CMS has, in the past, expressed concern regarding the use of concierge medicine by physicians treating Medicare patients.  CMS has prosecuted some concierge care practices for charging concierge fees for “non-covered services” under Medicare.  Despite this opposition, patients and physicians have increasingly implemented concierge-like relationships, including amenities that provide unlimited access to physicians via email,…

On February 24, 2012 the Centers for Medicare & Medicaid Services (“CMS”) released a Notice of Proposed Rulemaking setting forth the “Stage 2” Meaningful Use requirements.  The proposed rule specifies the Stage 2 criteria that eligible providers must meet in order to qualify for Medicare and/or Medicaid EHR incentive payments.

WHAT IS “MEANINGFUL USE”?

The…

The three-day payment window policy which formally only applied to hospital payments, will now also apply to hospital-affiliated entities including physician practices, ambulatory surgery centers, or clinical lab facilities which provide Medicare Part B services.  Specifically, the Centers for Medicare and Medicaid Services (“CMS”) has expanded the three-day payment window to cover any hospital-associated entity…

Outpatient Surgery Magazine recently published an article describing a case in New Jersey in which an ASC successfully defended an action brought by three physicians who were forced to sell their ownership interests in the ASC due to the physicians’ failure to meet the “one-third procedures test” under the applicable federal anti-kickback statute safe harbor. …

Today the Centers for Medicare and Medicaid Services (CMS) posted a pre-publication version of a proposed rule regarding the reporting and returning of overpayments.  The proposed rule is intended to address requirements implemented by the Patient Protection and Affordable Care Act (ACA).  Although the proposed rule offers some guidance with regards to some significant issues…

First, Happy Valentine’s Day!  Second, the rest of this post has absolutely nothing to do with Valentine’s Day.

Background

“Living trusts” designed to avoid probate have not found as widespread acceptance in Texas as in some other states.  This is likely due to our independent administration procedures that allow most estates to be settled with…

Recently-issued interpretive guidance related to rehabilitation and respiratory care services under hospital Conditions of Participation (CoPs) has prompted the American Hospital Association (AHA) to send a request to Centers for Medicare & Medicaid Services (CMS) to clarify the confusion caused by the guidance.  Specifically, Transmittal No. 72, issued on November 18, 2011, states that a

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In the 2011 regular legislative session, Senate Bill 1661 was passed, and as of January 1 of 2012, is law.  The law requires that Non-Profit Health Organizations (“NPHO”) (formerly known as 5.01(a)’s), ensure through policies, that their employed physicians’ professional judgments are not interfered with, controlled, or otherwise directed by the NPHO.  To comply with…