On November 16, 2010, the Centers for Medicare and Medicaid Services (CMS) announced the establishment of the Center for Medicare and Medicaid Innovation (CMI), under the Patent Protection and Affordable Care Act (PPACA). The acting director of the Center is Richard Gilfillan, M.D., the former president and CEO of Geisinger Health Plan and executive vice president…

In OIG Advisory Opinion No. 10-24, a sleep testing entity with no physician ownership proposes to provide sleep disorder diagnostic testing and related services to a hospital as “under arrangements” contract, in which the hospital would bill for the services as a hospital outpatient service. The Requester would provide the sleep testing equipment, the sleep…

In Kandel v. The Nebraska Medical Center, Dr. Kandel sought an injunction against the Medical Center for reporting Dr. Kandel to the National Practitioner Data Bank after surrendering his medical staff privileges while being under an investigation. The Nebraska Trial Court granted a Motion for Summary Judgment by the hospital and the Nebraska Appeals…

The 2011 Medicare Physician Fee Schedule adds an additional requirement to the in-office ancillary services exception of the Stark Rules. New Section 411.355(b)(7) requires that providers of MRI, CT and PET services must provide a written notice to the patient at the time of the referral, advising that the patient may receive the same services from…

As they do every year, the Internal Revenue Service released the dollar limits that apply to qualified retirement plans. There are three separate charts below that list the limits for 2011. The three charts are separated to identify the limits for: (1) defined contribution plans, (2) defined benefit plans, and (3) both defined contribution and defined benefit…

In Genchi v. Lower Florida Keys Hospital District, a Florida State Appeals Court took the opposite view from the Arkansas Supreme Court in Baptist Health, posted just last week, regarding the importance of preserving physician/patient relationships.

In Baptist Health, the Arkansas Supreme Court recognized the potential interference with physician patient relationships posed by…

After years of litigation and appeals, the Arkansas Supreme Court has finally decided in Baptist Health v. Murphy that the economic credentialing policy tortiously interfered with the physician/patient relationships of a group of its staff cardiologists and enjoined Baptist Health from using its economic credentialing policy to deny staff appointments and clinical privileges to 12…

Contributed by Jo-Anne Mineweaser

jmineweaser@tuckerlaw.com, 412.594.3920

The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of healthcare coverage provided to their employees on Form W-2.  The aggregate cost is to be determined in the same way that the “applicable premium” is determined under the COBRA rules.   This requirement…

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