The Department of Health and Human Services (HHS) hosted a press conference today to announce changes to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Privacy, Security and Enforcement Rules. The rule proposed by HHS will be in a notice and comment period for the next two months,…
Wachler & Associates Health Law Blog
Michigan’s Medicaid Funding at Risk
Last week, Michigan’s Governor Jennifer Granholm announced that Michigan could have a $560 million budget gap if Congress does not provide the funding promised in last year’s stimulus package. The Detroit News reported that Governor Granholm was concerned that without the mandated Medicaid funding programs and services would have to…
Update on ABIM Recommended Suspensions
On June 11 we posted that the American Board of Internal Medicine (ABIM) had immediately suspended the board certifications of 139 physicians. Since that time, our office has submitted a series of written submissions and had other communications with the ABIM’s counsel in order to clarify that the “suspensions” were…
The OIG’s Report on Inpatient Rehabilitation Facility Claims Could Lead to RAC Reviews
The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) released a report of its review of inpatient rehabilitation facilities’ transmission of patient assessment instruments for 2006 and 2007. Inpatient rehabilitation facilities (IRFs) are required to submit patient assessment instruments for each stay to the…
Codification of the Hospital 3-Day Payment Window
President Obama signed the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” The law includes a provision that clarifies Medicare’s position for payment of hospital outpatient services provided on either the day of or the three days prior to an inpatient admission. The 3-day…
RACs Post New Issues
Three Recovery Audit Contractors (RACs) posted new issues. The RAC for Region A, DCS Healthcare, posted 23 new approved issues. One new issue applies to DME supplier claims and applies to providers in all Region A states. Connolly Healthcare, the RAC for Region C, posted 3 new issues for non-medical…
CMS Reports that Providers Are Winning a Large Percentage of Appeals
In its report, “The Medicare RAC Program: Update to the evaluation of the three-year demonstration,” the Centers for Medicare and Medicaid Services (CMS) reveals that providers have been winning more appeals since its last report in January 2009. The report first noted that the number of reported claims for appeal…
The OIG Releases an Advisory Opinion Regarding the Dietitian and Social Worker Services Provided at a Freestanding Radiation Oncology Center
The U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 10-08 to address the provision of dietitian and social worker services at a freestanding radiation oncology center (Center) at no extra charge to the beneficiaries. The OIG determined that the proposed arrangement would not…
The Senate Passes a Plan to Fix Medicare Physician Payment for Another Six Months
On June 18 the U.S. Senate passed a six-month plan to prevent the Medicare physician 21 percent payment cut. The measure, which will cost $6.4 billion, was pushed through with the concern that the steep payment cut would raise the possibility that medical providers would turn away patients covered by…
Federal Wrangling May Negatively Impact Michigan’s Medicaid Program
Michigan’s budget may be threatened by U.S. Congressional action. Crain’s Detroit Business reported that Congress’ concern over the nation’s deficit may affect its willingness to pay for an estimated $24 billion in Medicaid assistance to states and other financial assistance, leading to the removal of the enhanced Federal Medical Assistance…