November 2007

Health Plan Subrogation –   In the News

            By Joni L. Landy, Esq.  

In a nutshell, subrogation is the right of a health plan to recover money it paid out for medical care to treat injuries or conditions caused by another party. For example, subrogation may apply when a participant sustains injuries as a result of a slip and fall on a slippery sidewalk, or may apply if a participant is injured by another driver in a car accident. If the participant sues the party that caused his injuries and recovers, the health plan gets paid back from the recovery. Subrogation rights are typical provisions in health plans.   Continue Reading Health Plan Subrogation – In the News

The Medicare Anti-Markup provisions for diagnostic tests, which will be effective as of January 1, 2008, are intended to prevent physicians or other medical suppliers from purchasing either the professional component (PC) or technical component (TC) of any diagnostic test (excluding clinical laboratory tests subject to separate restrictions) and profiting or marking up the acquisition cost by billing globally in accordance with the fee schedule.Continue Reading The New Medicare Anti-Markup Diagnostistic Test Results

2008 MEDICARE PHYSICIAN FEE SCHEDULE DELAYS STARK RULES

CMS announced in the 2008 Medicare Physician Fee Schedule final rule that the following proposed revisions will not be finalized until the future publication of a final rule:

§                     burden of proof;

§                     obstetrical malpractice insurance subsidies;

§                     unit of service (per click);

§…

HIGHMARK  ANNOUNCES AMBULATORY SURGERY  CENTER

ACCREDITATION REQUIREMENTS

In the October 2007 PRN, Highmark announced that, as of January 2008, it will require freestanding ambulatory surgery centers (ASC) to be accredited by one of three accrediting bodies, i.e., the Joint Commission, the Accreditation Association for Ambulatory Healthcare ("AAAHC"), or the American Association for Accreditation of Ambulatory…

For Immediate Release: Thursday, November 01, 2007
Contact: CMS Office of Public Affairs
202-690-6145

MEDICARE FINAL RULE ANNOUNCES 2008 PHYSICIAN FEES AND REFORMS FOR ACCURATE PAYMENTS AND QUALITY

The Centers for Medicare & Medicaid Services (CMS) today issued a final physician payment rule designed to improve accuracy of Medicare payments and give physicians and health

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Med Law Blog Editor

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Tucker Arensberg’s Healthcare Practice Group includes some of the most experienced health law attorneys in the region. We handle the legal problems so our clients can handle the important work of caring for patients. We work with physicians, physical therapists, dentists, optometrists, and all other professional care givers to help them avoid the many legal traps of running a practice. Tucker Arensberg lawyers have experience in all major health law issues.