Many physicians mistakenly believe that federal healthcare fraud and abuse statutes only apply to the Medicare fee-for-service program. However, physicians need to be aware that many federal healthcare statutes apply
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Todd Rodriguez
A Physician May Violate Anti-Kickback Laws Even Without Steering Patients To A Specific Provider.
The United States Court of Appeals for the Seventh Circuit recently issued an interesting decision concerning the definition of “referral” in the context of federal anti-kickback…
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CMS Releases Physician Value Modifier Payment Data
Many physicians are aware of the push by the Medicare program to move away from a fee for service physician payment model to one which recognizes higher quality and lower…
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Excluded Physician Not Precluded from Collecting Pre-Exclusion Receivables According to OIG Advisory Opinion
A physician who was excluded from the Medicare program is not precluded from receiving payment for services rendered prior to the exclusion according to Advisory Opinion 15-02 published by the…
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Employers in Philadelphia Must Provide Paid Sick Leave
Beginning May 13, 2015, employers must provide paid sick leave to employees who work in Philadelphia, per the City of Brotherly Love’s newly enacted Promoting Healthy Families and Workplaces Ordinance.
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Physicians Go On Strike
According to various news outlets, physicians at the University of California student health centers (as many as 150 physicians in all) went on strike this week in protest of…
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CMS May Modify Meaningful Use Program Requirements in 2015
The Centers for Medicare and Medicaid Services (CMS) announced today that it intends to adopt regulations modifying the Medicare Electronic Health Record (EH R) Meaningful Use Program requirements as early…
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HHS to Shift 90% of Fee-For Service Payments to Performance-Based Payments by 2018
Yesterday the Secretary of the Department of Health and Human Services (HHS) formally announced HHS’ intention to shift 90% of all traditional Medicare payments from fee-for-service (FFS) to quality or…
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Study Finds That Many Hospitals Are Losing Money On Physician Networks
In news that may not come as a shock to those of us who have been through the cycle of hospitals purchasing physician practices before, a recent study has found…
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Medicare to Hold Claims for First 14 Days of 2014
Although unlikely to have a major impact on cash flow, physicians should keep in mind that under the CY 2015 Medicare Physician Fee Schedule (MPFS) which was published in November,…
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