Pittsburgh MSA Included in DMEPOS Medicare Competitive Bidding Program

Medicare will begin implementation of a Competitive Bidding Program for DMEPOS effective July 1, 2008. This program will affect patients in ten competitive bidding areas (CBAs) that align with the ten metropolitan statistical areas (MSAs) selected for the first phase of this program and includes ten product

Highmark Medicare Local Coverage Determinations (LCDs)

Highmark Medicare Services has published the initial draft set of LCDs as part of its plans to fulfill CMS requirements to consolidate ICEs by July 1, 2008. Highmark’s instructions for submitting comments for the proposed Local Coverage Determinations (LCDs) and the proposed LCDs are included in the attached link. The following

Georgia Peer Review Decision Exhibits Rare Common Sense

Finally, there seems to be a peer review decision that exhibits common sense. In Madonna v. Satilla Health Services, Inc., and LeFever vs. Satilla Health Services, Inc., the Georgia Court of Appeals handed a peer review decision in a case pitting exclusive contract rights against individual

PHYSICIANS LEARN THAT CHARITY ENDS AT THE OFFICE

Although charity may begin at home, two different physician groups, one on the east coast and one on the west, have learned that charity stops at the office.


Tax Deductions For Contributing Good Will

In Derby v. Commissioner, TC No. 10930-02, the United States Tax Court

I spoke with Eric Berkman as he reported the lead story on retail clinics in the current issue of Massachusetts Medical Law Report, as did a number of other authorities on the subject.  Massachusetts recently promulgated "limited service" clinic regulations in order to regulate retail clinics appropriately, after CVS applied for a host of

CMS has decided to make no change to Section 220.1 of the existing National Coverage Determination Manual titled “Computed Tomography” (PUB 100-3, 220.1). The link to the CMS announcement is:

https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=206

The summary of the decision is as follows:

Conclusions

In summary, there is uncertainty regarding any potential health benefits or patient management alterations from including coronary CTA in the diagnostic workup of patients who may have CAD. No adequately powered study has established Continue Reading CMS DECISION MEMO FOR COMPUTED TOMOGRAPHIC ANGIOGRAPHY (HEART CT)

TOO MUCH IMMUNITY IN PEER REVIEW!

An Iowa Appellate Court has reversed the earlier trial court decision in Estate of Horst G. Blume v. Marian Health Center, first reported in the MedLaw Blog on April 9, 2007. 

The trial court previously held the hospital had breached the medical staff bylaws and was therefore excluded from