CMS ADDS PAYMENT FOR CHRONIC CARE MANAGEMENT SERVICES TO MEDICARE PHYSICIAN FEE SCHEDULE
CMS has published the Medicare Physician Fee Schedule Final Rule for 2014. One of the modifications adopted by CMS is the implementation of a separate payment for chronic care management services under the Physician Fee Schedule starting in calendar year 2015. The separate payment will be made for chronic care management services furnished to patients […]
Recent Appellate Division Decision Represents Importance of Employee Background Checks
The New Jersey Appellate Division issued a decision in Township Pharmacy v. Division of Medical Assistance and Health Services which Medicaid reaffirms the absolute obligation on the part of providers to comply with the Medicaid requirements (which are also applicable to Medicare) to perform background checks for all individuals working for a provider who are […]
2013 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Insurance Trust Funds
As you are aware from the numerous newspaper articles, they are now projecting that this fund will remain solvent for an additional two years. However, as we have pointed out consistently in the last couple of years with our blogs , this report is fundamentally flawed as set forth on the last two pages of […]
Court Upholds Stark Restriction on Under Arrangements Joint Ventures
Last week, the U.S. District Court for the District of Columbia issued a decision upholding the validity of regulatory provisions contained in the 2008 amendments to the federal Stark regulations. The amendments prohibit a physician owner from referring his or her Medicare patients for designated health services to a joint venture in which the physician […]
RECENT HEALTH CARE LEGISLATION IN NEW JERSEY
The following represents a summary of laws that have been recently enacted in the State of New Jersey that may impact health care facilities and other health care providers: P.L. 2012, c. 62 – prohibits health care facilities from discharging prescription medications into sewer or septic systems in certain circumstances and provides for civil administrative […]
Providers Sequester or its Alternatives
While health care providers will be penalized under the sequester, if the approach going forward in lieu of the sequester is to provide for alternate cuts in government spending, the result as shown in the linked articles (http://www.businessweek.com/ap/2013-02-27/no-ruckus-about-medicare-cuts-in-sequester; http://www.modernhealthcare.com/article/20130227/NEWS/302279950/sequesters-medicare-cuts-would-start-with-services-provided-in-april?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJWdjhHRWxiNUtpQzMyWmVwNVhzWUpibWhiUVE2MWxZYzhYdVNIdUY4amk2UXI5SzVRTnI0Vk; http://www.modernphysician.com/article/20130301/MODERNPHYSICIAN/303019975?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJWLzBBRWxYek9UYktwUGZUamg5b1g4WFFERmhzbHhCSnN6Yk9XNmM9&utm_source=link-20130301-MODERNPHYSICIAN-303019975&utm_medium=email&utm_campaign=mpdaily) to the providers could be much worse. The one thing that seems to be clear […]
Department of Labor Expands Whistleblower Protection Under Affordable Care Act
Below is a link to the Department of Labor’s website in regard to its proposed regulations expanding whistleblower protection to individuals who complain about the actions taken under the Affordable Care Act. The difficulty for the employers in this situation is the fact that they are looking at an Act that covers almost 2,000 pages […]
New Jersey Department of Health Unveils Its New POLST Form
The New Jersey Department of Health and Senior Services unveiled a new health care treatment planning tool which is intended to better facilitate implementation of a patient’s treatment goals and wishes. Known as the POLST form (shorthand for Physician/Practitioner Orders for Life Sustaining Treatment), it is designed to be completed concurrently by the patient and […]
OIG Provides Guidance Regarding Provision of Electronic Interface to Physicians
The provision of free access to an electronic interface designed to transmit orders to and from a hospital by physicians was the subject of OIG Advisory Opinion 12-20. Under the facts reviewed in the Advisory Opinion, the hospital would provide free access to an electronic interface to community physicians and physician practices. The physicians could […]
OIG Offers Additional Guidance on Hospital Relationships with Physicians
In two recently published Advisory Opinions, the HHS Office of Inspector General provided guidance concerning financial relationships between hospitals and members of their medical staffs. Advisory Opinion No. 12-15 involved per diem fees paid by a hospital to physicians to provide on-call coverage for the hospital’s emergency department. Advisory Opinion No. 12-20 involved a proposal […]
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