According to Bloomberg News it takes six lobbyists per lawmaker; on August 14, 2006, Bloomberg reported that $3,300 lobbyists have lined up to work on health reform. "That six lobbyists for each of the 535 members of the House and Senate, according to Senate records, and three times the number of people registered to lobby on
Medicare & Reimbursement
OIG Seeks Revision of “Incident To Rules”
By Michael Cassidy on
Posted in Compliance, Medicare & Reimbursement
The Office of Inspector General of the Department of Health and Human Services has just released a report examining problems with incident to billing by physicians, and seeking restrictions on the use of that billing arrangement. The report, titled "Prevalence and Qualifications of Non-Physicians Who Performed Medicare Physician Services" was posed by the OIG on…
Radiology Self-referral Bill May Be Folded Into Health Reform
By Michael Cassidy on
Posted in Medicare & Reimbursement
A bill introduced into the U.S. House of Representatives in June that would close the in-office ancillary service exemption for MRI, CT and PET allowed under the Start anti-self-referral law may be added to a healthcare reform package currently under consideration in Congress.
Rep. Jackie Speier (D-CA) introduced HR 2962, or the Integrity in Medicare…
Obama Hails Advance of Health-Care Reform Bill in Senate
By Michael Cassidy on
Posted in Medicare & Reimbursement
Reprinted from Physician News Briefs
By Ceci Connolly and Michael D. Shear
Washington Post Staff Writer
Wednesday, July 15, 2009; 2:42 PM
After a key Senate committee pushed forward with an overhaul of the nation’s health care system, President Obama today sought to reassure Americans satisfied with their current health insurance that the plans passed…
CMS Issues Proposed Changes to Physician Supervision Requirements for Hospital Outpatient Services
By Michael Cassidy on
Posted in Medicare & Reimbursement
In the proposed changes to the Hospital Outpatient Prospective Payment System, CMS is proposing to change the physician supervision requirements applicable to hospital outpatient services described in the 2009 Hospital Outpatient Prospective Payment System (OPPS) final rule. In the proposed rulemaking release, issued July 1, 2009, CMS indicates that physician supervision requirements requiring "direct supervision"…
CMS Issues Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates
By Michael Cassidy on
Posted in Medicare & Reimbursement
This proposed rule would update the revised Medicare Ambulatory Surgical Center (ASC) Payment System to implement applicable statutory requirements and changes arising from CMS’s continued experience with administrating that system. The proposed rule sets forth applicable relative payment weights and amounts for services furnished in ASCs, the specific HCPCS codes to which these proposed changes would…
CMS Releases Proposed 2010 Physician Fee Schedule and Projects 21.5% Decrease
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare and Medicaid services released its proposed Medicare Physician Fee Schedule for 2010. The press release and the entire 1,200 fee schedule are attached. CMS is projecting a 21.5% physician fee schedule decrease based upon the application of the sustainable growth rate (SGR) formula. Of course, Congress has intervened in each of the last five…
Significant New False Claims Act Changes
By Michael Cassidy on
Posted in Compliance, Medicare & Reimbursement
President Obama signed the Fraud Enforcement and Recovery Act of 2009 on May 28, 2009, which is the effective date of the Act.
I am attaching a compared version identifying all the changes, but I would like to direct your attention to what I believe is the most significant change impacting typical healthcare providers.
Retentions …
Alert!: CMS Warns of Physician Scam
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent…
Highmark Medicare Services Teleconference On Billing Of Time Units For Physical And Occupational Therapy Services
By Paul Welk on
Posted in Medicare & Reimbursement
Highmark Medicare Services will be hosting a teleconference on May 15, 2009 at 12:00 p.m. Eastern to discuss the billing of time units for physical and occupational therapy services. The teleconference may reference issues such as CMS Online Manual, Pub. 100-2, Chapter 15, Sections 220 and 230; Change Request CR6321; Frequently Asked Questions…