Additional Federal Contractor Obligations
The Office of Federal Contract Compliance Programs on December 16, 2010 issued Transmittal Number 293, which is attached to this blog. The purpose of that transmittal is to alert healthcare providers that they may be considered subcontractors subject to the requirements of the Office of Federal Contract Compliance Programs. While it has been clear (and […]
Delay In Physician Pay Reduction
The 2012 Federal budget proposed by the Obama Administration delays the threatened 28% cut in Medicare payments to doctors for two (2) more years, until after the elections. This approach continues kicking the can down the road, and does not permanently resolve the situation. At a hearing on Tuesday, February 15, 2011, both Senate Finance […]
Florida Judge Rules That Healthcare Law Is Unconstitutional
This week’s headlines announced that a Federal Judge in Florida struck down the healthcare law as unconstitutional. However, until the constitutionality issue is finally resolved by the U.S. Supreme Court, the federal government and most (if not all), state agencies will continue to proceed with the implementation of the statute. As stated in an earlier […]
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 […]
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 […]
FURTHER POSTPONEMENT OF PHYSICIAN MEDICARE CUT POSSIBLE
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, […]
IMPLEMENTATION PROCESS
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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