On January 21, 2009 I posted an article describing the preliminary injunction obtained by Jesse Cole, M.D. against St. James Healthcare in Montana, pursuant to which Dr. Cole’s clinical privileges were reinstated. For more information, see the website describing the final settlement in that case in which St. James Healthcare paid $4,000,000 to settle the
2011
HHS Concludes Getting Punched In The Head Is Dangerous
By Michael Cassidy on
Posted in Legal News
We needed a study for this???
CMS Permits Self-Reporting Nursing Homes 50 Percent Penalty Reduction
By Michael Cassidy on
Posted in Compliance
CMS has issued a final rule in 42 CFR § 488.438(c)(2), which will be effective January 1, 2012, which states:
· “When CMS determines that a SNF, a dually participating SNF/NF, or an NF-only facility subject to a civil money penalty imposed by CMS self-reports and promptly corrects the non-compliance for which the…
Physician’s Clinical Privileges Suspended for Long History of Disruptive Conduct
By Michael Cassidy on
Posted in Credentialing and Peer Review
The memorable lesson of Sternberg v. Nanticoke Memorial Hospital is that the Delaware Supreme Court upheld a grant of summary judgment to the hospital on the basis of immunity under the Health Care Quality Improvement Act (HCQIA), despite:
· The physician was admittedly a competent orthopaedic surgeon; and
· There had been no…
ONC Publishes Federal HIT Strategic Plan
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
ONC Announces open public comment period on the Federal Health IT Strategic Plan: 2011-2015
The Office of the National Coordinator for Health Information Technology (ONC) today announced an open public comment period on the Federal Health IT Strategic Plan: 2011-2015 (“the Plan”). The Plan reflects ONC’s strategy, developed in collaboration with other federal…
Accountable Care Organizations
By Michael Cassidy on
Posted in Legal News
Important update today regarding Accountable Care Organizations participating in the Medicare Shared Savings Program (Shared Savings Program).
Please click here to read more information.
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
…
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…