Michael Cassidy

Subscribe to Michael Cassidy's Posts

The Pennsylvania Superior Court has decided the Pennsylvania Peer Review Protection Act does not apply to alleged peer review activity conducted by Blue Cross of Northeastern Pennsylvania, because Blue Cross is not a professional healthcare provider as defined in the Pennsylvania Peer Review Act.  Blue Cross argued it should have been protected because it’s activities…

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions.  The full text of these proposal and CMS comments and explanations is available at:

https://www.federalregister.gov/articles/2015/07/15/2015-16875/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions

http://www.gpo.gov/fdsys/pkg/FR-2015-07-15/pdf/2015-16875.pdf

Perhaps the most noteworthy of the lesser proposals were clarifications that:

  • “hold over arrangements” are permitted to satisfy the

…

CMS issued a special edition MLN Matters meant to be effective August 1, 2015.  The guidance reflects CMS instructions to Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) regarding the scope of review for redeterminations and reconsiderations of certain claims.

CMS acknowledges its concern that MACs and QICs were using their discretion to conduct…

CMS has acknowledged that arrangements among providers to satisfy the Stark exceptions need not be created in a single document.  Although a single written document memorializing the key facts of an arrangement could provide the surest and most straightforward means of establishing compliance with the applicable exception, there is no requirement under the physician self-referral…

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions.  Over the next few days, I will post comment on what I consider the most significant new exceptions and clarifications.  The full text of these proposal and CMS comments and explanations is available at:

https://www.federalregister.gov/articles/2015/07/15/2015-16875/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions…

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions.  Over the next few days, I will post comments on what I consider the most significant new exceptions and clarifications.  The full text of these proposals and CMS comments and explanations are available at:

https://www.federalregister.gov/articles/2015/07/15/2015-16875/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions…

There are two interesting items in telehealth news.

Iowa Supreme Court Rejects Ban on Telemedicine Abortions

An Iowa Board of Medicine rule requires the presence of a physician when abortion inducing drugs are provided.  Planned Parenthood sued claiming the requirement of physician presence was unconstitutional on the basis that it discriminated against women, due to…

Med Law Blog Editor

About Our Practice Group

Tucker Arensberg’s Healthcare Practice Group includes some of the most experienced health law attorneys in the region. We handle the legal problems so our clients can handle the important work of caring for patients. We work with physicians, physical therapists, dentists, optometrists, and all other professional care givers to help them avoid the many legal traps of running a practice. Tucker Arensberg lawyers have experience in all major health law issues.