TUCKER ARENSBERG HEALTH PLAN SUBROGATION SERVICES
Aggressive Subrogation Saves on Health Plan Costs.
An aggressive subrogation program can save your business money on health plan costs. Tucker Arensberg has handled subrogation for employer health plans for many years. We like to tell the story about how one year, one subrogation recovery alone paid for all…
On April 21, 2008 the Centers for Medicare and Medicaid Services ("CMS") released a proposed rule regarding the Fiscal Year 2009 Inpatient Rehabilitation Facility Prospective Payment System. The proposed rule discusses changes to the 75% rule and requires a freeze on inpatient rehabilitation facility rates from April 1, 2008 through September 30, 2009. The proposed rule also…
Form 990 Redesign for Tax Year 2008
The IRS currently requires every charitable organization, and every similar tax-exempt organization, with gross receipts of at least $100,000 or assets of at least $250,000 to file an annual return on Form 990. On December 20, 2007, the IRS published major changes to its Form 990. Certain of the changes…
Gainsharing is generally defined as an arrangement between physicians and hospitals to share cost reductions, which can be narrowly targeted projects such as standardization of hospital equipment and supplies or broadly targeted projects such as average cost per case. Gainsharing is an attempt to align financial incentives in an environment where the existing incentives are actually…
Malpractice Plaintiff Obtains Peer Review Records
A United States District Court has decided that malpractice plaintiffs seeking recovery pursuant to the Federal Tort Claims Act are entitled to obtain hospital peer review records, regardless of state immunity laws. In Vezina vs. United States of America, the Plaintiff brought suit for personal injuries, allegedly suffered while…
STARK: "STAND IN SHOES" REGULATIONS
The original proposed physician "Stand in Shoes" regulations provide that any physician would stand in the shoes of any other doctor in the following circumstances:
1. Another physician who employs the referring physician;
2. His or her wholly owned professional corporation;
3. A physician’s medical practice that employs or contracts with…
CMS has proposed new Stark regulations as part of the hospital in-patient perspective payment system rules for Fiscal Year 2009.
On April 14, 2008, CMS proposed new IPPS rules which contain proposed Stark regulations with respect to alternative solutions for the "stand in the shoes" provisions which were first proposed in the Stark Phase III…
Pittsburgh MSA Included in DMEPOS Medicare Competitive Bidding Program
Medicare will begin implementation of a Competitive Bidding Program for DMEPOS effective July 1, 2008. This program will affect patients in ten competitive bidding areas (CBAs) that align with the ten metropolitan statistical areas (MSAs) selected for the first phase of this program and includes ten product…
WASHINGTON – U.S. Citizenship and Immigration Services (USCIS) announced today that it has received enough H-1B petitions to meet the congressionally mandated cap for fiscal year 2009. USCIS has also received more than 20,000 H-1B petitions filed on behalf …Read More
Lisa Ventresca
Highmark Medicare Local Coverage Determinations (LCDs)
Highmark Medicare Services has published the initial draft set of LCDs as part of its plans to fulfill CMS requirements to consolidate ICEs by July 1, 2008. Highmark’s instructions for submitting comments for the proposed Local Coverage Determinations (LCDs) and the proposed LCDs are included in the attached link. The following…
