CMS Gainsharing Demonstration
The Centers for Medicare and Medicaid Services (CMS) announced its Physician-Hospital Collaboration Demonstration (PHCD) Project. This is a three year demonstration program designed to examine whether allowing hospitals to provide financial incentives for physicians to support better care can improve patient outcomes without increasing costs. The CMS Press Release is available in the…
Health Savings Accounts (HSAs) offer a unique and perhaps unintended opportunity to create tax-favored savings vehicles similar to IRAs. HSAs were established by the Medicare Modernization Act of 2003 with the intention of encouraging consumer-directed healthcare and providing an alternative source for health insurance coverage. The concept pairs HSAs with High Deductible Health Plans (HDHPs). Individuals and families who are covered by HDHPs and are not covered by other health insurance plans are permitted to fund HSAs as a means of financing the deductible portion of the HDHP. Continue Reading HSAs: A Real Alternative to Traditional Health Insurance
In the Proposed Rules, the link for which was provided in the August 29, 2006 MedLaw Blog post, CMS announced proposed changes to the reassignment exceptions for purposes of Medicare billing and to the definition of “centralized building” for purposes of the ancillary services exception of Stark II.
REASSIGNMENT
CMS is basically proposing to treat…
CMS and the OIG are concerned with the potential for erroneous payments for either unjustified or medically unnecessary services in the independent diagnostic testing facilities (IDTF), which concern is initially based upon an audit performed for fiscal year 2001 by the OIG (A-03-03-00002). Therefore, in the August 22, 2006 Proposed Regulations, a link to which was…
The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services issued the 2007 Proposed Physician Fee Schedule in the August 22, 2006 Federal Register: http://www.cms.hhs.gov/quarterlyproviderUpdates/downloads/cms1321p.pdf. In addition to the fee schedule reductions arising out of the proposed revisions to the work relative value units (RVUs) as proposed in…
JCAHO MS.1.20 (i.e. the proposed medical staff by-laws standards to be adopted by the Joint Commission for the Accreditation of Healthcare Organizations) has been generating significant controversy since amendments were first proposed in January of 2004, which amendments would have required approval of both the medical staff and the hospital governing board to adopt and…
An adverse peer review report to the National Practitioner Data Bank is a threat frequently used by hospitals to leverage physicians into otherwise unacceptable peer review compromises. Once the report has been made to the Data Bank, the alleged adverse peer review of action is public knowledge and significantly jeopardizes physicians’ continued practice opportunities. Although the Data…
Following is the text from the payment delay reminder issued by HGSAdministrators (now Highmark Medicare Services):
A brief hold will be placed on Medicare payments for all claims during the last 9 days of the Federal fiscal year (September 22 through September 30, 2006). These payment delays are mandated by Section 5203 of the Deficit…
The final rules for the Stark excetions allowing entities to provide non_monetry assistance for electronic health records and e-prescribing systems were issued in final form and are avaialable on the CMS web site mentioned in the press release reproduced in the MedLaw Blog.
Continue Reading Stark Exceptions for E-Prescribing and E-Health Records Final
The Pennsylvania Legislature enacted the Health Savings Account Act (the "HSA Act") 72 P.S. §§3402b.1-3402b.6, on July 14, 2005, to be effective sixty days thereafter. As enacted, Section 4 of the HSA Act did not provide an exclusion from Pennsylvania tax for contributions by employers and employees to health savings account plans. Accordingly, there were not deductions…
