In Cole vs. St. James Healthcare, the Montana Supreme Court affirmed the entry of a preliminary injunction against St. James Healthcare. The facts, briefly stated, were that the hospital had undertaken an investigation in a manner that was not authorized by the medical staff bylaws and changed Dr. Cole’s Medical Staff status without following the …

As required by Section 911 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), CMS is replacing its current claims payment contractors, previously known as Fiscal Intermediaries or Carriers, with new contract entities called Medicare Administrative Contractors (MACs). 

The responsibility for paying Medicare Part A and Part B claims is divided into …

A New Jersey Court has awarded $400,000 to a deaf patient who claimed her doctor discriminated against her by refusing to provide an interpreter. Irma Gerena sued Robert Fogari, a Jersey City rheumatologist, under the Federal Americans With Disabilities Act and Rehabilitation Act, claiming violations for refusing to provide to interpreter. This is not a new issue. The …

Thanks to Claire Miley of Bass, Berry & Sims in Nashville, Tennessee for posting an alert regarding the final DMEPOS Surety Bond requirements. Below is the text of the American Health Lawyers Association e-mail alert.

CMS Issues Final Rule Requiring Surety Bonds for DMEPOS

 

On December 29, 2008, the Centers for Medicare & …

The Congressional Budget Office has prepared two remarkably thorough analyses regarding the fundamental issues confronting healthcare policy and the projected costs of more than 100 different reform proposals. Great summer vacation reading — if you start now, you might finish by summer vacation. Check the links below:

 

http://www.cbo.gov/doc.cfm?index=9925

http://www.cbo.gov/ftpdocs/99xx/doc9924/12-18-KeyIssues.pdf

HIOs and Regional Health Information Networks (RHINs) are being created to facilitate the exchange of information among providers. HIOs and RHINs are typically not statutorily governed by HIPAA, other than perhaps as Business Associates. The HHS guidance, issued in conjunction with The Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information, covers …

OIG issues another in a string of gainsharing opinions involving hospitals and groups of cardiologists and radiologists. This and the solicitation by HHS of comments on shared savings exceptions and safe harbors confirm HHS’s intent to continue to encourage legitimate cost savings and incentive programs.

Link: http://www.oig.hhs.gov/fraud/docs/advisorgopinions/2008/AdvOpn08-21.2.pdf.

 

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