Important update today regarding Accountable Care Organizations participating in the Medicare Shared Savings Program (Shared Savings Program).
Please click here to read more information.
March 2011
CMS Launches Innovation Website
By Michael Cassidy on
Posted in Medicare & Reimbursement
Wednesday, March 23, 2011
CMS Innovation Center Website Launched To Collect Best Practices
On Monday, CMS launched a website for the Center for Medicare and Medicaid Innovation to serve as a warehouse of new care models for Medicare, Medicaid and the Children’s Health Insurance Program, Government Health ITreports.
Innovation Center Details
The new
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U.S. ex rel. Singh v. Bradford Regional Medical Center
By Michael Cassidy on
Posted in Fraud - Stark
The USDC for the Western District of Pennsylvania has issued a significant False Claims Act Whistleblower Opinion in the case of U.S. ex rel. Singh v. Bradford Regional Medical Center. The False Claims Act case rested on a lease arrangement between certain physicians and Bradford Regional Medical Center, which the court ruled violated the Stark…
Wyoming Supreme Court Permits Termination of Disruptive Surgeon
By Michael Cassidy on
Posted in Credentialing and Peer Review
Defining and disciplining disruptive physicians has been a difficult problem for hospital administration and the medical staff for quite some time now, long enough for the Joint Commission to actually require leadership standard LD.3.10 beginning in 2009. Medical staffs have frequently been torn between protecting their members, who are frequently high performing physicians, while maintaining appropriate…
CMS Estimates 29.9% Decrease for 2012 Medicare Conversion Factor
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Social Security Act requires CMS to provide annual estimates to the Medicare Payment Advisory Commission (MedPAC) for both the Medicare Physician Fee Schedule Conversion Factor (SCF) and the Sustainable Growth Rate (SGR). According to the letter just released by Jonathan Blum, Deputy Administrator and Director for CMS, the 2012 Medicare Physician Fee Schedule Conversion Factor…
Medical Staff and Employment Issues Collide Again
By Michael Cassidy on
Posted in Credentialing and Peer Review
The Mississippi State Appeals Court affirmed a summary judgment decision by a Mississippi State Court in the case of C. Jake Lambert, Jr. M.D. v. Baptist Memorial Hospital-North Mississippi, Inc. and Baptist Memorial Health Services, Inc. Dr. Lambert was a medical staff member of Baptist Memorial Hospital (Hospital) and an employee of Baptist Memorial…
U.S. District Court Holds that State Peer Review Confidentiality is Trumped by Federal Discovery Rights
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Sabharwal v. Mount Sinai Medical Center, Queens Hospital Center, and Won Chee, the plaintiff alleged employment discrimination in that she was subjected to a hostile work environment and unlawful discrimination by not being reappointed as the Assistant Director of Anesthesia on account of age, sex and disability. The plaintiff requested production of certain records…
Removal of Independent Contractor Did not Violate Due Process
By Michael Cassidy on
Posted in Credentialing and Peer Review
Schueller v. Goddard is a fairly typical hospital staffing scenario. Dr. Schueller was an independent contractor with an emergency services group, which in turn had an exclusive service contract with Drew Memorial Hospital in Arkansas. The 8th Circuit Court of Appeals affirmed a grant of summary judgment by the District Court in favor of the hospital…