Michael Cassidy

Michael Cassidy

Tucker Arensberg, P.C.

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CMS Announces One Year Partial ICD-10 Relief for Physicians

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

8/4/2015 - CMS Healthcare ICD-10 Medicare

Telehealth News

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

7/14/2015 - Abortion Discrimination Healthcare Medicare Physician Fee Schedule Physicians Planned Parenthood Prescription Drugs State Medical Board Telehealth

TelaDoc Wins Injunction Against Texas Medical Board re: Telehealth Restrictions

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

6/22/2015 - Healthcare In-Person Exam Physicians Preliminary Injunctions Prescription Drugs Standard of Care State Medical Board Telehealth

Colorado Approves Direct Medicare Payment to CRNA’s

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

6/22/2015 - Healthcare Medicare Nurses

OIG Issues Fraud Alert to Warn Hospitals and Physicians

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

6/19/2015 - Fair Market Value Hospitals Medical Directors OIG Physician Compensation Arrangements Physicians Risk Alert

Physician Estopped From Alleging FCA Violations in Contract He Previously Approved

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

6/17/2015 - Anti-Kickback Statute False Claims Act Health Care Providers Hiring & Firing Hospitals Restrictive Covenants Stark Law Termination

Pennsylvania Introduces Telehealth Bill

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

6/4/2015 - Health Care Providers Health Insurance Healthcare Pending Legislation Telehealth

TELADOC Sues Texas Over Telehealth Restraint

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

5/29/2015 - Dentists Sherman Act State Action Doctrine State Antitrust Claims State Medical Board

Allegheny County Court Rules UPMC/Highmark Agreements Trump Consent Decrees

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

5/22/2015 - Arbitration Arbitration Agreements Consent Decrees Hospitals Participation Agreements

Peer Review Privilege: Facts vs. Conclusions

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

5/15/2015 - Confidential Communications Healthcare Healthcare Professionals Hospitals Peer Review Physicians

Congress Repeals Medicare Sustainable Growth Rate (SGR)

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

4/16/2015 - CHIP Healthcare Medicare New Legislation Physician SGR Formula Physicians

News from MGMA re SGR Repeal

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

3/27/2015 - CHIP Healthcare Medicare Pending Legislation Physician SGR Formula Physicians

No SGR Action by Senate

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

3/27/2015 - Healthcare Legislative Agendas Medicare Physician SGR Formula Physicians Repeal

Concierge Practice Network Subject to Malpractice Liability

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

3/9/2015 - Medical Malpractice Physicians

Ohio Proposes New Telehealth Prescribing Regulations

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

1/27/2015 - Controlled Substances Health Care Providers Healthcare New Regulations Prescription Drugs State Medical Board Telehealth

New York Passes Telehealth Bill

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

1/13/2015 - Andrew Cuomo Health Insurance Healthcare Telehealth

Important Ruling on Required FMLA Notices

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

12/30/2014 - Employer Liability Issues FMLA Notice Requirements

Pennsylvania Superior Court Rejects Peer Review Confidential for “Business Records”

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

12/24/2014 - Business Records Hospitals Peer Review Physicians

Washington State Court Recognizes Prospective Patient Relationships as Protected Contracts

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

12/16/2014 - HCQIA Patient Prospective Payment System

Pa. Dept. of Health Establishes Website (stayinformed.pa.gov) for Highmark – UPMC Information

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

12/12/2014 - Department of Health Websites

CMS Proposes Rules to Improve Accountable Care Organizations (ACOs)

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

12/9/2014 - ACOs CMS Medicare Shared Savings Program Proposed Regulation

Global Surgery and 2015 Medicare Physician Fee Schedule

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

12/3/2014 - CMS Healthcare Medicare Physician Fee Schedule Physicians Surgery

Pennsylvania Workers Compensation Prescription Drug Reimbursement Restrictions

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

11/6/2014 - New Legislation Pharmacies Physicians Prescription Drugs Workplace Injury

District Court Approves Government’s Use of Sampling and Extrapolation to Prove False Claims Act Liability

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

10/15/2014 - False Claims Act Hospitals Statistical Sampling

Face-to-Face Medicare Reimbursement Requirements for Home Health Certification

CMS has announced its concern regarding the level of compliance for documenting the face-to-face elements necessary for home health care certification....more

9/18/2014 - CMS Healthcare Home Health Care Physicians

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