Mike Cassidy was one of 25 lawyers selected nationwide for participation in the American Health Lawyers Association Masters Program. The Masters Program conferences are held every few years as a high level study group or focus group for specific healthcare issues. The topic this year is "Improving Quality and Bonding with Physicians: A Health System Case Study." The format
April 2009
Fourth Circuit Affirms Summary Judgment under Health Care Quality Improvement Act of 1986
By Michael Cassidy on
Posted in Legal News
My colleague, Bob Coffield, who publishes Health Care Law Blog, has passed on the post below regarding the Wahi decision, which I recommend for your review.
healthcarebloglaw.blogspot.com/2009/04/fourth-circuit-affirms-summary-judgment.html
West Penn Allegheny accuses UPMC, Highmark of Conspiracy
By Michael Cassidy on
Posted in Legal News
West Penn Allegheny accuses UPMC, Highmark of Conspiracy
The West Penn Allegheny Health System has sued UPMC and Highmark in U.S. District Court, charging the region’s leading hospital system and health insurer with antitrust violations that have illegally raised prices for consumers in the region.
Tristani’s Blow to State Medicaid Agency’s Third Party Liability Collection Practices
By Michael Cassidy on
Posted in Medicare & Reimbursement
In a potentially striking blow to the Pennsylvania Medicaid (Medical Assistance)Third Party Liability (“TPL”) collection practices, the Honorable Joy Flowers Conti, Judge for the United States District Court for the Western District of Pennsylvania, issued a Memorandum Opinion dated March 25, 2009 in the Tristani v. Richman et al. proposed class action. PAWD Civil Action…
Red Flag Rules Compliance Package
By Michael Cassidy on
Posted in Compliance
On May 1, 2009, health care providers will be subject to the "Red Flag Rules" issued by the Federal Trade Commission under the Fair and Accurate Credit Transactions Act. The Red Flag Rules apply to health care providers who allow patients to pay for health care services, for example through co-payments and deductibles, in installments.
California Supreme Court Vindicates Dr. Mileikowsky
By Michael Cassidy on
Posted in Credentialing and Peer Review
The California Supreme Court vindicated Dr. Mileikowsky when it affirmed an appellate court decision setting aside the hospital’s governing board decision terminating Dr. Mileikowsky’s hearing and ordering the hospital to convene and conduct a new hearing in accordance with the medical staff bylaws.
The basis of the dispute was a ruling and action by the…
Highmark Issues Local Coverage Determinations (LCDs)
By Michael Cassidy on
Posted in Medicare & Reimbursement
Highmark has issued four new local coverage determinations, as follows:
- Intraoperative Neurophysiological Testing
- Sleep Disorders Testing
- Posterior Tibial Nerve Stimulation (PTN)
- Electromyography (EMG) and Nerve Conduction Studies
The following is the link of the full text of those LCDs: http://www.highmarkmedicareservices.com/policy/draft-status.html
OIG Open Letter Restricts Self-Disclosure Protocol
By Michael Cassidy on
Posted in Compliance
On March 24, 2009, the OIG issued an open letter (pdf) to healthcare providers restricting the application of the OIG Self-Disclosure Protocol (SDP).
The open letter states clearly that OIG is "narrowing the SDP’s scope regarding the physician’s self-referral law." This action has two components.
First, the OIG will accept providers into the SDP only when…