New Jersey Healthcare Blog

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Criminalizing Medicare

At a recent meeting of the American Health Lawyers Association in Boston, the representatives of various government agencies, the U.S. Attorney’s office from various states, the Justice Department representatives, the OIG representatives and the Attorneys from CMS all made a similar point.  That point was very simple, it is their feeling that recoupment, debarment, and […]

Diagnostic Testing: Accreditation for Medicare

Physicians, non-physician practitioners and Independent Diagnostic Testing Facilities that furnish the technical component (TC) of advanced diagnostic imaging services will need to become accredited in order to bill the Medicare program for such services after January 1, 2012. Advanced diagnostic imaging procedures are defined as including diagnostic magnetic resonance imaging (MRI), computed tomography (CT), and […]

Another Round of Potential Physician Reimbursement Reductions

On July 1, 2011, the Centers for Medicare and Medicaid Services (“CMS”) published proposed changes to the Medicare physician fee schedule for calendar year 2012.  CMS announced that absent a change in law, Medicare payments to physicians would be reduced by 29.5% effective January 1, 2012 as a result of the application of the sustainable […]

Government Stepping Up Criminal Enforcement Efforts

At the American Health Lawyers Association (AHLA) conference in Boston last week, the presenters, particularly those from the Justice Department or Centers for Medicare & Medicaid Services (CMS), consistently made the following position clear:  there will be more criminal enforcement activity in the healthcare arena. The government believes that civil monetary penalties, recoupment, and debarment […]


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