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 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…
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…
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…
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 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…
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…
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…
The Michigan Office of Financial and Insurance Regulation released details about a new high-risk pool that will offer insurance to the uninsured. To qualify the individuals must have been uninsured for at least six months, have been rejected by an insurer, and first spend $1,000 in out-of-pocket costs. The purpose…
As noted in our June 11 blog entry, the American Board of Internal Medicine (ABIM) recently took unprecedented action in immediately suspending the board certifications of 139 physicians. We have been in communication with the ABIM urging them to characterize the action as non-final recommended action pending appeal rather than…