Healthcare Law & Policy Archive

Insurer Erroneously Discloses Confidential Patient Information

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.

How to Earn Your Electronic Prescribing Bonus

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

Electronic Prescribing: Medicare Bonuses and Penalties

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.

Congress Stops Medicare Cuts and Creates E-Prescribing Bonus

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

Significant Health Law Developments

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

Doctors versus Payers: Round Two

Increasingly, payers throughout the country have been issuing “report cards” on participating physicians. While payers argue that these report cards provide valuable information to “consumers” (i.e., patients), physician groups have loudly opposed these report cards asserting that the grades are based on faulty assumptions and are presented in a misleading manner. This frustration regarding the

CMS Offers EMR Users Sizable Bonuses

Your primary care practice could earn up to $290,000, over a five year period, if you adopt and actively use an EMR in coordination with the new Medicare Demonstration Project, which is designed to measure and showcase the quality care improvements that can result from the widespread use of interoperable EMRs/EHRs. Since this program has

Physicians Brace for Summer Reimbursement Cuts

Medicare reimbursements for healthcare providers will be cut by an average of 10.6% on July 1st and Congress may not be capable of rolling back these planned reductions in time to beat the deadline. As many physicians recall, the Centers for Medicare & Medicaid Services CMS”) final 2008 Medicare physician fee schedule included average cuts

OIG Streamlines Provider Self-Disclosure Protocol

In its recent Open Letter to Providers (“Letter”), the Department of Health and Human Services Office of the Inspector General (“OIG”) further refined and streamlined its Provider Self-Disclosure Protocol (“SDP”). SDP Overview OIG created SDP in 1998 to encourage providers to voluntarily disclose Medicare billing fraud and abuse. It provides such encouragement by creating a

Medicare Reimbursement Cuts of 10.6% Scheduled to Take Effect on July 1, 2008

As July approaches, the healthcare community is once again bracing itself for significant, scheduled Medicare reimbursement cuts.  Those who have been following the news or reading this blog for more than one year will agree with Yogi Berra that “it’s like déjà vu all over again.” Unless congress is able to intervene, Medicare physician reimbursements