medicare – Page 4 – Duane Morris Health Law

November 30, 2010September 10, 2014 by Duane Morris

New Legislation Delays Medicare Physician Reimbursement Cut for an Additional Month

On November 30, 2010, President Barack Obama signed into law the Physician Payment and Therapy Relief Act of 2010. This legislation implements a one-month delay to a significant reduction in reimbursement—a 23-percent pay cut—for physicians treating Medicare beneficiaries. The legislation also provides a 2.2-percent reimbursement increase for physicians. The reimbursement reduction will go into effect, beginning on December 31, 2010. Both the Obama administration and Congress hope to use this delay to develop a long-term solution.

For more information regarding the Physician Payment and Therapy Relief Act of 2010, please go to: http://thomas.loc.gov/cgi-bin/bdquery/z?d111:HR05712:@@@D&summ2=m&.

November 16, 2010September 10, 2014 by Duane Morris

CMS Introduces New Center for Medicare and Medicaid Innovation

On November 16, 2010, the Centers for Medicare and Medicaid Services (CMS) announced the establishment of the Center for Medicare and Medicaid Innovation (CMMI), under the Patient Protection and Affordable Care Act (PPACA). The acting director of the Center is Richard Gilfillan, M.D., the former president and CEO of Geisinger Health Plan and executive vice president of insurance operations for Geisinger Health System. The goal of the CMMI is to improve quality of care and make coverage more affordable for Medicaid and Medicare patients. To do this, the CMMI will collaborate with key stakeholders, which include consumers, patient advocates, physicians, hospitals, federal agencies and states. The Center will focus on three main objectives:

Continue reading “CMS Introduces New Center for Medicare and Medicaid Innovation”

November 15, 2010September 10, 2014 by Duane Morris

New Regulation Outlining Changes to Medicare Program

This regulation, issued on November 24, 2010, outlines several changes to the Medicare program regarding the following: (1) the hospital outpatient prospective payment system, (2) the ambulatory surgical center payment system, (3) payments to hospitals for graduate medical education (GME) costs and indirect medical education (IME) costs, (4) rules governing physician self-referrals and related provider agreements in hospitals where physicians have investment interests or in hospitals owned by physicians, and (4) payments for certified registered nurse anesthetist services in rural and critical access areas. Changes to the hospital and ambulatory surgical centers payments systems will be to the amounts and factors used to determine payment rates. For both GME and IME hospital payments this regulation implements new provisions under the Patient Protection and Affordable Care Act. With respect to physician self-referrals, this regulation introduces new limitations. And as to anesthesia services there will be changes to the effective date of when hospitals can begin receiving reasonable cost payments for these services.

October 23, 2010September 10, 2014 by Duane Morris

CMS Issued Stark Self-Disclosure Protocol

On September 23, 2010, the Center for Medicare and Medicaid Services (CMS) announced a disclosure protocol pertaining to Stark Law self-referrals in accordance with Section 6409 of the Patient Protection and Affordable Care Act (PPACA). The purpose of the Medicare self-referral disclosure protocol (SRDP) is to create a mechanism that affords both health care providers and suppliers the opportunity to disclose either real or potential violations of the Stark law. In the event of a violation, a provider’s or supplier’s submission of this information to CMS may potentially result in a reduction in the amount due for the self-referral violations. For additional information regarding the SRDP, please go to the following website: http://www.cms.gov/PhysicianSelfReferral/65_Self_Referral_Disclosure_Protocol.asp

October 1, 2010September 10, 2014 by Duane Morris

Correction of Final IPPS for ACHs (Acute Care Hospitals) and LTCH (Long-Term Care Hospital) PPS and FY 2011 Rates

This regulation was adopted in order to correct technical and typographical errors that were found in the preamble and addendum of two documents regarding hospital inpatient prospective payment: a final rule and the interim final rule. The final rule and interim final rule documents containing the errors are titled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider Agreements and Supplier Approvals; and Hospital Conditions of Participation for Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation for Providers of Inpatient Psychiatric Services.” The regulation provides a summary of the errors and their corresponding corrections, which were effective beginning October 1, 2010.

September 23, 2010September 10, 2014 by Duane Morris

Alert: CMS’s Stark Law Self-Referral Disclosure Protocol Raises Tough Decisions for Healthcare Providers

August 3, 2010September 10, 2014 by Duane Morris

Changes to the Hospital Outpatient Prospective Payment System (OPPS) and CY 2010 Payment Rates

Summary: This regulation was adopted in order to correct technical errors that were identified in two documents regarding hospital outpatient prospective payment: a final rule and its subsequent correction document. The final rule containing errors is titled “Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates.” The subsequent correction document also containing errors is titled “Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates” Continue reading “Changes to the Hospital Outpatient Prospective Payment System (OPPS) and CY 2010 Payment Rates”