In the proposed 2015 Medicare Physician Fee Schedule, CMS is seeking comments regarding expanding coverage for secondary interpretation of diagnostic imaging.

I’m enclosing pages 40370 and 40371 of the proposed Medicare Physician Fee Schedule. The enclosed material sites the Medicare Claims Processing Manual provisions which make is clear that a professional component interpretation service should…

In the recently proposed 2015 Physician Fee Schedule, CMS devoted significant resources to discussing potentially misvalued services, which I believe is code for places where CMS would like to reduce reimbursement. One of the areas is global surgery fees.

CMS has concerns with the 10 and 90 day global surgery fees because these global packages…

CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs).

SGR Reduction

Although the Protecting Access to Medicare Act Prohibits any SGR reduction for the first 60 days of 2015, i.e., until March 1, 2015, CMS predicts a 20.9% decrease without legislative action.…

Perhaps not coincidentally, immediately following the release of the Questionable Laboratory Payments Special Fraud Alert by the OIG, posted yesterday on the Med Law Blog, the OIG has followed up with Audit Report OIG – 03-11-00730: Questionable Billing for Medicare Part B Clinical Laboratory Services. Below are two quoted paragraphs from the executive…

There has been significantly enhanced scrutiny of financial relationships between referring physicians by both the Office of Inspector General (OIG) and Pennsylvania authorities.

Pennsylvania

Pennsylvania enacted amendments to the Pennsylvania Clinical Laboratory Act on December 18, 2013 (the amendments are referred to as Act 122) and the Department of Health and Bureau of Laboratories just…

Last week, the American Medical Association (AMA) issued a new report regarding coverage of and payment for telemedicine (CMS Report 7-A-14). The report recognizes the telemedicine is a “key innovation in support of health bill reform, being used in initiatives to improve access to care, care coordination and quality, as well as reduce…

A Hospital in Ohio tried to prevent access to a patient incident report on the basis of Peer Review Privilege.  The Hospital claimed that, since the incident report was reviewed by the Hospital Peer Review Committee, the report was then privileged. 

In Ridenour v. Glenbeigh Hospital, the Ohio Appellate Court stated that the Ohio …

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.