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25 Jul 2013, 6:18 am by Todd Rodriguez
As the implementation of the federal Affordable Care Act (ACA) continues in fits and starts, healthcare providers are scrambling to best position themselves to accommodate anticipated and developing payment models. [read post]
23 Jul 2009, 11:46 am
In what many Pennsylvania physicians feel is a long overdue move, the Pennsylvania Insurance Commissioner has announced that the Department of Insurance will investigate whether any of Pennsylvania's Blue Cross-Blue Shield insurers have engaged in anti-competitive behavior in violation of the Unfair Trade Practices act. [read post]
14 Jun 2010, 6:43 am by Todd Rodriguez
On May 20, we presented a free Webinar to physicians and other interested parties regarding practical tips and key legal issues to be considered in selling a medical practice to a hospital.  [read post]
2 Aug 2011, 7:08 am by Todd Rodriguez
I frequently have the opportunity to speak with young physicians finishing their residencies and fellowships. [read post]
18 Jul 2017, 9:50 am by Edward J. Cyran
Under CMS’s new Quality Payment Program, which will adjust Medicare Part B payments starting in 2019 based on data from this year, physicians and other eligible clinicians must qualify for one of two payment “tracks”, either the Merit-Based Incentive System (MIPS) or the Advanced Alternative Payment Model (Advanced APM) track. [read post]
28 Apr 2014, 6:53 am by Todd Rodriguez
Many physicians I speak with are still surprised to learn that the federal Stark statute imposes restrictions on income division within group practices. [read post]
12 Mar 2008, 3:18 pm
According to a recent alert on the Centers for Medicare and Medicaid Services (CMS) website, physicians and other providers are required to begin using a new ABN form when services are expected to not be covered by medicare. [read post]
21 Oct 2008, 4:18 pm
According to a recent article in the Philadelphia Business Journal, the Pennsylvania Insurance Department will not issue a ruling on the merger until early next year. [read post]
12 Apr 2011, 10:58 am by Todd Rodriguez
Although many Medicare billing rules can present challenges for physicians, the incident-to billing rules consistently confound many physicians. [read post]
7 Apr 2009, 6:41 am
Several Congressman, including Senator Ted Kennedy, are renewing their efforts to change the way physicians receive information about new prescription drugs. [read post]
17 Nov 2009, 5:44 am by Todd Rodriguez
While all eyes are on the health care reform debate, a new Senate bill would give the government improved tools for investigating and prosecuting fraud and abuse in both federal and private health insurance programs. [read post]
25 Aug 2009, 11:07 am
With the rollout of the Recovery Audit Contractor (RAC) audit program in full swing, physicians should be paying close attention to their medical record documentation efforts. [read post]
15 Jan 2018, 7:02 am by Edward J. Cyran
Earlier this month, Attorney General Jeff Sessions issued a Memorandum rescinding the Obama Administration’s “hands off” policy with respect to the prosecution of licensed cannabis distribution in states where medical or recreational marijuana are legalized. [read post]
2 Oct 2008, 3:37 pm
The Office of Inspector General (OIG) of the Dept of Health and Human Services released its FY2009 Workplan yesterday. [read post]
22 Feb 2010, 11:22 am by Todd Rodriguez
In anticipation of a much publicized bipartisan meeting with representatives of Congress, President Obama released today a comprehensive health plan which seeks to combine the House and the Senate health care bills. [read post]
25 Nov 2013, 7:56 am by Todd Rodriguez
Hospital-physician acquisition of medical practices continues at a furious pace. [read post]
20 May 2009, 2:13 pm
Pennsylvania physicians need to be aware that legislation (House Bill 1405) has once again been introduced in the Pennsylvania House which would severely limit the ability of physicians to refer to entities in which they have investment interests. [read post]
8 Dec 2009, 6:00 am by Todd Rodriguez
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]