April 2006

CMS PUBLISHES FINAL ENROLLMENT REQUIREMENTS FOR MEDICARE PARTICIPATION

The Centers for Medicare and Medicaid Services (CMS) have published the final rule establishing the enrollment requirements for participation in Medicare. The proposed rule was published on April 25, 2003. There are no significant surprises in the final rule, which does the following:
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The Medicare Modernization Act of 2003 required the Secretary of Health and Human Services to make the national coverage determination (NCD) process a public and transparent process, with the intent of making the NCD process one that would be better serve Medicare providers and beneficiaries. On April 11, 2006, CMS issued two documents related to “Guidance for The Public, Industry and CMS Staff,” i.e.:
Continue Reading National Coverage Determination Process – CMS Issues Final Guidance Documents

“These are my patients – how can you stop me from seeing them?” This is a familiar refrain heard when medical practices break up or physicians leave an ongoing practice. Almost everyone knows that nobody “owns” patients and that patients have absolute freedom of choice as to what doctors they choose to see (excluding health plan participation issues). However, the fact that patients may be free to see the physician of their choice does not necessarily mean that physician will be just as free to see them. This issue is not about patient ownership; it is an issue about restrictive covenants, ownership of medical records, privacy and confidentiality, and ownership of confidential intellectual property or trade secrets.
Continue Reading Whose Patients Are They Anyway?