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14 Oct 2011, 6:04 am
According to a recent study published in the September issue of Health Affairs, one of the key drivers behind the skyrocketing healthcare costs in the United States is the amount of fees payable to the physicians. [read post]
30 Nov 2016, 7:01 am
Earlier this month, the Office of Inspector General of the Department of Health and Human Services (“OIG”), the agency charged with enforcement of key federal fraud and abuse laws, published its annual Work Plan identifying the areas of compliance concern under the Medicare program on which it will focus its review efforts in the coming year. [read post]
21 Jan 2009, 6:50 am
According to an article in today's Philadelphia Inquirer, the Pennsylvania Insurance Department has apparently unofficially informed Highmark Blue Shield and Independence Blue Cross of certain conditions it will place on the merger. [read post]
8 Apr 2010, 6:23 am
Among its many provisions, the newly signed Patient Protection and Affordable Care Act has imposed a new requirement on physicians who rely on the Stark "In-Office Ancillary Services" exception. [read post]
31 Dec 2014, 6:48 am
Although unlikely to have a major impact on cash flow, physicians should keep in mind that under the CY 2015 Medicare Physician Fee Schedule (MPFS) which was published in November, the Centers for Medicare and Medicaid Services (CMS) indicated that it will hold claims for 14 days in order to implement the Fee Schedule changes. [read post]
28 Oct 2010, 6:10 am
Hot on the heels of the online article in the Wall Street Journal focusing on questionable physician billing practices and Medicare's Carrier Standard Analytic File database, another recent online Wall Street Journal article is now questioning the propriety of physician involvement in setting the relative values used to establish Medicare physician fees. [read post]
24 Jul 2012, 9:26 am
I mentioned recently to one of my physician practice clients that all indications suggest to me that in-office dispensing of drugs by physicians is likely to become a target for increased regulation and enforcement. [read post]
30 Aug 2012, 9:32 am
Federal antitrust enforcement authorities have historically not gotten too excited about hospitals acquiring physician practices. [read post]
24 Apr 2017, 12:40 pm
As first posted on our sister blog, “In The Weeds” (Fox Rothschild’s Cannabis Law Blog), the Pennsylvania Department of Health issued its long-awaited proposed temporary regulations regarding physicians on April 11, 2017. [read post]
21 Dec 2015, 6:47 am
After many years counseling physicians regarding Medicare fraud and abuse compliance, I’m still perplexed at the general lack of understanding in the physician community regarding the need to comply with complex healthcare fraud and abuse laws and the serious risks of noncompliance. [read post]
22 Apr 2014, 7:13 am
By Michael Coco The New Jersey Supreme Court, through the Committee on the Rules of Evidence (the “Committee”) is proposing changes to the rules on admitting evidence and allowing testimony from health care professionals involved in the counseling and treatment of mental health patients. [read post]
19 Jan 2010, 8:38 am
In case you missed it, the Centers for Medicare and Medicaid Services (CMS) eliminated use of the evaluation and management Consultation Codes. [read post]
4 Dec 0001, 4:00 pm
Curious about what the future of medicine will look like? [read post]
19 Feb 2014, 7:10 am
Many physicians still haven’t come to grips with the fact that . [read post]
21 Oct 2008, 11:54 pm
It's pretty clear that the good old days of detailing prescribing physicians with freebies are gone. [read post]
8 Oct 2009, 2:59 pm
According to the Congressional Budget Office (CBO), the Chairman’s mark for the Healthy Futures Act of 2009 proposed by Senator Max Baucus will be paid for, in part, through a reduction in Medicare payment rates. [read post]
30 Jan 2013, 2:04 pm
Today I am focusing on the self-referral ban under the federal Stark laws. [read post]
29 Aug 2014, 9:14 am
The Centers for Medicare and Medicaid Services (CMS) has agreed to permit Pennsylvania to expand its Medicaid program under the federal Affordable Care Act to cover low income adults whose incomes exceed the federal poverty level. [read post]
9 Nov 2015, 7:49 am
A new study in the BMJ suggests that the more services a physician provides to his or her patients, the less likely the physician is to be sued for malpractice. [read post]
5 Feb 2008, 4:20 pm
If you have a question about Medicare coverage or how a particular service is to be billed, who do you call? [read post]
