There has been an explosion in the Qui Tam litigation in the healthcare industry, as well as other industries dependent upon government payment. Qui Tam litigation allows private parties, frequently disgruntled employees (and more frequently disgruntled ex-employees) or competitors to file suit to recover damages on behalf of the government. The complaints are filed under seal and
Michael Cassidy
CMS To Host Physician Quality Reporting Initiative (PQRI) Teleconferences
By Michael Cassidy on
Posted in Medicare & Reimbursement
2007 Physician Quality Reporting Initiative (PQRI)
National Provider Conference Call with Question & Answer Session
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the first in a series of national provider conference calls on the 2007 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:00 p.m. …
Physican Cases: Antitrust, Restrictive Covenant & Credentialing
By Michael Cassidy on
RESTRICTIVE COVENANT UNENFORCEABLE
BY SURVIVING SPOUSE
The Virginia Supreme Court ruled that a medical practice corporation, ownership of which had transferred from the deceased sole physician shareholder to his spouse and which was converted to a business corporation by state law, could not enforce a restrictive covenant because it could not practice medicine and had…
New MedPAC Reports: Physician Medicare Reimbursement, Sustainable Growth Rate, and P4P
By Michael Cassidy on
Posted in Medicare & Reimbursement
MEDICAL PAYMENT ADVISORY COMMISSION (MEDPAC) REPORTS
DEAL WITH PRACTICE EXPENSE METHODOLOGY, SGR AND P4P:
MedPac reported to Congress on a variety of issues in March of 2007. MedPac predicted that the new practice expense methodology will produce a 7% E&M increase, but an 8-9% decrease for major imaging procedures by 2010. MedPac concluded that Sustainable Growth Rate…
Presription for Pennsylvania: Governor Rendell’s Proposal for Pennsylvania Healthcare Reform
By Michael Cassidy on
Posted in Medicare & Reimbursement
PRESCRIPTION FOR PENNSYLVANIA – GOVERNOR RENDELL’S PROPOSAL
FOR PENNSYLVANIA HEALTH CARE REFORM
Representatives of Governor Rendell’s administration reported at the Pennsylvania Bar Institute Annual Health Law Institute that Governor Rendell’s “Prescription for Pennsylvania,” the comprehensive state health care reform program, is expected to be presented to the Pennsylvania Legislature before the end of the month. Prescription for…
Basic Physician Contract Issues for Residents and Fellows
By Michael Cassidy on
When physicians have finally completed the medical education journey, many are confronted with a “physician employment contract,” usually from a hospital or medical practice, which could define the essential terms of their professional relationship for many years to come. If the parties live happily ever after, neither may ever read the contract again. However, if a problem arises, the scramble to find and read the contract begins.
Continue Reading Basic Physician Contract Issues for Residents and Fellows
What is the Impact of Professional Society Expert Witness Standards?
By Michael Cassidy on
Posted in Uncategorized
There have been two recent developments regarding the enforcement of expert witness standards, one enforcing standards by a society and one declining to enforce the standards in a private defamation action.
The American Academy of Orthopaedic Surgeons suspended one member and censored another for violating the Standards of Professionalism (SOPs) on orthopaedic expert witness testimony. The…
CMS Reverses Position On New IDTF Standards
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare and Medicaid Services (CMS) has quietly reversed itself on the new standards for Independent Diagnostic Testing Facilities (IDTFs). Transmittal 187, which established new standards for IDTFs and was scheduled to be effective as of February 26, 2007, was rescinded without explanation. Therefore, some of the more significant changes, such as:
§ …
CMS Establishes Website for Physician Quality Reporting Initiative (PQRI) Mandated by Tax Relief and Health Care Act of 2006
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the 2007 Physician Quality Reporting Initiative (PQRI) webpage is now available.
On December 20, 2006 the President signed the Tax Relief and Health Care Act of 2006 (TRHCA). Section 101 under Title I authorizes the establishment of a physician quality reporting system …
IRS Issues Guidance in Notice 2007-22 Facilitating FSA and HRA Rollovers to Health Savings Accounts
By Michael Cassidy on
Posted in Uncategorized
The Internal Revenue Service has issued guidance regarding rollovers from Flexible Spending Arrangements (FSAs) and Health Reimbursement Arrangements (RHAs) to Health Savings Accounts (HSAs). The guidance is necessary because Health Savings Accounts are typically not available to individuals who are covered by standard FSAs and HRAs. The Tax Relief and Health Care Act of 2006…