Conrgress is working on an unusual solution to the yearly Medicare update. The SGR formula mandates a fee decresase, projected to be about 10%. In past years, Congress has overidden the fee reduction with a modest increase. Of course, since the sustainable growth reate formula is never changed, the chasm gorws every year. This year

A.        Refinement of Work Relative Value Units.

            Since the physician fee schedule is first established in 1992, it has been composed of three categories of relative value units, i.e., work, malpractice expense, and overhead. Each of these units is assigned a value and the sum of those units is multiplied by the dollar conversion factor to establish the Medicare reimbursement for each particular CPT code. The system includes a process for refining the work relative value units, i.e., a re-evaluation of the value of the work units assigned to each CPT code. CMS uses a standard five year review cycle based upon input by the AMA/Specialty Society Relative Scale Update Committee (RUC). For 2008, CMS has revised the work units for comprehensive hearing tests (92557), visual audiometry (92579), doppler color flow (93325), and 14 home visit codes (99336 through 99350). The values, which are contained in Table 14 of the proposed physician fee schedule, is attached below at the link entitled Table 14: Work RVU Revisions.

www.medlawblog.com/Table 14 Work RVU Revisions(1).pdfContinue Reading 2008 MEDICARE RVU REFINEMENTS

The 2008 Medicare Physician Fee Schedule also includes revised performance standards for Independent Diagnostic Testing Facilities (IDTFs). The revisions are promulgated via 42 CFR § 410.33. The link below is the text of the regulations with the new provisions "boxed" for easy identification. Following is a description of these new IDTF performance standards beginning January 1, 2008:   Continue Reading New Medicare IDTF Performance Standards Effective January 1, 2008

Pennsylvania law states that medical providers and hospitals must provide copies of patients’ medical records upon request, but may charge a fee for copying and producing the medical records. That fee is addressed annually. 

The link below is the announcement by the Pennsylvania Department of Health, entitled “Amendments to Charges for Medical Records,” which was published

Posted by: Lisa Ventresca

As posted previously, Tucker Arensberg is now offering immigration law services. As such, our firm strongly believes that the 2008 H1B Temporary Worker Visa Cap will be closing in early April 2008, shortly after the United States Citizenship and Immigration Service (USCIS) begins accepting petitions on April 1, 2008. If your organization desires to hire a foreign national in a specialty occupation (those occupations requiring a Bachelor’s degree or higher) for 2008, you will needContinue Reading H1B Visa Applications for 2008

During the period of October 2005 through September 2006, doctors’ offices received 156 citations for bloodborne pathogen violations resulting in $51,064 in fines. (http://www.osha.gov). Additionally, during that same period general medical and surgical hospitals received 118 citations while nursing care facilities received 344 citations (http://www.osha.gov). 
Continue Reading Bloodborne Pathogen Standard Compliance Resources

Health Plan Subrogation –   In the News

            By Joni L. Landy, Esq.  

In a nutshell, subrogation is the right of a health plan to recover money it paid out for medical care to treat injuries or conditions caused by another party. For example, subrogation may apply when a participant sustains injuries as a result of a slip and fall on a slippery sidewalk, or may apply if a participant is injured by another driver in a car accident. If the participant sues the party that caused his injuries and recovers, the health plan gets paid back from the recovery. Subrogation rights are typical provisions in health plans.   Continue Reading Health Plan Subrogation – In the News

The Medicare Anti-Markup provisions for diagnostic tests, which will be effective as of January 1, 2008, are intended to prevent physicians or other medical suppliers from purchasing either the professional component (PC) or technical component (TC) of any diagnostic test (excluding clinical laboratory tests subject to separate restrictions) and profiting or marking up the acquisition cost by billing globally in accordance with the fee schedule.Continue Reading The New Medicare Anti-Markup Diagnostistic Test Results