New Jersey Healthcare Blog

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Obama Healthcare Plan Unconstitutional? Maybe

A Virginia Federal District Court declared the Obama Healthcare plan unconstitutional today.  Other Federal District Courts have declared it constitutional.  In light of these conflicting judicial outcomes, there is no doubt that this case will ultimately be decided by the United States Supreme Court.  That of course, will take a period of time which will […]

Medical Loss Ratio Regulations

As the regulations required under the Patient Protection and Affordable Care Act which mandate use of the 85/15 or 80/20 medical loss ratio, are being implemented, it is clear that insurance companies will be able to dedicate a smaller and smaller amount of the premium for use in covering the non-medical expenses, including payments made […]

Get Ready for Physician Compare

Hospitals have had to report quality data, which is made available to the public on the CMS Hospital Compare website, for some time.  Pursuant to Section 10331 of the Patient Protection and Affordable Care Act (“PPACA”), data applicable to physician performance will also be collected and made available for review by the public.  In addition […]

“Before The OIG Comes Knocking”

Changes made to the federal laws over the past year and a half have greatly increased the exposure of medical practices under the federal False Claims Act. As part of these changes, it is now a violation of the False Claims Act to retain an overpayment received from the Medicare or Medicaid program, and physicians […]


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