in a specialty occupation (those occupations requiring a Bachelor’s degree or higher) for 2008, you will need
Continue Reading...Med Law Blog is published by Michael Cassidy
Enter keywords:
Add this blog to your feeds or put your e-mail in the box below and hit GO to subscribe by e-mail.