Medicare recently announced that it will be increasing the frequency of its audits under the Medicare Recovery Audit Program in the near future. Under the Recovery Audit Program, Medicare contracts with auditors who review the records of health care providers to determine if Medicare was incorrectly billed for services and if so, to determine the amounts…

One of our  Medlaw Bloggers, Software Advice, contacted us about EHR certification. We thought the information would be useful.

Here are 4 questions we answered in our analysis:

  • What are the benefits of CCHIT? CCHIT has taken on the task of defining the key components of an EHR, how it should communicate with other systems

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The Medicare Appeals Process: Five Levels to Protect Providers, Physicians and Other Suppliers brochure has been updated and is now available to order print copies or as a downloadable PDF file. To view the PDF file, go to http://www.cms.hhs.gov/MLNProducts/downloads/MedicareAppealsProcess.pdf or to order hard copies, please visit the MLN Product Ordering Page at http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5 on the…

CMS PUBLISHES CORRECTED 2008
AMBULATORYSURGERYCENTER FEE SCHEDULE

On February 22, 2008, CMS published corrections to the 2008 payment rates for ambulatory surgery centers. Following is the link to the corrected final rule.

http://a257.g.akamaitech.net/7/257/2422/01jan20081800/edocket.access.gpo.gov/2008/pdf/08-671.pdf

PEER REVIEW NEWS: NEVER RESIGN PREMATURELY

Catholic Health Initiatives v. Gross is an excellent example of why premature resignations of medical staff privileges could have permanent adverse consequences. Dr. Gross was recruited by Centura Health – St. Thomas Moore Hospital, which is operated by Catholic Health Initiatives. Shortly after the commencement of the contract, Dr. Gross was involved…

SIMPLE CMS EXPLANATION OF MEDICARE PHYSICIAN FEE SCHEDULE

CMS issued a relatively simple explanation of the Medicare Physician Fee Schedule on February 19, 2008. The release is entitled The Revised Medicare Physician Fee Schedule Fact Sheet for January 2008. It explains the following:

1.     the work, practice expense, and malpractice expense components of the RVU formula;…

BY: Kenneth M. Ventresca, Esq., Lisa M. Ventresca, Esq. and Michael Cassidy, Esq.

Foreign Medical Graduates (FMGs) who reside and are employed in the United States on a J-1 Visa generally are required to return to their home country for a period of two (2) years as a prerequisite for applying for permanent residency or an H1B Visa. This requirement is known as the foreign residency requirement and constrains the immigration options for FMGs on J-1 Visas. The only way to get around the foreign residency requirement is to obtain a waiver.Continue Reading Waiver Options for Foreign Medical Graduates on J-1 Visas

PENNSYLVANIA HOSPITAL IMPOSES MANDATORY CALL

AND TERMINATES CLINICAL PRIVILEGES

Lehigh Valley Hospital has terminated the clinical privileges of three orthopedic hand surgeons because they won’t accept every hand injury case transferred to the Cedar Crest emergency room. The story was reported in the February 17, 2008 edition of the Morning Call and the full story can…

On January 25, 2008 CMS published a proposed rule which clarifies and expands the current enrollment requirements that durable medical equipment and prosthetics, orthotics and supplies ("DMEPOS") suppliers must meet to establish and continue to have billing privileges in the Medicare Program. These provisions may affect the ability of physical therapists to provide DMEPOS to their…

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