A bill proposed in the US House of Representatives may cause physicians to significantly restructure their practices as they relate to in-office ancillary services (IOAS).
Promoting Integrity in Medicare Act of 2013
The Stark Law is a federal statute which prohibits physicians from making referrals for Medicare-covered designated health services (DHS) to an entity with
On May 29, 2013, the US Departments of Health and Human Services, Labor, and Treasury issued final regulations regarding wellness programs under the Patient Protection and Affordable Care Act (the “ACA”). Wellness programs are programs offered by employers, or directly by insurance companies to their enrollees, to improve health and promote fitness. The ACA, in
The Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more full-time employees (“large employers”) offer “affordable” health insurance to its employees. Failure to do so will subject the employer to penalties.
Future blog postings will address the coverage requirements and penalties under
On December 2, 2012, Interfaith Medical Center, Inc. (“Interfaith”) filed for chapter 11 bankruptcy protection in the United States Bankruptcy Court for the Eastern District of New York, becoming the latest New York hospital to fall victim to the current economic downturn. It remains to be seen whether Interfaith will be able to
The Health Information Technology for Economic and Clinical Health Act (the “HITECH”) Act of 2009 aims to have all hospitals and physicians use electronic health records (“EHRs”) for all persons in the United States by 2014. Federal and State financial incentives, electronic billing requirements, and the need for ever-increasing collaboration and sharing of information among
The New York State Office of the Medicaid Inspector General (“OMIG”) recently finalized regulatory changes to New York State law which relate to the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” A credible allegation of fraud is defined as an “allegation that has indicia of reliability and has
The Centers for Medicare & Medicaid Services (“CMS”) will be penalizing more than 2,000 hospitals nationwide starting in October 2012 under the Hospital Readmission Reduction Program (the “Program”). A number of New York hospitals were included on the list of hospitals to which CMS will apply the readmission penalty to reimbursements, including Beth Israel Medical
The recent increase of prescription drug abuse led both chambers of the New York State Legislature to pass the Internet System for Tracking Over-Prescribing (I-STOP) Act on June 11, 2012. The legislation seeks to tighten control over certain controlled substances in an effort to decrease criminal diversion and abuse of such prescription drugs which can
Now that the Affordable Care Act has been upheld by the U.S. Supreme Court, the requirement to control costs is critical. One thing we can learn from the experience of near universal coverage in Massachusetts is that providing access to more citizens without containing costs is a recipe for disaster. In 2006 Massachusetts achieved coverage
The recent decision in United States ex. rel. Drakeford v. Tuomey Healthcare Sys. Inc., No. 10-1819 (4th Cir. Mar. 30, 2012) provides a sobering reminder that hospital-physician contracts should be drafted carefully in order to avoid containing any provisions that could inadvertently result in Stark law liability.
Subject to certain limited exceptions, the federal