Save the Date: NALTH 2011 Education Conference

Posted by Jason Greis on January 9, 2011 under Events | Be the First to Comment

LTACH PHYSICIAN FOCUS
October 6-7, 2011
Omni Royal Orleans Hotel
New Orleans, Louisiana Read More...

ACOs and the Shared Savings Program: Some Common Misconceptions

Posted by Jason Greis on October 2, 2010 under Articles | Be the First to Comment

Section 3022 of the Patient Protection and Accountable Care Act (the Act) creates the Shared Savings Program for Medicare. Under the Shared Savings Program, which is to take effect no later than Jan. 1, 2012, Accountable Care Organizations (ACOs) that meet certain requirements established by the Secretary of Health and Human Services will be eligible to receive additional payments from Medicare where certain performance guidelines are met and cost-savings targets are achieved. The amount of the additional payment will be a percentage of the difference between the estimated per capita Medicare expenditures for patients assigned to the ACO and the cost-savings per capita Medicare expenditures threshold. Read More...

CMS Issues Proposed Rule on Changes to Stark In-Office Ancillary Services Exception

Posted by Jason Greis on August 12, 2010 under Articles | Be the First to Comment

Section 6003 of the Patient Protection and Affordable Care Act, Public Law 111-148 (H.R. 3590) (PPACA) makes a change to the “in-office ancillary services” exception to the Stark physician self-referral law that impacts physician practices providing certain radiology services in their offices. In short, the change requires physicians making a referral for magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT), or certain other radiology services in their offices, to make a disclosure to the patient that such services can be provided elsewhere and to include a list of alternative providers. Read More...

CMS Proposes Rule to Cross-Privilege Physicians Practicing Telemedicine

Posted by Jason Greis on June 23, 2010 under Articles | Be the First to Comment

Telemedicine consultations are often provided by physicians at large hospitals, often called “distant-site” hospitals (See § 1834(1)(m)(4)(A) of the Social Security Act), to patients at smaller ones, such as those in rural areas. Physicians providing these consultations are privileged and credentialed at their home institutions, but often not, at the outset, at the hospitals to which they provide their advice electronically, which for purposes of this discussion, we refer to as local hospitals. Read More...

Exploring the Adverse Impact of Federal Healthcare Reform on Physician-Owned Hospitals

Posted by Jason Greis on April 1, 2010 under Articles | Read the First Comment

After almost a year of heated debate, President Obama signed into law the Patient Protection and Affordable Health Care Act (P.L. 111-148) (“PPACA” or the “Act”) on March 23, 2010, as amended by the Health Care and Education Affordability Act of 2010 (H.R. 4872) (“HCEAA”) on March 30, 2010.  While many of these laws’ provisions are benign, some contain “bombshells” that will permanently alter the business and regulatory landscape for certain businesses.  One such provision is contained in Section 6001 of PPACA, which significantly curbs physician ownership and investment in hospitals by restricting application of the Federal Ethics in Patient Referrals Act’s (the “Stark Law”) statutory “whole-hospital exception.” Read More...

When MedPAC Speaks Congress Listens: What the Inclusion of MedPAC Health Care Delivery Reform Proposals in Health Care Reform Legislation Means for Physicians

Posted by Jason Greis on March 28, 2010 under Articles | Be the First to Comment

On March 1, 2010, the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) released its 2010 Report to the Congress: Medicare Payment Policy (the “Final Report”) recommending annual Medicare payment updates for Medicare fee-for-service (“FFS”) payment systems, including among others, hospitals (including both general acute care and long term care hospitals) and physicians.  MedPAC is an independent congressional agency established by the Balanced Budget Act of 1997 to formulate recommendations to Congress to address quality and cost-containment issues affecting the Medicare program and its beneficiaries.  Two reports, issued in March and June each year, are the primary outlets for MedPAC’s policy and payment system updates, which change base rates paid by Medicare for a unit of service provided by a FFS provider—for example, a hospital admission or a physician visit or procedure.  Recommended payment system updates are based on an assessment of payment adequacy that takes into account beneficiaries’ access to care, supply of providers, quality of care, providers’ access to capital and Medicare margins.  Read More...