Physicians

News & Analysis as of

CMS says to physicians: Pick your pace for MACRA implementation. Physicians say to CMS: Thank you for hearing us.

On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) issued proposed regulations (Proposed Regs.) as a first step in the implementation of the Quality Payment Program (QPP) provisions of the Medicare Access...more

Ugly details emerge on how Big Pharma fueled painkiller scourge

New information has surfaced about Big Pharma’s relentless campaign to sell the public on prescription, opioid painkillers-powerful, addictive drugs whose wide availability and abuse now has become a killer scourge that...more

House Approves Medicare ESRD Coverage, Rural Hospital Supervision Bills

On September 21, 2016, the House of Representatives approved HR 5659, the Expanding Seniors Receiving Dialysis Choice Act of 2016, which would allow Medicare beneficiaries with end stage renal disease (ESRD) to enroll in...more

South Carolina Court Decides Key Health Care Case - Physical therapists win in employment lawsuit

The South Carolina Supreme Court has decided a case with great significance in the health care industry. The court overturned a ban on physicians employing physical therapists and gave guidance regarding how state agencies...more

OMB Is Reviewing MACRA Final Rule

On September 14, 2016, the White House Office of Management and Budget (OMB) received CMS’s final rule implementing the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models established in MACRA. CMS had...more

FDA Mandates Black Box Warnings For Opioids And Benzodiazepines

The Food and Drug Administration (FDA) recently decided to require so-called “black box warnings” on nearly 400 products, warning of the risks of combining certain opioid medications and central nervous system depressants...more

California Joins New York and Florida, Passes Out-Of-Network Legislation

Last month the California legislature passed AB-72, which amends the Health & Safety Code to address reimbursement for out of network (OON) providers who provide services at in-network facilities, such as hospitals and...more

The Future Is Now: CMS Proposes Broad Bundled Payment Expansion for Cardiac Care Episodes

Furthering the agency’s stated intention to pay for value over volume, the Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule representing the first expansion of mandatory hospital-centric bundled...more

Health Care E-Note - September 2016

In an article published in the September 2016 MASA Newsletter, Jim Hoover and Angie Cameron Smith discuss how physicians should properly respond to subpoenas and requests for patients’ health information. They stress how...more

Will Physicians Accept CMS's Offer to "Pick Your Pace"?

The Acting CMS Administrator, Andy Slavitt, announced that CMS would propose new options for physician participation in the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)....more

Physicians Must Be Cautious When Responding To A Subpoena or Request for Medical Records

Doctors must educate themselves and particularly their staff on the legal obligations to protect the confidentiality of medical records and how to properly respond to subpoenas and requests for patients’ health information....more

CMS Proposes Flexible Reporting Under MACRA

In a blog post last week, CMS acting administrator Andy Slavitt said that physicians will have the ability to choose among several options to report data to Medicare under the new physician payment system ushered in by the...more

CMS Prioritizes Patient Care, Allows Flexibility with MACRA Implementation

CMS has given health care providers a little breathing room when it comes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) implementation. MACRA will take effect on January 1, 2017, and moves toward the CMS...more

California Physician Loses at Dating Game

A California appellate court has declared physician Visha Dev the loser in his dating contest with Blue Shield Life and Blue Shield California. The contest arose when the Blues moved for summary judgment in Dev’s action...more

CMS Announces Flexibility for Physician First-Year Participation in MACRA Quality Payment Program

In a recent blog post, CMS Acting Administrator Andy Slavitt announced CMS’s plans to give physicians more options for complying with significant upcoming changes to Medicare physician fee schedule (MPFS) rules – which will...more

CMS Says MACRA Implementation Will Begin on January 1, 2017 but Physicians Can “Pick Their Pace of Participation”

On September 8, 2016, CMS announced in a blogpost that new physician payment model reforms, established in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will begin implementation on January 1, 2017, as...more

When a Discount May be a Kickback

Healthcare providers of all kinds, as well as medical equipment suppliers, have traditionally relied upon discounts as a legitimate means of attracting patients and commercial clients without running afoul of the federal...more

Medicare Proposes Tiered Outpatient Therapy Evaluation Codes for 2017

In July, the Centers for Medicare & Medicaid Services (CMS) announced its intent to add several new codes for physical therapy and occupational therapy evaluation under the Medicare Physician Fee Schedule Proposed Rule for...more

End of Confusion: Commission’s Changes to Form 14B Physician’s Statement

In an effort to possibly avoid a future hearing or deposition of a physician to determine the extent of future medical treatment, the South Carolina Workers’ Compensation Commission on September 7, 2016 introduced the...more

Put the Candle Back: the AstraZeneca FCPA Enforcement Action

I am back from a two-week summer study program at Oxford, run by Michigan State University through its Odyssey to Oxford program. It was a great experience. My class was on The Tudors in film and print so not only did I...more

Lessons Learned from AstraZeneca’s $5.5 Million SEC FCPA Settlement

Last week, the SEC added another pharmaceutical company to its list of FCPA violators when AstraZeneca agreed to a $5.5 million settlement with the SEC. AZ is now the 25th drug or medical device company to pay an FCPA penalty...more

Insurer’s Optional Appeals Process Does Not Toll Statute of Limitations Following Unequivocal Written Denial

In Vishva Dev, M.D., Inc. v. Blue Shield of Cal. (No. B270094, filed 8/31/16), a California appeals court confirmed that the unequivocal denial of a claim, in whole or in part, commences the running of the statute of...more

Healthcare Compliance: Juggling Risk Mitigation Strategies

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more

Health Care Legislation Maryland 2016 First Interim Report

The bills cited and reviewed in this Report are not an exhaustive presentation of all healthcare legislation. Rather, they represent either proposed or adopted legislation that we believe are among the most beneficial,...more

New OkPOLST form designed to improve end-of-life and crisis care

Beginning Friday, August 26, 2016, Oklahomans have another tool available to them for use in planning end-of-life care and treatment. It’s called an OkPOLST, which stands for Oklahoma Physician Orders for Life-Sustaining...more

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