In a controversial move, last Thursday, HHS proposed regulations that would prevent healthcare providers from being compelled to refer patients to abortion providers if doing so would violate the provider’s conscience. Before diving into the proposed rule, let’s quickly consider the history of this issue. ACOG Opinion On November 7, 2007, the American College of
Notwithstanding years of litigation and multi-million dollar settlements, many healthcare providers continue to experience inappropriate evaluation and management service (“E/M”) denials. Earlier today, I spoke with a provider who had a well-founded complaint regarding his denials, so I want to take a minute to quickly review the basics. E/M is a visit or consultation provided
Uninsured New Jersey patients will soon be seeing lower hospital charges. Earlier this week, New Jersey’s governor signed into law Assembly Bill 2609, which caps the fees that hospitals can charge uninsured patients. According to the New Jersey Commission on Rationalizing Health Care Resources, the constraints contained in this new law will cause a decrease
As we discussed earlier this year, Medicare has created an ever expanding list of hospital-acquired conditions for which it no longer provides reimbursement. This list includes conditions such as 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
Physician societies, patient groups and federal and state agencies are rarely on the same page; so, on an occasion where they unanimously and enthusiastically support a common objective, things must move quickly, right? Not quite. For about a decade, electronic prescribing (also known as “e-prescribing”) has been praised for its promises of reducing deaths and
According to news accounts, Blue Cross Blue Shield of Georgia (“BCBS of Georgia”) recently sent more than 200,000 benefits letters (e.g., EOBs) to incorrect recipients, causing widespread concern among BCBS of Georgia’s patients and forcing the insurer to quickly rollout a mitigation plan. The Atlanta Journal-Constitution reports that most of the erroneous mailings were EOBs.
In recent blogs, we focused on Congress’ carrot and stick approach to encourage e-prescribing. As we discussed, providers who implement e-prescribing could receive Medicare bonuses (above and beyond the Medicare fee schedule payments) equal to 2% of their annual Medicare collections. However, providers who do not implement e-prescribing will eventually see their reimbursements drop below
While we have seen many news stories regarding H.R. 6331’s rollback of the scheduled 10.6% Medicare reimbursement cuts, there has been virtually no coverage regarding the bill’s groundbreaking provisions calling for Medicare bonuses for providers who adopt and regularly utilize electronic prescribing. Therefore, let’s take a few minutes to discuss some of the basics. H.R.
By a veto-proof, bipartisan majority, Congress has just passed H.R. 6331, which will rollback the 10.6% Medicare reimbursement cuts that were scheduled to become effective today and provide an incentive to physicians who adopt and utilize electronic prescribing technology. Background regarding the Scheduled Cuts The Centers for Medicare & Medicaid Services (“CMS”) final 2008 Medicare
During the last twelve months, we’ve seen significant developments in health law. At today’s opening session of the annual meeting of the American Health Lawyers Association, we took stock of many of these developments, which include the following: Medicare Cuts Saga Continues to Unfold. On June 30th, we witnessed the latest chapter in the Medicare