If you’re a provider or supplier that furnishes the technical component of advanced diagnostic imaging (ADI) services and bill Medicare under the Physician Fee Schedule for these services, you should know that you must be accredited by Sun Jan 1, 2012. Those not accredited by that deadline will not be able to bill Medicare
Michael Cassidy
CMS to Host Teleconference for Medicare & Medicaid EHR Incentive Program Basics for Eligible Professionals on July 14th
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
Target Audience:
Eligible Professionals (EPs): Doctors of Medicine or Osteopathy, Doctors of Dental Surgery or Dental Medicine, Doctors of Podiatric Medicine, Doctors of Optometry, Chiropractors, Nurse Practitioners, Certified Nurse Midwives, Physician Assistants (PA) who practice at an FQHC/RHC led by a PA.
Subject: A session for individual practitioners on the basics of the Medicare…
Interim Final Rule Published for “Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions”
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
An interim final rule has been recently published for "Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions." Section 1104 of the Affordable Care Act establishes new requirements for administrative transactions that will improve the utility of the existing HIPAA transactions and reduce administrative costs.
This interim final…
HIPAA Audits
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
HHS has awarded a contract to KPMG to aid the Office of Civil Rights to provide assistance in operating an audit program to ensure that healthcare providers, health plans, and business associates are compliant with the HIPAA Privacy and Security Rule.
From the FBO.gov contract award notice:
"The protocol and audit program performance requested under this contract …
Healthcare Provider Criminally Indicted for Violating HIPAA
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
Contributed by Paul J. Welk
412.594.5536
Dr. Richard Allen Kaye, the Medical Director of Sentara Obisi Hospital, in Suffolk, VA was indicted by a federal grand jury for disclosing patient identifiable information in violation of the HIPAA Privacy Rule. The indictment accuses Dr. Kaye of disclosing patient information without authorization to an agent of the…
Lack of Adverse Final Outcome Not Necessarily a Valid Peer Review Defense
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Georgopoulos v. Humility of Mary Health Partners Inc., Dr. Georgopoulos was placed upon a six month surgical proctoring requirement because of extended operating times and excessive use of blood products. In addition to many procedural defenses, Dr. Georgopoulos’s primary substantive defense is that his patient survival and freedom from major cardiac events…
UCLA Health System Settles HIPAA Privacy and Security Case
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
UCLA Health System ("UCLAHS") has agreed to settle potential HIPAA Privacy and Security Rule violations for $865,000 after an investigation by the Department of Health and Human Services Office for Civil Rights ("OCR"). UCLAHS has committed to a corrective action plan for compliance purposes.
“Covered entities are responsible for the actions of their employees. This is…
CMS Approves Physician Recruitment Contracts with Restrictive Covenants
By Michael Cassidy on
Posted in Uncategorized
In CMS Advisory Opinion AO-2011-01, CMS has issued a favorable advisory opinion allowing the physician recruitment arrangement with a hospital and a physician practice which imposes a restrictive covenant upon the recruited physician.
Restrictive covenants and recruitment arrangements had initially been prohibited by the Stark Rules. However, bowing to industry comment, CMS amended the physician…
Google Pulls The Plug on Google Health
By Michael Cassidy on
Posted in Uncategorized
Google announced it will shut down its Google health personal health record service by the end of this year. The Company plans to make existing data recoverable through the end of 2013, after which it will be permanently deleted.
CMS Releases 2012 Medicare Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
The 2012 Medicare Physician Fee Schedule is out!
It contains a proposed Medicare Conversation Factor of $23.9635. This is a 29.5% DECREASE, mandated by the Sustainable Growth Rate (SGR) formula.
Med Law Blog will be presenting analysis of key additional provisions in the coming weeks.