Important update today regarding Accountable Care Organizations participating in the Medicare Shared Savings Program (Shared Savings Program). Please click here to read more information.… Continue Reading
Contibuted by Paul J. Welk pwelk@tuckerlaw.com; 412.594.5536 The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination, marking the first civil money penalty issued by HHS for HIPAA Privacy Rule violations, finding that Cignet Health of Prince George’s County, Md., (Cignet) violated the Privacy … Continue Reading
Every once in a while we try to provide some information that is interesting, helpful and a little different than our usual fair. I have attached a link to an article provided by nursingschools.net describing amazing emerging advances in medical technology. For the readers who would like more of this type of information, I have added nursing.net … Continue Reading
Experts Say Medical Office Embezzlement Common At Medical Practices, Particularly At Start Of Year. American Medical News (1/17, Elliott) reported that medical office embezzlement "is common at medical practices, and experts say the risk is especially high at the beginning of the year." This is because "patients are paying an ever-larger share of their … Continue Reading
Proposed regulations for the Affordable Care Act were announced today. Insurers in all states are now required to publicly justify any unreasonable rate increases starting in 2011. For 2011, proposed rate increases of 10 percent or higher will be publicly disclosed and thoroughly reviewed. Links: http://www.hhs.gov/news/press/2010pres/12/20101221a.html http://www.whitehouse.gov/photos-and-video/video/2010/12/21/white-house-white-board-health-reform-rate-review http://www.ofr.gov/OFRUpload/OFRData/2010-32143_PI.pdf … Continue Reading
(CNN) — A Virginia federal judge on Monday found a key part of President Barack Obama’s sweeping health care reform law unconstitutional, setting the stage for a protracted legal struggle likely to wind up in the Supreme Court. U.S. District Judge Henry Hudson struck down the "individual mandate" requiring most Americans to purchase health … Continue Reading
DEPARTMENT OF HEALTH Amendments to Charges for Medical Records Under 42 Pa.C.S. 6152 and 6155 (relating to subpoena of records; and rights of patients), the Secretary of Health (Secretary) is directed to adjust annually the amounts which may be charged by a health care facility or health care provider upon receipt of a request … Continue Reading
The American Medical Association maintains a website for current information on healthcare reform – from a provider perspective. www.ama-assn.org/ama/home/index.shtml… Continue Reading
Contributed by Paul J. Welk pwelk@tuckerlaw.com, 412.594.5536 On December 7, the House of Representatives passed S. 3987, the Red Flag Program Clarification Act of 2010. The Red Flags Rule requires financial institutions and creditors to develop and implement a written identity theft program. This legislation would exempt physical therapists and other health care providers from the forthcoming … Continue Reading
On November 30, 2010 the U.S. Senate passed the Red Flag Program Act of 2010 (Senate Bill 3987 available at http://thomas.loc.gov/) which seeks to exempt certain health care providers from the Red Flags Rule. The bill will next be considered by the House. Please check back for future updates on this legislation.… Continue Reading
In Kandel v. The Nebraska Medical Center, Dr. Kandel sought an injunction against the Medical Center for reporting Dr. Kandel to the National Practitioner Data Bank after surrendering his medical staff privileges while being under an investigation. The Nebraska Trial Court granted a Motion for Summary Judgment by the hospital and the Nebraska Appeals Court … Continue Reading
The 2011 Medicare Physician Fee Schedule adds an additional requirement to the in-office ancillary services exception of the Stark Rules. New Section 411.355(b)(7) requires that providers of MRI, CT and PET services must provide a written notice to the patient at the time of the referral, advising that the patient may receive the same services from … Continue Reading
As they do every year, the Internal Revenue Service released the dollar limits that apply to qualified retirement plans. There are three separate charts below that list the limits for 2011. The three charts are separated to identify the limits for: (1) defined contribution plans, (2) defined benefit plans, and (3) both defined contribution and defined benefit … Continue Reading
Contributed by Jo-Anne Mineweaser jmineweaser@tuckerlaw.com, 412.594.3920 The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of healthcare coverage provided to their employees on Form W-2. The aggregate cost is to be determined in the same way that the “applicable premium” is determined under the COBRA rules. This requirement was … Continue Reading
This symposium, sponsored by the University of Pennsylvania Law Review, is taking place at Penn Law School in Philadelphia from Oct. 28-30. There is no cost to attend, but registration is requested in advance. There is up to 12.5 hours of CLE credit available for this seminar. For more information or to register, please click here.… Continue Reading
The Department of Justice has filed a civil anti-trust lawsuit against BlueCross/Blue Shield of Michigan alleging that the Most Favored Nations’ Clause (MFN) in their hospital contracts prevent other insurers from entering the market place and discourage discounts, resulting in higher prices for Michigan health care consumers. The state of Michigan has joined the lawsuit. MFNs generally … Continue Reading
HHS has issued a memorandum on amendments to the HIPAA opt-out provision (formerly section 2721(b)(2) of the Public Health Service Act) made by the Affordable Care Act. More information is available at: http://www.hhs.gov/ociio/regulations/opt_out_memo.pdf.… Continue Reading
What Every Business should know about Healthcare Reform Thursday, October 14, 2010 8:30 a.m. – 10:30 a.m. Pittsburgh Athletic Association 4215 Fifth Ave Pittsburgh, PA 15213 Complimentary Breakfast & Parking RSVP by October 10 to: Susan Zelenak at 724-322-0116 or susan.zelenak@pnc.com The impact of healthcare reform on businesses is quickly becoming a major topic of … Continue Reading
Michael Cassidy is presenting today on Healthcare Banking Issues at the new Fairmont in downtown Pittsburgh for the PNCBank Healthcare Business Banking Group . The presentation is from 8:30 – 9:30 am and includes information on how this new act impacts the banking industry.… Continue Reading
Contributed by Michael Cassidy & Donna Kell mcassidy@tuckerlaw.com, djk@kellgroup.com An overlooked byproduct of health care reform and the general economic recession is the “multiplier” effect of larger deductibles and co-pays and the reduced ability of patients to make those payments, resulting in more collection problems and the perhaps unintended creation of consumer financing issues. This article … Continue Reading
Contributed by Jo-Anne Mineweaser jmineweaser@tuckerlaw.com, 412.594.3920 The Patient Protection and Affordable Care Act and subsequent regulations set forth new rules for group health plans regarding the processing of claims and appeals. These rules are effective for plan years beginning on or after September 23, 2010 (January 1, 2011 for calendar year plans) and apply only … Continue Reading
Contibuted by Jo-Anne Mineweaser 412.594.3920, jmineweaser@tuckerlaw.com On September 3, 2010, the Internal Revenue Service issued Notice 2010-59 to provide guidance on the revised definition of “medical expenses” under the Patient Protection and Affordable Care Act. Beginning on January 1, 2011, expenses incurred for medicines or drugs may be paid or reimbursed by an employer-provided plan, … Continue Reading
