Click on the link to read the Poliner Opinion, as referenced in the previous blog post:
www.medlawblog.com/Poliner.pdf
Continue Reading Poliner Opinion: Full Text
July 2008
Fifth Circuit Reverses Poliner
By Michael Cassidy on
Posted in Credentialing and Peer Review
The Fifth Circuit reversed the dictrict court holding in the Poliner case, and concluding that the hospital had conducted an appropriate investigation and was therefore entltled to HCQIA immunity.
As with most of these cases, the law is fairly clear and the facts are the issue. In Poliner, the physician was asked or coerced into accepting…
Medicare Audit Program Identifies Significant Over-Payments
By Michael Cassidy on
Posted in Medicare & Reimbursement
In follow up to a previous posting, the Wall Street Journal recently reported that the Medicare Recovery Audit Contractor Program has identified 1.03 billion dollars of improper payments over the past three years, about 992.7 million dollars of which were over-payments by Medicare. While the Recovery Audit Contractor Program is currently underway in six states, Medicare…
Proposed Stark Exceptions For Incentive Payments And Shared Savings Program
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS is acknowledging the continued interest in Pay for Performance ("P4P") and gainsharing ideas, and is issuing a specific self-referral exception in Anti-Kickback Safe Harbor to permit these programs. P4P programs are being hereinafter referred to as incentive payments, and gainsharing programs are now being referred to as shared savings programs.
The …
CMS Medicare Physician Fee Scedule Notice: .5 % Increase
By Michael Cassidy on
Posted in Medicare & Reimbursement
New 2008 Medicare Physician Fee Schedule Payment Rates Effective for Dates of Service July 1, 2008 through December 30, 2008
The Medicare Improvements for Patients and Providers Act of 2008 was enacted on
July 15, 2008. As a result, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent has been replaced with …
Congress Overrides Medicare Veto
By Michael Cassidy on
Posted in Compliance
Congress Overrides Medicare Veto
The House voted 383 to 41 to override the veto, while the Senate voted 70 to 26, in both cases far more than the two-thirds necessary to block the president’s action.
With organized medicine and other lobbies promoting the popular measure in an election year, Republicans broke heavily from the White
…
Congress Overrides Medicare Veto
By Michael Cassidy on
Posted in Medicare & Reimbursement
The House voted 383 to 41 to override the veto, while the Senate voted 70 to 26, in both cases far more than the two-thirds necessary to block the president’s action.
With organized medicine and other lobbies promoting the popular measure in an election year, Republicans broke heavily from the White House. A total…
MGMA Reports That President Vetos Medicare Bill to Prevent Physician Fee Cut
By Michael Cassidy on
Posted in Medicare & Reimbursement
medicare payment UPDATE
Today the president vetoed the Medicare Improvement Act for Patients and Providers (H.R. 6331). The House of Representatives must now schedule a new vote to override the veto, followed by a similar vote in the Senate. A two-thirds majority in each chamber must support a veto override for it to succeed.
Please …
Notice 2008-59 – Health Savings Accounts (HSA)
By Michael Cassidy on
Posted in Uncategorized
In Notice 2008-59, the Treasury and IRS have recently provided guidance related to Health Savings Accounts (HSAs) in the form of 42 frequently asked questions and corresponding answers related to HSAs. HSAs are medical savings accounts which are available to US taxpayers who are enrolled in a High Deductible Health Plan. The funds from HSAs…
Physician Self-Referral and Anti-Markup Issues
By Michael Cassidy on
Posted in Medicare & Reimbursement
The proposed 2009 Medicare Physician Fee Schedule also deals with proposed changes to the reassignment rules related to diagnostic tests, sometimes referred to as the Anti-Markup Provisions. The discussion of the proposed rules, which occupies pages 237 through 260 of the Federal Register publication, which pages are attached at the link below, discusses the …