Medicare Compliance & Reimbursement
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with physicians if legislation introduced April 1 works its way through Congress. Rep. Pete Stark (D-CA) - architect of the physician self-referral laws - and Rep. Jerry Klec-zka (D-WI) crafted the Hospital Investment Act of 2003 to put restrictions on physician ownership of specialty hospitals that typically limit their services to highly profitable areas such as cardiac care and orthopedic surgery. Stark and Kleczka worry that such facilities end up bleeding much-needed revenue from full-scale hospitals without providing the range of services most communities need. The legislation would permit physicians to refer patients to a hospital in which they have an ownership interest only if the interest was purchased on terms that were available to the public - a move designed to stifle what Stark calls "sweetheart deals" between hospitals and referring doctors. Violations would be punished by fines of up to $15,000 per referral and $100,000 per scheme. Lesson Learned: Specialty hospitals should brace themselves for a significant overhaul in the way they structure their businesses.
Medicare Compliance & Reimbursement
- Legislation:
MEDICAID CUTS HANG IN THE BALANCE
The House and Senate are duking it out over $93 billion in Medicaid cuts, and [...] - Quality Improvement:
NEWSPAPER ADS COMPARING HHA OUTCOMES WEEKS AWAY
The Centers for Medicare & Medicaid Services will trumpet home health agency patient outcomes in [...] - Pharmaceuticals:
COURT OKS MICHIGAN MEDICAID RX PROGRAM
Michigan may go forward with its effort to obtain deep discounts from prescription-drug manufacturers for [...] - Medicare+Choice:
MOST POPULAR M+C PLANS TO GET TWO PERCENT RAISE
In 2004, managed care plans serving the majority of Medicare+Choice beneficiaries will again see only [...] - Compliance:
HEALTH CARE DIRECTORS MUST SPEAK UP ON COMPLIANCE
As the Enron fiasco continues to play out and the HealthSouth debacle puts the corporate [...] - Medicare:
MEDICARE REGULATORY REFORM MOVES FORWARD, BUT HALTINGLY
It's nice to know that even in the House Ways and Means Committee, occasionally a [...] - Self-Referral:
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with [...] - Quality of Care:
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very [...] - Physicians:
STAFFING COMPANIES IN LINE FOR STEPPED UP SCRUTINY
Staffing companies that contract with physicians to staff emergency rooms and other hospital departments could [...] - HIPAA:
PROVIDERS ADOPT 'JUST-IN-TIME' APPROACH TO HIPAA COMPLIANCE
Have you deferred a good chunk of your Health Insurance Portability and Accountability Act compliance [...] - Medicaid:
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils [...] - Reimbursement:
NEW APPROACHES TO NEW TECH PAYMENTS
Health care providers that deal extensively with new and emerging technologies may soon see some [...] - Medicaid:
AUDIOLOGISTS FACE NEW RULES FOR MEDICAID
Audiologists would have to meet a new set of requirements to provide services - including [...] - Medicare+Choice:
FINAL M+C APPEAL RULE EASES ADVANCE NOTICE REQUIREMENT
Medicare+Choice organizations will have to notify enrollees two days prior to terminating services under a [...] - PROGRAM MEMO ROUNDUP
Health care providers that bill Medicare for Part B mental health services should take special [...] - BILL WATCH
The following House bills were introduced:
H.R. 1539. A bill to amend title XVIII of [...]
