Healthcare Law & Policy Archive

Florida Moves Closer to Requiring Healthcare Providers and Facilities to Provide Cost Estimates to Uninsured Patients

The Florida House of Representatives’ Healthcare Council recently voted unanimously to recommend the approval of landmark legislation that would require healthcare providers to provide each uninsured patient with a good faith estimate of charges for non-emergency treatment. The “Health Care Consumer’s Right to Information Act”, if adopted, would impose a monetary fine upon any healthcare

CMS Proposes Doubling the Number of Non-reimbursable Hospital-Acquired Conditions

My August 13, 2007 blog discussed CMS’ then-groundbreaking move to deny reimbursement for seven hospital-acquired conditions including pressure ulcers, hospital falls, certain catheter-associated infections, air embolism as a result of surgery, leaving an object in during surgery, providing incompatible blood or blood products and mediastinitis following coronary bypass surgery. CMS has now announced that it

MTBC to CA Regulators: Make Payers Play by the Rules

As I explained in my April 1st blog, California regulators have proposed new rules that would allow payers to continue to underpay non-participating providers, while penalizing the providers who seek customary and reasonable reimbursement. The proposed rules are now open for public comment and we have supplied the following comments to California’s regulators: “The underlying

The Terminator Declares War on Balance Billing

Earlier this week, California Governor Arnold Schwarzenegger’s administration followed the lead of a handful of other states by moving to ban certain balance billing practices. This latest lost hardware debacle is instructive for New Jersey health care providers and payers. Likewise, since most states have laws similar to New Jersey’s data breach law, providers and

How to Avoid Paying One Million Dollars for Your Practice’s Laptop

New Jersey Blue Cross Blue Shield (BCBSNJ) recently made news as word of one lost employee laptop spread like wildfire through the health care community and press, adding BCBS to a long list of payers and physicians who have been forced to disclose the loss of computer hardware containing patients’ personal information. Legal Duty of

Technology as a Safeguard against Medical Malpractice Claims.

A growing chorus of health care industry experts, physicians’ groups, politicians and medical malpractice insurance carriers are urging doctors to adopt new technologies to reduce the likelihood and costs associated with medical malpractice. Most of this focus has been on electronic prescribing, medical practice management software and electronic medical records. Electronic Prescribing Sloppily written prescriptions

Attention All Healthcare Employers – Revised I-9 Form Just Released

The U.S. Citizenship and Immigration Service’s (USCIS) Form I-9, which every U.S. employer must complete in conjunction with the hiring process, has just been revised. Failure to utilize and properly complete the Form I-9 can result in a fine of $1,000 per infraction; therefore, it is important for every employer to be aware of and

Medicare Authorizes Missed Appointment Charges

It is increasingly common for physicians to charge their patients a fee for missed appointments. For example, approximately 31% of MTBC’s clients routinely charge a missed appointment fee. Most of these providers charge approximately $25, while others charge as little as $15 or as much as $100 per missed appointment1. Until recently, there has been

Court Decision Supports Data Mining of Provider-Patient Encounter Details

In a decision that could have broad implications for physicians and patients alike, the United States District Court for the District of Columbia has recently ordered the Centers for Medicaid and Medicare Services (“CMS”) to disclose claim information regarding hundreds of thousands of patient encounters. The Lawsuit In March 2006, Consumers’ Checkbook, a consumer group

Medicare will Deny Claims Relating to Hospital-Acquired Conditions

Newly adopted Medicare regulations make it clear that Medicare intends to stop reimbursing hospitals for expenses associated with “hospital-acquired conditions”. Background Pursuant to the Deficit Reduction Act of 2005 (Pub. L. 109-171), the Secretary identified certain high cost and/or volume preventable conditions that result from inadequate hospital care and are identifiable by unique ICD-9-CM codes.