CMS has established a Medicare learning network web page dedicated to Medicare fee for services advance practice nurses and physician assistants. It includes definitions, licensing requirements, enrollment procedures, reimbursement guidelines, and links to related materials. The website is accessible at the following link:

http://www.cms.hhs.gov/MLNProducts/70_APNPA.asp

Highmark has established new provider privileging requirements from diagnostic imaging to be effective January 1, 2009. The text of the requirements is available on the Highmark website in the ResourceCenter and is also attached below as a PDF.

www.medlawblog.com/uploads/file/Privileging Requirements.pdf

Independent Diagnostic Testing Facility Developments

 

            The 2009 Medicare Physician Fee Schedule Regulations include two provisions regarding Independent Diagnostic Testing Facilities. 42 CFR §410.33 has been supplemented with two additional subsections.

            First, Section (16) states all entities that provide diagnostic imaging services to Medicare beneficiaries will be required to enroll as IDTFs regardless…

The revised Anti-Markup Final Rules were published by CMS on November 19, 2008 in the Federal Register, as part of the Medicare 2009 Physician Fee Schedule. The entire text of the 2009 Medicare Physician Fee Schedule and the related rules, i.e. Anti-Markup, Independent Diagnostic Testing Facility, physician referral issues, etc. were posted by the Med …

Dr. Poliner has petitioned the United States Supreme Court to review the Fifth Circuit decision dismissing his claims against Texas Health Systems based upon immunity under the Health Care Quality Improvement Act. Dr. Poliner is arguing that the Fifth Circuit in particular and courts in general have gone too far in granting immunity under the "objective…

CMS published the final rule containing the Medicare Physician Fee Schedule for 2009 on November 19, 2008. Included in the final rule are:

1.         Confirmation of the 1.1% Physician Fee Schedule increase for 2009.

 

2.         Designated Health Service list for 2009 for Stark/Physician Self-Referral purposes.

 

3.         Final performance standards for Independent Diagnostic Testing …

 

CMS says physicians will receive a 1.1 percent Medicare pay increase starting in 2009.

Modern Healthcare (10/31, Lubell) reports, "Physicians will receive a 1.1 percent increase to their Medicare payments in 2009 under a final rule issued by" the Centers for Medicare and Medicaid (CMS). This "update reflects a provision included in the…

The Electronic System for Travel Authorization (ESTA) is an electronic system for screening
Visa Waiver Program passengers before they begin travel to the United States without a visa. It is anticipated that ESTA will become mandatory for Visa Waiver Program travelers on January 12, 2009.

www.medlawblog.com/uploads/file/Visa waiver – passport reqts.pdf

Lisa Ventresca

There has been some consternation whether the FTC Red Flag rules applied to medical practices as creditors. Organized medicine has been seeking clarification. which has not been forthcoming. Fortunately, this 6 month delay should allow somtime to review this issue.

FTC Will Grant Six-Month Delay of Enforcement of ‘Red Flags’ Rule Requiring Creditors and Financial Institutions

…

Advisory Opinion 08-16, the text of which is linked below, involved a nonprofit hospital’s Pay for Performance (P4P) program with a commercial insurer and certain physicians on the hospital’s medical staff. Under the P4P program, the insurer pays the hospital bonus compensation calculated as percentage of the annual base compensation it otherwise pays to the …

Med Law Blog Editor

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