Advancements in healthcare technology continue at an explosive pace and nowhere is this more evident than in the field of mobile healthcare applications. Technology giants such as Apple and Garmin are diving into the wearable healthcare device arena and healthcare app companies are rapidly developing technology to enable devices to transmit healthcare information directly to
Todd Rodriguez
Follow: Read more about Todd Rodriguez
Office of Inspector General Work Plan Identifies Compliance Areas of Focus for Physicians
By Todd Rodriguez on
Earlier this month, the Office of Inspector General of the Department of Health and Human Services (“OIG”), the agency charged with enforcement of key federal fraud and abuse laws, published its annual Work Plan identifying the areas of compliance concern under the Medicare program on which it will focus its review efforts in the coming…
Does Your Practice Have a Leadership Succession Plan?
By Todd Rodriguez on
Many medical groups have difficulty developing a succession plan for practice leadership. Some practices do not even have a formal governance structure in place (though they should), but even those that do may find it challenging to identify and train new leaders to assume responsibility when senior physician leaders step down.
Having a leadership succession…
Understanding Medicare Overpayments
By Todd Rodriguez on
Under the federal Affordable Care Act, physicians and other providers have only 60 days to refund overpayments to the Medicare program before they face potential liability under the False Claims Act. In addition, if CMS or the Medicare Area Contractor (MAC) identifies an overpayment, physicians have a limited period of time to respond or reply…
OIG Issues Favorable Advisory Opinion on Patient Assistance Charitable Foundation
By Todd Rodriguez on
This week the Office of Inspector General (OIG) published Advisory Opinion 15-16 addressing a 501(c)(3) charitable foundation (the “Requestor”) that would seek donations from third parties (including drug manufacturers) and provide financial assistance with out-of-pocket patient expenses for outpatient prescription drugs.
Under the proposed arrangement, the Requestor would maintain two disease funds, one of which…
New Medicare Dashboard Highlights Drug Spending
By Todd Rodriguez on
Earlier this month, the Centers for Medicare and Medicaid Services released a new tool designed to give providers and consumers insight into Medicare drug spending. The Medicare Drug Spending Dashboard, which at present only includes 2014 data, summarizes information on 80 drugs, 40 of which are covered under Medicare Part B and 40 of which…
OIG Issues Advisory Opinion Regarding Radiology Transcription Feeds
By Todd Rodriguez on
This week, the Office of Inspector General (OIG) issued OIG Advisory Opinion No. 15-15 regarding a proposed arrangement in which a hospital would bill a radiology group for transcription of the radiology group’s reports for patients who are not hospital patients, but rather patients of a third-party clinic that provides radiology studies and refers to…
Feds Extend Reporting Deadline of Employer Health Insurance Information
By Todd Rodriguez on
The federal Affordable Care Act requires certain employers to provide employees with forms reporting offers of health coverage and coverage provided by the employer in 2015 by no later than February 1, 2016. Employers then had to report that information to the IRS by February 29 (by paper) and March 31 (electronically). According to a…
CMS Publishes Draft Plan for Quality Measurement in Support of Payment Reform
By Todd Rodriguez on
The Centers for Medicare & Medicaid Services (CMS) has stated its intention to move at least 50% of Medicare payments from fee for service to alternative payment systems based on quality and/or value by 2018. In furtherance of this goal, the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) passed…
An Effective Compliance Program is as Important as Ever
By Todd Rodriguez on
After many years counseling physicians regarding Medicare fraud and abuse compliance, I’m still perplexed at the general lack of understanding in the physician community regarding the need to comply with complex healthcare fraud and abuse laws and the serious risks of noncompliance. Unfortunately, it seems that many physicians still mistakenly believe that they are “below…