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New Medicare/Medicaid Enrollment and Screening Requirements Proposed

On September 23, 2010, the Centers for Medicare and Medicaid Services (“CMS”) published proposed regulations which will modify Medicare/Medicaid provider screening and enrollment requirements.  These proposed regulations are designed to implement changes in the screening and enrollment process which were included in the federal healthcare reform legislation.  Under the proposed regulations, providers will be separated […]


In an earlier blog post, we reported on a temporary fix adopted by Congress to address the reduction in Medicare reimbursement to physicians.  That temporary fix is due to expire at the end of this month.  Yesterday, the Senate voted once again to postpone the cut in Medicare physician payment rates on a temporary basis, […]


In an earlier blog post entitled “New Era in Healthcare” dated May 1, 2010, I pointed out that a substantial part of PPACA implementation will occur pursuant to the administrative process.  With the passage of time, we can see that this will be both a contentious as well as a complex issue which will require […]

PPACA Expands Medicare/Medicaid Suspension Authority

One of the most draconian weapons that can be utilized by the Medicare and Medicaid programs is the suspension of payment remedy.  Typically, most Medicare and Medicaid claims are submitted for payment by a provider or supplier and are paid, subject to later post-payment review.  Existing regulatory authority allows the Secretary of Health and Human […]

Medicare Part B Physician Payment Reduction Alert

CMS posted on November 2nd the 2011 Medicare payment rules that apply to, among others, physician services.  This rule provides that without Congressional action, Medicare Part B physician payments will be slashed 23% beginning December 1st, with an additional 2% reduction scheduled as of January 1, 2011. In light of the election, the issue is […]


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