By now, everyone knows ICD-10 coding starts October 1, 2015.
Starting October 1, 2015, Medicare claims with dates of service after October 1, 2015 will only be accepted if they contain a valid ICD-10 code. The Medicare...more
Iowa Supreme Court Rejects Ban on Telemedicine Abortions -
An Iowa Board of Medicine rule requires the presence of a physician when abortion inducing drugs are provided....more
The Federal District Court of the Western District of Texas has ruled against the Texas Medical Board and granted TelaDoc’s Motion for a Preliminary Injunction prohibiting the Texas Medical Board from enforcing new rules...more
Medicare Regulations allows CRNA’s to administer anesthesia without physician supervision if the state governor opts out of the regular physician supervision requirement.
Governor Ritter of Colorado opted out in 2010,...more
On June 9, 2015, the OIG issued a Fraud Alert entitled “Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability”. This is just a one page letter warning hospitals and physicians by stating the...more
Cooper v. Pottstown Hospital is another case where a dissatisfied party is attempting to use the federal Anti-Kickback Statute or the Stark Law in litigation arising out of the contracts to which they were willing parties at...more
House Bill 706 has been introduced in the Pennsylvania House. This is a “parity” bill which does the following:
It defines telehealth in such as way as to neither mandate nor prohibit asynchronous or synchronous...more
The Texas Medical Board recently adopted a new rule requiring face to face encounters by physicians with patients before prescribing medication. Teladoc has sued the Texas Medical Board in Federal Court alleging restraint of...more
The ruling by Judge Ward of the Allegheny County Court of Common Pleas highlights another facet of the ongoing dispute between UPMC and Highmark.
On February 18, 2015, Judge Ward of the Allegheny County Court of Common...more
All states have some degree of confidentiality protection for peer review activities and the information generated by those activities, and there is additional federal protection for information gathered and created by...more
MGMA has published the following alert: Congress repeals SGR!
In a significant victory for physician group practices and MGMA, late last night the Senate voted (92-8) to approve the Medicare Access and CHIP...more
Historic SGR repeal passes in House -
Today, the House of Representatives passed the Medicare Access and CHIP Reauthorization Act, H.R. 2, by a vote of 392–37. This legislation permanently repeals the SGR and returns...more
Senate leaves for recess with no action on SGR repeal -
Despite a successful vote in the House yesterday, the Senate failed to bring to a vote legislation to repeal the flawed Medicare Sustainable Growth Rate (SGR)...more
In Beber v. Metzger and MDVIP, along with other physician defendants, a Florida jury awarded $8.5 million in a malpractice claim, and found MDVIP, a national concierge physician network with over 800 physicians, partially...more
The Ohio State Medical Board has proposed new telehealth prescribing regulations, which are predicated upon whether the drug is a controlled or not a controlled substance....more
New York Governor Andrew Cuomo signed a Bill late last week, which will take effect as of January 1, expanding telehealth coverage in New York. This law does three things which are on the leading edge of telehealth coverage....more
Scott Leah, an attorney in Tucker Arensberg’s Pittsburgh office, recently circulated the below client alert:
Employers with more than 50 employees need to be aware of a recent ruling on FMLA notices, which employers...more
In Kates v. Doylestown Hospital, the Pennsylvania Superior Court, in a non-precedential decision, held back the Pennsylvania Peer Review Protection Act does not provide confidentiality protection for certain records....more
42 U.S.C. § 1981 prohibits discrimination affecting citizens rights to make contracts. In the credentialing field, § 1981 has been used to circumvent the immunities provided by the Health Care Quality Improvement Act (HCQIA)...more
The Pa. Departments of Health and Insurance have established a website in an attempt to provide ongoing information and guidance regarding the termination of the Highmark...more
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule intended to make ACOs and Medicare Shared Savings Plans more practical and attractive to potential providers. The proposed rule was released on...more
On July 21, 2014, I posted the proposed Medicare Physician Fee Schedule, and described the intent by CMS to eliminate global surgery.
On November 13, 2014, CMS issued the final 2015 Medicare Physician Fee Schedule, and...more
On October 27, 2014, the Governor signed Pennsylvania General Assembly enacted House Bill 1846, which limits both the authority and the reimbursement of physicians and providers other than pharmacies for prescription drugs. ...more
In United States ex rel. Martin et al. v. Life Care Centers of American, Inc., the Court held that the government could extrapolate from a random sample in order to impose False Claims Act (FCA) liability against Life Care...more
CMS has announced its concern regarding the level of compliance for documenting the face-to-face elements necessary for home health care certification....more