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It’s clear that hospitals and health systems are once again acquiring physician practices in an effort to stabilize their referral networks. However, according to a recent article in the Washington Post, health systems are not the only buyers looking to get into the doctor business. Apparently, a number of large health insurance companies, including United Health Group, are quietly … Continue Reading

The health reform law (PPACA) requires referring physicians who provide in-office MRI, CT or PET services to inform a patient in writing at the time of the referral that the patient may obtain the service from an alternative source and provide a list of suppliers who furnish the service in the area in which the patient resides. In the 2011 Medicare Fee … Continue Reading

One of the few true payment reform models built into the health care reform law passed earlier this year is the Accountable Care Organization (ACO). Unfortunately, absent final regulations implementing the ACO model, very little guidance exists for physicians who are interested in pursuing this model. To that end, tomorrow, October 5, 2010, the Federal Trade Commission, the Office of … Continue Reading

As if physicians didn’t already have enough to worry about, it appears that many states are now contemplating expanding the scope of practice of nurse practitioners.  According to recent AP article, at least 28 states are looking at expanding the scope of services nurse practitioners can provide as a means of addressing the looming shortage of primary care physicians expected … Continue Reading

For physicians in the process of developing physician-owned hospitals, the race is on to get those facilities up and running by December, 2010. The recently enacted “Health Care and Education Affordability Reconciliation Act of 2010” amends the Stark law to once and for all prohibit physician-owned specialty hospitals unless: (1) the hospital has a Medicare provider agreement by December … Continue Reading

Among its many provisions, the newly signed Patient Protection and Affordable Care Act has imposed a new requirement on physicians who rely on the Stark "In-Office Ancillary Services" exception.  Physicians who refer patients for CT, MRI or PET (or other Stark services as designated by the Secretary of HHS) that will be provided by the referring physician’s practice under the Stark In-Office Ancillary … Continue Reading

In what should be welcome news for physicians, yesterday the House of Representatives quietly passed a bill which would repeal a long-standing exemption for insurance companies from federal anti-trust laws.  The exemption left anti-trust enforcement against insurance companies in the hands of the states.  If the Senate approves the legislation, health and malpractice insurance companies will be subject to federal … Continue Reading

In anticipation of a much publicized bipartisan meeting with representatives of Congress, President Obama released today a comprehensive health plan which seeks to combine the House and the Senate health care bills. The President’s proposal, which can be read on the Whitehouse.gov website, would not include a public option but would include, among a lot of other things, the … Continue Reading

In a 2008 report, the the Congressional Budget Office estimated that the savings from tort reform would amount to only about $4 Billion over the period from 2010 to 2019.  However, acording to a letter dated December 10, 2009 to Senator Rockefeller, the CBO’s original estimate failed to take into consideration that tort reform would result in lower utilization of services.  Based … Continue Reading

Despite efforts by Senator Harry Reid to pass legislation which would have effectively frozen Medicare payment rates for physicians, it looks like Congress will once again look to freeze physician payment rates with a one-year patch. According to an article published by the Wall Street Journal, Senator Reid’s proposed bill would have permanently prevented Medicare payment cuts to doctors. … Continue Reading