The Louisiana Department of Health and Hospitals and the Louisiana Health Care Quality Forum have formed the Health Information Technology Advisory Council. Seventeen members from across the state were chosen to provide expertise to help develop health IT-related strategies in an effort to advance statewide health IT improvements. For more information go to: http://theadvocate.com/news/business/12878547-171/business-briefs-for-july-26.
Written by: Traci Thompson
On July 8, 2015, the Centers for Medicare and Medicaid Services released its proposed Calendar Year 2016 Physician Fee Schedule (“PFS”) Proposed Rule, which was published in the Federal Register on July 15, 2015. Although the proposed PFS includes a section specific to telehealth, the proposed changes to telehealth coverage policies were not as expansive as some had hoped. In summary,
The pages specific to the proposed telehealth rules can be found here: 2016-Fee-Schedule and include some helpful information on the requirements and payment opportunities for those codes that are eligible for payment under Medicare.
Written By: Traci Thompson
The HHS’ Office of Inspector General released a report this past Monday indicating that a number of states providing services to Medicaid beneficiaries enrolled in managed care are not complying with the mandatory quarterly reporting requirements. In response to this study, the OIG recommended that the Center for Medicare and Medicaid Services use its authority to begin withholding federal funds from non-compliant states citing that the data is crucial to Medicaid oversight and the prevention of fraud and abuse. Although states struggle with capturing the level of quality data needed to complete the reporting requirements, CMS continues to make enforcement a priority. In response to the report, CMS indicated that it has already issued a notice of proposed rulemaking that would allow for the withholding of federal funds. For those states who lack the ability to capture the data whether through lack of technological infrastructure or other reasons, this latest policy does not bode well. For more information, go to: http://www.modernhealthcare.com/article/20150706/NEWS/150709966/not-all-states-reporting-required-medicaid-data-oig-says.
Written by: Traci S. Thompson
On June 25, 2015, the U.S. Supreme Court rendered a decision in the highly anticipated case of King v. Burwell[1], which centered around the viability of certain provisions of the Patient Protection and Affordable Care Act (“ACA”). The King decision, rendered three months after arguments were heard, decided an issue the Court described as “a question of deep ‘economic and political significance.’”[2] Specifically, the Court decided whether the ACA intended for tax credits to be available to individuals who purchased their insurance through either a State or Federal Exchange or just through a State Exchange. Ultimately, the Court held both State and Federal Exchanges should offer tax credits to purchasers. Continue reading
“Physicians who enter into compensation arrangements such as medical directorships must ensure that those arrangements reflect fair market value for bona fide services the physicians actually provide. Although many compensation arrangements are legitimate, a compensation arrangement may violate the anti-kickback statute if even one purpose of the arrangement is to compensate a physician for his or her past or future referrals of Federal health care program business.”
http://oig.hhs.gov/compliance/alerts/guidance/Fraud_Alert_Physician_Compensation_06092015.pdf
Written by: Traci Thompson
bswhealthlaw.com 