Follow Us
twittergoogle_pluslinkedinrssyoutube
Subscribe to the BT Healthcare Blog

By signing up, you agree to our Terms of Service and Privacy Policy.

Recent Posts
The Legal Stuff
BT Health Law Blog
Healthcarehospital
0 0

22 Apr 2016 CMS to Reverse Payment Cuts Made Under “Two-Midnight” Rule

On April 18, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that addresses the controversial inpatient payment cuts resulting from the so-called “two-midnight” rule.  The two-midnight rule, which was introduced in the Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS) final rule, said that inpatient payment under Medicare Part A was generally only appropriate if the patient’s hospital stay was expected to span two midnights. If the patient’s stay was expected to be less than two midnights, the care should generally…

READ MORE
0 0

04 Apr 2016 New Indiana Law Expands Use of Telemedicine

Indiana Gov. Mike Pence recently signed into law House Enrolled Act (HEA) 1263, which expands physicians’ use of telemedicine. HEA 1263 will permit providers, which include physicians, optometrists, and advance practice nurses and physician assistants with prescriptive authority, to prescribe certain prescriptions, drugs and devices during remote patient visits. Currently, Indiana allows the prescribing of drugs through telemedicine only if a provider first examines a patient in person.   Effective July 1, HEA 1263 will provide greater convenience to patients located in rural areas by eliminating…

READ MORE
0 0

01 Apr 2016 DOJ Launches Targeted Elder Justice Task Forces

On March 30, the Department of Justice (“DOJ”) announced the formal launch of 10 regional Elder Justice Task Forces designed to identify nursing homes and other long-term care (“LTC”) facilities that provide “grossly substandard care” to residents.   Similar to DOJ’s previously launched Medicare Fraud Strike Force and Health Care Fraud Prevention & Enforcement Action Team (“HEAT”) initiative, the newly created Elder Justice Task Forces will focus on coordination and information sharing among federal, state and local enforcement agencies to combat suspected cases of physical…

READ MORE
hand browsing through stack of magazines
0 0

21 Mar 2016 OCR Releases Details of Phase 2 HIPAA Audit Program

  The Office for Civil Rights (OCR) announced Phase 2 of its HIPAA audits, according to a public announcement. In its 2016 Phase 2 Audit Program, OCR will review the policies and procedures of selected covered entities and business associates to examine compliance with the HIPAA Privacy, Security and Breach Notification Rules.   Every covered entity and business associate is eligible for an audit, which will consist of three phases. The first set of audits will be desk audits for covered entities while the second…

READ MORE
0 0

17 Feb 2016 CMS Relaxes 60-day Overpayment “Look Back” Period for Medicare Providers

  Federal regulators have relaxed the provider reporting obligations for overpayments by decreasing the period of time providers or suppliers must “look back” when reporting and repaying overpayments from ten to six years. The final rule issued by the Centers for Medicare and Medicaid Services (CMS) on Feb. 11, provides much needed clarity and consistency for providers and suppliers who participate in the Medicare program.   Section 1128J(d)(1) of the Social Security Act requires a provider who has received an overpayment to report and return the overpayment to…

READ MORE
0 0

15 Feb 2016 Physician Owed Duty to Nurse Practitioner’s Patient

  The Indiana Court of Appeals recently held that a physician, who entered into a collaborating practice agreement (CPA) with a nurse practitioner, had a duty of care to the nurse practitioner’s patient even though the physician never treated or saw the patient.   In John Collip, M.D. v. Vickie Ratts on behalf of Robert A.J. Ratts, deceased, and Little Creek Family Health Center, LLP, Dena Barger, a nurse practitioner who owns her own practice, saw her patients under a CPA with Dr. John Collip….

READ MORE
0 0

15 Jan 2016 Hospitals Mount Another Challenge to the CMS “2 Midnights” Policy and Reductions in Reimbursement Rates

  On Jan. 8, 55 general acute care hospitals from 19 different states filed suit against U.S. Department of Health and Human Services (HHS) Secretary Sylvia Matthews Burwell.   The suit alleges that the Centers for Medicare & Medicaid Services’ (CMS) decision to institute a 0.2 percent decrease in hospital payment rates from FY 2014 through FY 2018 violated the Administrative Procedure Act (APA) because the rule was finalized without following proper notice and comment procedures. The plaintiffs’ further allege that the rule was arbitrary,…

READ MORE
0 0

14 Jan 2016 Illinois Appellate Court Rules Hospital Tax Exemption Law Unconstitutional

  Last week, in a unanimous ruling, the Illinois Appellate Court for the Fourth District declared that a state law granting property tax exemptions to hospitals was unconstitutional. The Fourth District’s ruling could have ramifications for a number of Illinois hospitals, but it remains to be seen whether the decision will be reviewed by the Illinois Supreme Court.   The case originated when a hospital system, after being assessed a tax bill by its local jurisdiction, sought a declaratory judgment from the circuit court that…

READ MORE
stethoscopes
0 0

13 Jan 2016 What You May Not Know (But Should) About Voluntarily Surrendering Your DEA Registration

  The scenario is not all that uncommon: Drug Enforcement Administration (DEA) agents or investigators show up at your office as part of a routine audit, administrative inspection or, worse, a criminal investigation. Not having expected the unanticipated visitor, you or your medical office staff feel unprepared, anxious, and perhaps a bit fearful. Eager to resolve any issues so your normal business can resume, when the DEA representative presents you with Form 104 “Voluntary Surrender,” you grudgingly think your best option is to sign it. After all, the DEA…

READ MORE
0 0

12 Jan 2016 How to Differentiate Between a Consultation and Pre-Procedure Encounter

    Physician clinicians commonly interact with their patients before and after their procedures and subsequently bill patients for that time. As with most medical billing, there are guidelines which provide when a physician may bill under an Evaluation and Management Services (E/M) code in addition to the procedure code, and when the physician may only bill one code or the other.   The guidelines advise that if the physician-patient encounter is at the request of another physician and the purpose of the visit is…

READ MORE