In follow up to a previous posting, the Wall Street Journal recently reported that the Medicare Recovery Audit Contractor Program has identified 1.03 billion dollars of improper payments over the past three years, about 992.7 million dollars of which were over-payments by Medicare. While the Recovery Audit Contractor Program is currently underway in six states, Medicare
Medicare & Reimbursement
Proposed Stark Exceptions For Incentive Payments And Shared Savings Program
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS is acknowledging the continued interest in Pay for Performance ("P4P") and gainsharing ideas, and is issuing a specific self-referral exception in Anti-Kickback Safe Harbor to permit these programs. P4P programs are being hereinafter referred to as incentive payments, and gainsharing programs are now being referred to as shared savings programs.
The …
CMS Medicare Physician Fee Scedule Notice: .5 % Increase
By Michael Cassidy on
Posted in Medicare & Reimbursement
New 2008 Medicare Physician Fee Schedule Payment Rates Effective for Dates of Service July 1, 2008 through December 30, 2008
The Medicare Improvements for Patients and Providers Act of 2008 was enacted on
July 15, 2008. As a result, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent has been replaced with …
Congress Overrides Medicare Veto
By Michael Cassidy on
Posted in Medicare & Reimbursement
The House voted 383 to 41 to override the veto, while the Senate voted 70 to 26, in both cases far more than the two-thirds necessary to block the president’s action.
With organized medicine and other lobbies promoting the popular measure in an election year, Republicans broke heavily from the White House. A total…
MGMA Reports That President Vetos Medicare Bill to Prevent Physician Fee Cut
By Michael Cassidy on
Posted in Medicare & Reimbursement
medicare payment UPDATE
Today the president vetoed the Medicare Improvement Act for Patients and Providers (H.R. 6331). The House of Representatives must now schedule a new vote to override the veto, followed by a similar vote in the Senate. A two-thirds majority in each chamber must support a veto override for it to succeed.
Please …
Physician Self-Referral and Anti-Markup Issues
By Michael Cassidy on
Posted in Medicare & Reimbursement
The proposed 2009 Medicare Physician Fee Schedule also deals with proposed changes to the reassignment rules related to diagnostic tests, sometimes referred to as the Anti-Markup Provisions. The discussion of the proposed rules, which occupies pages 237 through 260 of the Federal Register publication, which pages are attached at the link below, discusses the …
Medicare 2009 IDTF Proposals
By Michael Cassidy on
Posted in Medicare & Reimbursement
Medicare is proposing that all physician practices providing diagnostic testing must enroll as independent diagnostic testing facilities effective as of September 30, 2009. A copy of the comments on the proposal is attached.
This proposal would make physician practices subject to the performance standards for independent diagnostic testing facilities. This will …
Medicare Payment Update
By Michael Cassidy on
Posted in Medicare & Reimbursement
White House continues to threaten veto of Medicare payments bill.
The AP (7/11) reports, "President Bush intends to block a bill protecting doctors from a cut in their Medicare pay, even though Congress has enough votes to override his veto, a White House spokesman indicated on Thursday." The President opposes "reduce[d] spending on private…
Senate Passes Medicare Physician Fee Savings Bill
By Michael Cassidy on
Posted in Medicare & Reimbursement
The LA Times has reported that the senate passeds a medicare savings bill, but the President has threated a veto.
WASHINGTON — In a floor session electrified by the appearance of Sen. Edward M. Kennedy, the critically ill Massachusetts Democrat, the Senate voted Wednesday to stave off a cut in Medicare fees to doctors who
…
2009 Medicare Physician Fee Schedule Issues
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare/Medicaid Services posted the proposed 2009 Medicare Fee Schedule Rule on July 7, 2008. The link to those rules was provided in an earlier Medlaw Blog post.
The proposals include numerous items, but I would like to highlight the following:
1. Proposed changes to the Independent Diagnostic Testing Facility (IDTF
enrollment requirements; …