CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs).
SGR Reduction
Although the Protecting Access to Medicare Act Prohibits any SGR reduction for the first 60 days of 2015, i.e., until March 1, 2015, CMS predicts a 20.9% decrease without legislative action.…
Perhaps not coincidentally, immediately following the release of the Questionable Laboratory Payments Special Fraud Alert by the OIG, posted yesterday on the Med Law Blog, the OIG has followed up with Audit Report OIG – 03-11-00730: Questionable Billing for Medicare Part B Clinical Laboratory Services. Below are two quoted paragraphs from the executive…
There has been significantly enhanced scrutiny of financial relationships between referring physicians by both the Office of Inspector General (OIG) and Pennsylvania authorities.
Pennsylvania
Pennsylvania enacted amendments to the Pennsylvania Clinical Laboratory Act on December 18, 2013 (the amendments are referred to as Act 122) and the Department of Health and Bureau of Laboratories just…
http://www.attorneygeneral.gov/press.aspx?id=7909
Included is the link to the PA Attorney General announcement on the UPMC – Highmark Consent Decree. I will be adding mu=y summary and comments later today.
Mike Cassidy
Last week, the American Medical Association (AMA) issued a new report regarding coverage of and payment for telemedicine (CMS Report 7-A-14). The report recognizes the telemedicine is a “key innovation in support of health bill reform, being used in initiatives to improve access to care, care coordination and quality, as well as reduce…
Interesting in our Pittsburgh area that is renowned for the quality of its healthcare that St. Clair Hospital in Mt. Lebanon , PA is the only Truven Top 100, and for the 3rd year running.
A Hospital in Ohio tried to prevent access to a patient incident report on the basis of Peer Review Privilege. The Hospital claimed that, since the incident report was reviewed by the Hospital Peer Review Committee, the report was then privileged.
In Ridenour v. Glenbeigh Hospital, the Ohio Appellate Court stated that the Ohio …
The American Health Lawyers Association Regulatory Accreditation and Payment Practice Group (RAPPG) has issued an email alert regarding the issuance of a final rule by CMS intending to streamline Medicare regulatory requirements. Two aspects of that rule which are a great concern to physicians are:
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U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently announced yet another enforcement action. Specifically, OCR opened a compliance review of Concentra Health Services (Concentra) upon receiving a report that an unencrypted laptop was stolen from the Springfield Missouri Physical Therapy Center. The investigation revealed that Concentra had previously recognized…
