KEY FACTS: PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI)
PQRI is a precursor to Medicare pay for performance (P4P) or quality incentives established by the Tax Relief and Healthcare Act of 2006 (TRHCA). The first quality reporting period will be July 1, 2007 through December 31, 2007.
Payment Amount: Congress budgeted $1.35 billion but the payment amount per provider…
Dr. John C. Perry and his practice, Teddy Bear Obstetrics & Gynecology, P.S., sued Kadlec Medical Center (which you may recall is the hospital that obtained a negligent credentialing judgment against Lakeview Medical Center in Louisiana for failing to provide credentialing information) and several members of the medical staff alleging that his credentials at Kadlec…
PITTSBURGH, PA – The law firm Tucker Arensberg, PC is proud to announce that Michael A. Cassidy has been named to the list of Pennsylvania Super Lawyers for 2007 by Philadelphia Magazine and Pennsylvania Super Lawyers Magazine. Selection for the honor is determined through the independent research of Law & Politics magazine. Over 36,000 Pennsylvania…
View David Harlow’s HealthBlawg for an update onn CMS PQRI.
The California Department of Insurance and the Orange County District Attorney’s Office have arrested three doctors in what they are describing as the largest medical fraud prosecution in the nation. Some stories are so abhorrent they taint entire professions. In Orange County, three physicians and a group of ambulatory surgery center developers, some of whom have already…
The Internal Revenue Service issued a directive on May 11, 2007 confirming that the provision of hardware and software components of electronic health records (EHR) will not constitute private inurement jeopardizing the tax exempt status of non-profit hospitals. This directive is another step forward in facilitating hospital subsidized EHR for private practice physicians.
The Centers for…
Curtsinger v. HCA, Inc.
Dr. Curtsinger’s case illustrates one of the traps for the unwary in medical staff privileging cases. Dr. Curtsinger was summarily suspended, but was reinstated upon agreeing to a leave of absence to fulfill certain conditions for reinstatement. Upon completion of those conditions, Dr. Curtsinger requested return from his leave of absence; the hospital…
Michael A. Cassidy has been appointed Chair of the American Health Lawyers Association Medical Staff, Credentialing and Peer Review Practice Group (MSCPR) for a one year term beginning July 1, 2007.
The General Accounting Office (GAO) has issued a report recommending physician profiling, which they define as identifying efficient physicians. The entire report, i.e., GAO-07-307, is available at the following link: http://www.gao.gov/new.items/d07307.pdf
Following are key findings:
GAO estimates that physician account for 20% of the total health care expenditures, but influence 90% of total expenditures through referrals…
The Internal Revenue Service issued a private letter ruling on April 20, 2007 concluding that captive professional corporations were beneficially owned by the hospital, but that the activities of the professional corporations were conducted on a larger scale then was reasonably necessary for the performance of the hospital’s exempt functions and that the professional corporations&rsquo…
