Entries from HEALTH LAW SECTION BLOG tagged with 'medicare'

ACO Medicare Shared Savings Program Rule Released

If you breezed through the 653 pages of the Medicaid Managed Care regulations CMS released 10 days ago, there's another hefty portion of rules for you to take a run at. Yesterday, CMS released the pre-publication version of the Medicare...

Medicare Begins Paying Primary Care Docs for Care Coordination

An AP wire covers this development in Medicare reimbursement. Starting this month, Medicare will pay primary care doctors a monthly fee to better coordinate care for the most vulnerable seniors -- those with multiple chronic illnesses -- even if they...

Study of Medicare Patients Finds Most Hospital Errors Unreported - NYTimes.com

Hospital adverse events are woefully underreported, if a new inspector general report covered in today's New York Times is to be believed: Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare...

Ouch! Industry Reacts to Obama Budget Proposal

Yesterday's New York Times covered President Obama's proposed health care spending reductions in fair detail.

NY Pharmacists Busted for $3 Million Medicare Fraud

CBS news reported yesterday: Two New York State pharmacists were arrested Tuesday for allegedly defrauding Medicare of more than $3 million after billing the federal government for prescriptions they never filled. Read the full article (with video!) on the CBS...

New NYLJ Article: "When to Get Counsel Involved in Audits, Investigations and Self-Disclosures"

Section Member Frank Serbaroli, with the New York office of Greenberg Traurig, writes a regular "Expert Analysis" column for the New York Law Journal. The latest article, "When to Get Counsel Involved in Audits, Investigations and Self-Disclosures," appears in the...

Brookhaven Settles Medicare Fraud Charges

According to a PRNewswire, Brookhaven has settled a Medicare fraud matter that stretches back to 2005: Brookhaven Memorial Hospital Medical Center, a Long Island, N.Y.-based hospital, has agreed to pay $2.92 million, plus interest, to settle allegations that the hospital...

Stark IV Regulations

The 2009 Hospital Inpatient Prospective Payment System Final Rule published on August 19, 2008 (pp. 48688-48745) makes some significant changes to the Stark regulations. A previous post discussed the changes to the stand-in-the-shoes regulations. This post discusses the new provisions...

OIG Audit of MR Services

The OIG just issued a report on Provider Relationship and the Use of Magnetic Resonance Under the Medicare Physician Fee Schedule. This study focuses on the provision of the technical component of MR services. It presents data about all MR...

Physicians Using EHRs Will Get Medicare Bonus (Updated)

Yesterday's online edition of the Congressional Quarterly included an announcement that Medicare will spend some additional money on physicians deploying EHR technology: The Bush administration announced on Tuesday a new program providing bonuses to doctors using electronic health records —...

New Web Site Helps Patients Shop for Hospital Care Based On Quality and Price

From a CMS News Release, Friday March 28: The Centers for Medicare & Medicaid Services (CMS), part of the U.S. Department of Health and Human Services (HHS), today posted new survey information at the Hospital Compare consumer Web site offering...

OIG Takes Aim at Docs

Today's New York Times online reports: A long-running federal investigation into the orthopedic device industry's suspected kickback payments to hip and knee surgeons now has the doctors in the spotlight. Having reached settlements with the five leading makers of artificial...

Hospitals Win Favorable Medicare Settlement

In today's Wall Street Journal: The federal government reached a $666 million settlement with 667 hospitals that had sued for back payments stemming from shifts in Medicare reimbursement policies dating back to the 1980s. The deal, resulting from negotiations under...

GAO Disses Medicare Advantage

A report released by the U.S. Governnment Accountability Office February 28, 2008, suggests that Medicare Advantage may be at a disadvantage to traditional Medicare: Although private health plans were originally envisioned in the 1980s as a potential source of Medicare...

WellCare's FL Office Raided by Feds

According to the Miami Herald Online: Federal authorities searched the headquarters of Florida's largest provider of managed healthcare for the poor Wednesday and trading of its stock was suspended, but nobody would say why the company is being targeted. More...

Comptroller's Audit Finds Overpayments

According to a OSC press release issued October 16th: The State Department of Health (DOH) overpaid about 2,000 medical providers an estimated $600,000 for Medicare Part B services, according to an audit released today by State Comptroller Thomas P. DiNapoli....

Stark III Regulations

CMS published the long-awaited Phase III Stark regulations on September 5, 2007.Here are some of the highlights of the Stark III regulations:: - CMS eliminated the fair market value safe harbor in the definition of fair market value. Commentators objected...

CMS Proposes Modifications to Home Health Payment System

CMS has submitted a proposed rule regarding home health reimbursement for publication in an upcoming Federal Register. The pre-published draft of the proposed rule is available on the CMS website. Here is an excerpt from the summary: This proposed rule...

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