Blogs / Events / Articles / News

CMS Issues Final Rule for Medicare Shared Savings Program

This month, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) regarding an update to the Medicare Shared Savings Program (the “Program”). The Final Rule will seek to enhance primary care services, reduce administrative burdens, and provide flexibility in the Pro...

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OIG Issues New Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability Under the Anti-Kickback Statute

Medical directors, beware. The Office of Inspector General (“OIG”) warns in its recently released fraud alert (“Fraud Alert”) that physician compensation arrangements, such as medical directorships, run the risk of violating the anti-kickback statute (“AKS”). The release of this Fraud Alert follows a series of ...

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CMS Issues New Proposed Rule to Modernize Managed Care for Medicaid

The Centers for Medicare and Medicaid Services (“CMS”) has issued a new proposed rule (the “Proposed Rule”) intended to “modernize Medicaid and the Children’s Health Insurance Program (CHIP) managed care regulations to update the programs’ rules and strengthen the delivery of quality care for beneficiarie...

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Pennsylvania Physicians Now Required to Wear Photo Identification Badges

As of June 1, 2015, a new Pennsylvania law went into effect, requiring the following individuals to wear photo identification badges: All employees and physicians working at health care facilities licensed by the Department [of Health] who provide direct care to patients or consumers; All employees and physicians working at the private pr...

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Revised Guidance for Privacy and Security of Electronic Health Information Released by Government

The Office of the National Coordinator for Health Information Technology (“ONC”) has released a revised Guide to Privacy and Security of Electronic Health Information (the “Guide”), which is intended to be a resource for small and medium-sized health care providers, health IT and other information technology professionals,...

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Pharmacy Pays $125,000 for Failure to Properly Dispose of Paper Records

Cornell Prescription Pharmacy (“CPP”), a Colorado single-location pharmacy, has agreed to pay $125,000 to the United States Department of Health and Human Services, Office for Civil Rights to settle alleged violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). CPP will also adopt a two-ye...

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“Doc Fix” Signed into Law; 21% Physician Pay Cut Avoided

President Obama has signed the “doc fix” into law, which permanently avoids a 21% pay cut for physicians that was slated to take effect this April. The law received broad bipartisan support, passing in the House of Representatives by a sweeping vote of 392-37 and passing in the Senate by a vote of 92-8.  (Continue reading).

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Health Care Payment Learning and Action Network Is Open for Registration

On March 25, 2015, the Centers of Medicare and Medicaid Services (“CMS”), launched the Health Care Payment Learning and Action Network (the “Network”), an ambitious  private-public partnership designed to further move the health care system away from quantity-based care and closer to value-based, quality-driven care. ...

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One Step Forward, One Step Out the Door – Senate Action Needed for SGR Repeal

The House of Representative recently passed legislation, by a sweeping vote of 392-37, which aims to change the way physicians are paid. The legislation, called the Medicare Access and CHIP Reauthorization Act, repeals and replaces Medicare’s sustainable growth rate formula (“SGR”). Despite the broad bipartisan support the legis...

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CMS Launches Next Generation ACO

  The Centers for Medicare and Medicaid Services (“CMS”) has released information about a new accountable care organization (“ACO”) model, called the Next Generation ACO. According to CMS, “the Next Generation ACO Model offers a new opportunity in accountable care – one that sets more predictable financial ...

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