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18 Oct 2010, 7:29 am
Hospital-owned practices may take an unexpected hit in revenue under a new Medicare rule that bundles certain physician service fees into hospital payments. [read post]
8 Jan 2013, 2:05 pm
This week the Office of Inspector General published an interesting Advisory Opinion (AO 12-22) dealing with a cardiology co-management agreement between a hospital and a private cardiology group practice. [read post]
12 Feb 2013, 7:24 am
Yesterday the U.S. [read post]
31 Oct 2013, 9:16 am
It is still evident to me that too many physician practices still do not have effective fraud and abuse compliance programs integrated into their practices. [read post]
18 Feb 2008, 3:04 pm
According to an article in the Los Angeles Times, a dispute is brewing in California over what one insurer is calling an “outreach effort” but others are calling an attempt to pit physicians against their patients. [read post]
7 May 2008, 3:37 pm
The federal government was apparently not kidding when it said it planned to take a closer look at physician/hospital arrangements. [read post]
21 Oct 2008, 3:25 pm
Under Medicare regulations, the interest rate that may be charged on Medicare overpayments and underpayments is the higher of the current value of funds rate (five percent for calendar year 2008) or the private consumer rate as fixed by the Department of the Treasury. [read post]
8 Dec 2009, 6:00 am
According to a recent Transmittal from the Centers for Medicare and Medicaid Services, physicians and others are using modifier -PC to designate the "professional component" of diagnostic tests. [read post]
9 Nov 2010, 11:20 am
The health reform law (PPACA) requires referring physicians who provide in-office MRI, CT or PET services to inform a patient in writing at the time of the referral that the patient may obtain the service from an alternative source and provide a list of suppliers who furnish the service in the area in which the patient resides. [read post]
22 Sep 2011, 6:50 am
This month, the Centers for Medicare and Medicaid Services (CMS) published a final rule for 2011 Electronic Prescribing Incentive Program. [read post]
27 Dec 2011, 9:36 am
My physician clients often ask me for advice on how best to negotiate with managed care payers for improved reimbursement. [read post]
30 Jun 2010, 6:04 am
The Centers For Medicare and Medicaid Services (CMS) has published the CY2011 Proposed Medicare Physician Fee Schedule for public inspection. [read post]
26 Feb 2015, 2:28 pm
A physician who was excluded from the Medicare program is not precluded from receiving payment for services rendered prior to the exclusion according to Advisory Opinion 15-02 published by the HHS Office of Inspector General (OIG) earlier this month. [read post]
15 Dec 2008, 9:51 pm
In response to an unusually straightforward fact pattern, the OIG today released an advisory opinion blessing certain part-time physician employment arrangements. [read post]
22 Jun 2011, 7:56 am
Kathleen Sebelius, Secretary of the Department of Human Services, recently announced during a press conference that HHS will as of July 1, 2011 be rolling out a $77 million computer program designed to prospectively identify potentially fraudulent Medicare claims by collecting and analyzing patterns in large numbers of submitted claims. [read post]
4 Jun 2009, 7:55 am
According to a June 2, 2009 letter from President Obama to key Democrat Congressman, the President is pushing for major health care reform legislation by October 2009. [read post]
15 Apr 2008, 6:21 pm
Proving the theory that no good deed goes unpunished, according to a March 17, 2008 Department of Justice press release, Hardeman County Memorial Hospital in Texas agreed to pay the federal government a total of $398,230 to resolve allegations that it violated the federal False Claims Act by submitting improper claims for payment to the Medicare program for healthcare items and services that were provided as a result of improper physician referrals. [read post]
29 Apr 2014, 8:55 am
None of us knows what the future holds for physicians and the practice of medicine. [read post]
30 Oct 2014, 7:47 am
In response to the development of alternative payment systems, provider networks are forming at a frenetic pace. [read post]
8 Aug 2012, 10:40 am
Recent press releases provide notice of activities that draw the government's ire -- and result in serious criminal consequences. [read post]
