CMS Bars Funds for Certain Preventable Conditions

The Centers for Medicare & Medicaid Services on June 6 published a final rule that will deny federal matching funds under Medicaid for state payments to providers for certain preventable health care-acquired illnesses or injuries. The rule implements a provision of the Patient Protection and Affordable Care Act (PPACA) that requires the secretary of Health […]

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OIG Semiannual Report Highlights Recoveries and Strike Force Activities

The Department of Health and Human Services Office of Inspector General’s (OIG’s) activities during first half of fiscal year 2011 amounted to $3.4 billion in recoveries in the Medicare and Medicaid programs, and resulted in the exclusion of 883 individuals and entities from participating in federal health care programs, according to the OIG’s semiannual report […]

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HIPPA and Health Record Requests in Litigation

Whenever asked to hand over protected health information (PHI) for use in litigation one should be mindful of both the Health Insurance Portability and Accountability Act (HIPAA) and the rules regarding litigation and discovery. Providers should make certain that such requests are proper, should not release more PHI than necessary, and should keep a close […]

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CMS to Change Physician Signature Requirement for Clinical Diagnostic Lab Requisitions

On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) indicated it intends on changing the regulation that requires certain signatures on laboratory requisitions. CMS is making this change because of concerns that physicians, non-physician practitioners (NPPs), and clinical diagnostic laboratories are having difficulties complying with the signature policy, as previously published. The […]

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CMS Publishes Final Rule for Privileging and Credentialing Telemedicine Providers

Effective July 5, 2011, CMS will permit hospitals to credential and grant clinical privileges to a telemedicine practitioner based upon the credentialing and privileging decisions of another entity who provides the telemedicine services. If it so chooses, the hospital where the patient is located will no longer be required by CMS to independently verify and […]

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Computer Containing Patient Records Stolen from Hospital

Over 600 patient records stored on a laptop computer, were stolen when the laptop was taken from Rancho Los Amigos National Rehabilitation Center in Downey, CA. Notices were sent to patients affected by the theft. Among the information stolen were patient names, dates of birth, and medical and diagnostic information. Identity theft is a growing […]

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CMS Releases Proposed Rule on Accountable Care Organizations

On March 31, 2011, the Centers for Medicare & Medicaid Services released a proposed rule under the health reform law (PPACA) to help doctors, hospitals, and other health care providers better coordinate care for Medicare beneficiaries by establishing accountable care organizations (ACOs). The proposed rule calls for a 60-day public comment period. Under PPACA, the […]

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CMS Unveils Data On Hospital-Acquired Conditions

The Federal government has recently released data allowing consumers to learn how often patients in local hospitals acquire infections, develop bed sores or are harmed by gas or air bubbles entering blood vessels. This information regarding hospital-acquired conditions will guide consumers when choosing hospitals and facilities. CMS stated that it is working together with the […]

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Senate Sends 1099 Repeal Bill to Obama

Congress sent the White House its first rollback of last year’s health care law, a bipartisan repeal of a burdensome tax reporting requirements found in health care reform’s 1099 provisions. The measure passed the senate with an overwhelmingly bipartisan vote of 87-12. President Obama is expected to sign it despite concern about how to replace […]

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Raleigh Hospital Agrees To Settle Medicare Overbilling Case

Federal prosecutors say that Rex Healthcare in Raleigh, NC has agreed to pay nearly $2 million to settle allegations it overbilled Medicare by ordering higher-cost services for patients who only needed outpatient treatment. The Justice Department said Monday that between 2004 and 2007, Rex Healthcare billed Medicare for inpatient admissions to increase what it could […]

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