Medicare Compliance & Reimbursement
PROVIDERS GET BREATHING ROOM ON 'SET-IN-ADVANCE' RULE
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare July 7 received a reprieve from the Centers for Medicare & Medicaid Services. CMS April 25 once again delayed the effective date of a controversial element of the Stark physician self-referral regulations - a single sentence in the Jan. 4, 2001 Stark rule that deals with percentage compensation arrangements and the definition of "set in advance." This is the third time CMS has delayed the rule, which is now effective Jan. 7, 2004. The agency says that the "set in advance" issue will be definitively worked out in the Stark Phase II rule. To see the notice, go to www.access.gpo.gov/su_docs/fedreg/a030425c.html.
Many of the exceptions to the Stark rule that apply to compensation arrangements can only be invoked if the amount of compensation is set in advance. CMS is grappling with whether its interpretation of "set in advance" automatically excludes percentage compensation deals from the Stark exceptions - a reading that could leave teaching hospitals, physician practices and medical foundations scrambling to rework thousands of contracts.
Medicare Compliance & Reimbursement
- Home Health:
'HOME HEALTH COMPARE' SET TO GO LIVE, FLAWS AND ALL
Widespread errors with administrative data on the soon-to-be-unveiled Home Health Compare Web site will make [...] - Medicare Pass-Through:
ANEMIA DRUG DISPUTE FILLS CMS MAILBAG
Both Republicans and Democrats are criticizing the way the Centers for Medicare and Medicaid Services [...] - Medicaid Drugs:
LEGISLATIVE OFFICE URGES FLORIDA TO DUMP PFIZER MEDICAID PROGRAM
Saying it hasn't seen solid evidence of significant savings produced by disease-management and other services [...] - Business Arrangements:
EXPANDING SERVICES THROUGH A JV? 5 RED FLAGS IN OIG'S SCOPES
If your expansion plans have led you to create a new business that subcontracts out [...] - Physicians:
FRAUD HUNT SPOOKS DOCS INTO DOWNCODING
Haunted by late-night worries about being targeted in a Medicare fraud investigation? If you're a [...] - HCA Watch:
GRASSLEY CONTINUES SCRUTINY OF HCA SETTLEMENT
Senate Finance Committee chair Chuck Grassley (R-IA) has written a fourth letter regarding the government's [...] - HealthSouth Watch:
REHAB GIANT FACES CONGRESSIONAL PROBE
Imploding rehab giant HealthSouth Corp.'s woes deepened April 22, with a Congressional panel joining the [...] - Coverage:
WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES
Health care providers will soon be able to bill Medicare for positron emission tomography scans [...] - Self-Referral:
PROVIDERS GET BREATHING ROOM ON 'SET-IN-ADVANCE' RULE
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare July 7 received a [...] - Hospitals:
NEW RULES HIT HOME FOR HOSPITAL SURVEYS
With new hospital quality rules in effect for Medicare, surveyors will be taking a different [...] - Medicare:
PROVIDERS, SUPPLIERS FACE NEW ENROLLMENT STANDARDS
A wider range of Medicare providers could be subject to site visits to verify their [...] - Fraud & Abuse:
PLANS, AGENCIES GET PRICE CUT ON HIPDB
Health plans and government agencies soon will get a price cut when they run a [...] - Fraud & Abuse:
DRUGMAKERS' FRAUD SETTLEMENTS BIGGEST EVER FOR MEDICAID
Pharmaceutical manufacturers Bayer AG and GlaxoSmithKline will pay the federal government, all states except Arizona, [...] - PROGRAM MEMO ROUNDUP
Hospitals that "self attest" their provider-based entities could save themselves a bundle if the Centers [...] - REGISTER WATCH
In its last-Friday-of-the-month flurry of regulations, the Centers for Medicare & Medicaid Services issued technical [...]
