Despite efforts by various groups to have the face-to-face encounter requirement delayed for hospices and home health agencies, the requirement became effective as of April 1, 2011. For more information regarding this issue, please see a recently authored article by Wachler & Associates attorneys Amy K. Fehn and Jennifer Colagiovanni entitled…
On April 7, 2011 CMS held a telephone conference for hospitals to answer questions on the recently released Accountable Care Organizations proposed rule and to provide further instruction on the submission of comments to CMS for consideration. The CMS representatives stated that more information regarding the Centers for Medicare and…
CMS Recently released a proposed rule which would reverse the policy of heightening restrictions on suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The proposed rule relaxes previously onerous rules regarding the prohibition of telemarketing and beneficiary solicitation which were implemented on September 27, 2010. If you have…
On March 31, 2011, CMS released the proposed rule implementing the Medicare Shared Savings program and establishing the requirements for Accountable Care Organizations (ACOs) that wish to participate in this program. The following is a list of some of the highlights from this Proposed Rule. 1. The proposed rule contemplates…
If the rumors are true, tomorrow the Centers for Medicare and Medicaid Services, the Office of the Inspector General and the Federal Trade Commission will be releasing voluminous regulations governing the formation of Accountable Care Organizations (“ACO”) and the Medicare Shared Savings Program. But before we receive all the minutiae…
The OIG recently issued a favorable opinion concerning (1) the waiver of patient cost sharing amounts, without regard to patient need and (2) providing limited lodging and transportation for all patients of a network of pediatric charity hospitals. The requestors were pediatric non-profit charity hospitals which currently provide free services…
The Affordable Care Act requires that all home health and hospice services be initiated by an in-person encounter with the patient and their physician in order to be covered under Medicare. This requirement began January 1, 2011, but CMS has announced that it will not begin enforcing the requirement until…
The final rule changed several elements from the proposed rule. One changed feature under the final rule is that one entity will be responsible for testing EHRs, and another entity will be responsible for certifying the EHRs. No single entity will be allowed to perform both activities. Other changes involve…
Due to confusion surrounding whether an IDTF was considered a “mobile” or “fixed-base” delivery structure, the DAB has explicitly stated that there are two types of mobile IDTFs. Mobile IDTFs can either be “portable units” or a “mobile facility or unit.” The difference between the two definitions is that a…
The Adminstration has increased fraud prevention spending to $1.7 billion during the past fiscal year, a substantial increase from previous years. This increase has been used to combat the estimated $60 billion lost to fraud in any given year. The funds are going towards new law enforcement intra-agency teams called…