Prior to passage of the Medicare Modernization Act of 2003 (MMA), CMS was not restricted in recouping overpayments, despite the provider’s ongoing appeal rights.

Finally, as of November 16, 2009, CMS will implement new rules required by MMA to restrict immediate recoupment. Section 1892(f) of the Social Security Act prohibits recoupment of overpayment during a supplier…

The following is the Med Law Blog’s Top 10 List for Areas of Interest in the OIG 2010 Work Plan for physicians and providers, which will draw particular scrutiny next year:

1.         Medicare Incentive Payment for E-Prescribing

2.         Practice Expense Components of Diagnostic Imaging

3.         Outpatient Physical Therapy Services by Independent Therapists

4.         Place of…

In Isaiah v. WMHS Braddock Hospital Corporation and Memorial Hospital and Medical Center of Cumberland, the Fourth Circuit affirmed an order granting summary judgment against Dr. Isaiah in favor of WMHS Braddock Hospital on the basis that summary judgment was appropriate under both HCQIA and the Maryland statutes providing immunity for peer review activity…

This is just a reminder of the effective date for certain new Stark Rules:

1.         CMS prohibits percentage formulae conjunction with space on equipment leases, fair market value exception transactions and indirect compensation effective October 1, 2009.

2.         Per click leases are prohibited effective October 1, 2009.

3.         "Under arrangement" relationships have been changed because…

With cases of the H1N1 Virus continuing to increase, employers’ concerns about the H1N1 virus and seasonal flu are mounting.  Employers are facing workplace and leave issues and many are developing written H1N1 and contagious disease policies to help minimize the negative effects an influenza outbreak could have on their business. Anticipating many questions from employers, the …

The Joint Commission has released a revised draft of Hospital Accreditation Standard MS.1.20, which was first proposed in June 2007 and intended to establish a balance of power between hospital administration and hospital medical staffs. Although originally scheduled to become effective January 1, 2009, the controversy and uproar accompanying the proposals in 2007 were so…

The Centers for Medicare & Medicaid Services (CMS) reminds Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) suppliers enrolled with the National Supplier Clearinghouse (NSC) they are required to obtain accreditation by September 30, 2009. Without accreditation, DMEPOS suppliers’ billing privileges will be revoked on or after October 1, 2009. Further, without accreditation, DMEPOS suppliers will not…

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