"Nationwide Healthcare Lawyers"
(February 27, 2015): On February 2, 2015, President Obama released his fiscal year 2016 budget proposal. This latest proposal affects a significant number of Federal health care programs and includes over $1 trillion allocated to the U.S. Department of Health and Human Services (HHS). More than 85 percent of HHS’s budget is devoted to programs […]
The FY 2016 Budget Proposes Medicare Appeals Process Reforms Read More »
(February 24, 2015): Medicare recently finalized regulations allowing enrollment as a Medicare provider to be denied if any owner or control person of the enrolling provider is affiliated with another provider which owes money to Medicare. These regulations are based on sections of the 2010 Affordable Care Act (ACA). They provide CMS an indirect means
Individual Liability for Medicare Overpayment Claims Read More »
(February 5th, 2015) The Texas Medical Board recently set forth a proposed rule that would dictate what physicians must do in order to prescribe certain medications or face sanctions. Under the proposed rule, Texas physicians must establish a defined physician-patient relationship in order to prescribe any dangerous drug or controlled substance. This relationship must include,
Texas Physicians — Is There a Defined Physician-Patient Relationship? Read More »
(January 21, 2015): Starting this year, the Centers for Medicare and Medicaid Services (CMS) will have three Medicare quality and safety incentive programs go into effect. As a result, a number of hospitals across the U.S. will be penalized more than 3% on most of their CMS reimbursements. I. Medicare Incentive Programs Now in Effect:
New Medicare Incentive Programs Read More »
(January 9th, 2015) Health care providers increasingly complain that the Recovery Audit Program creates numerous administrative and financial burdens for those participating in the federal Medicare program. Providers continue to advocate for numerous changes to the program, especially those that will reduce their burden when dealing with Recovery Audit Contractors (RACs). In response to these
CMS Implements RAC Program Improvements Read More »
(December 30, 2014): In a recent webinar presentation, I was asked whether I believed one of the many file sharing services that are available, was adequately encrypted. After investigating some of the particulars, the answer to that question was “yes”, but the answer raised more questions as to what else the Cloud Service Provider (CSP)
Cloud Storage Providers & BAAs – Where is Your Data? Read More »
(September 29, 2014) In the last article, we discussed the importance of conducting HIPAA security risk assessments, as part of your obligations under the HIPAA Security rules. The importance of promptly conducting a risk analysis if it has not yet done cannot be overestimated, as the HHS Office for Civil Rights (OCR) has now announced
HIPAA Security Risk Assessments are Essential Read More »
(September 16, 2014): Consider the following scenario. You own a durable medical equipment (DME) company that you run out of a leased location in a local office building. Your customers are a mix of privately insured and Medicare/Medicaid beneficiaries. You’ve been in business for about 10 years, but money is tight and you need to
Medicare Revocation Action: Steps for Avoiding and Appealing Read More »
(August 29, 2014) The American Cancer Society has estimated that 43.92% of all males and 38.00% of all females in the United States will develop cancer at some point during their lifetime. While a number of clinical advances have been made over the last 25 years, chemotherapy remains one of the predominant tools used to
Oncology Fraud: Michigan Oncologist Indicted Read More »
(August 31, 2014): The Healthcare Quality Improvement Act of 1986[1] (“HCQIA”, generally pronounced “Hick Kwah”), affords peer-reviewing bodies and their members legal immunity from liability from suits by the physicians they discipline, so long as their peer-review processes include certain due process rights for the accused physician. Unfortunately, the provider peer review process is irrevocably
Peer Review: How HCQIA Due Process is a Fiction Read More »
You must be logged in to post a comment.