View CMS’s full press release. The American College of Radiology, the Intersocietal Accreditation Commission, and The Joint Commission have each been designated to accredit suppliers furnishing the technical component of advanced diagnostic imaging procedures. All suppliers who furnish the technical component of advancing imaging must become accredited by January 1, 2012, as required by the Medicare Improvements for Patients and Providers Act of 2008.
von Briesen Health Law Blog
January 29, 2010
January 28, 2010
National Summit on Health Care Fraud – Webcast
The National Summit on Health Care Fraud webcast.
Thursday, January 28, 2010 from 8:45 a.m. – 4:00 p.m. (CST)
January 26, 2010
City of Angels Executives No Angels
The U.S. Attorney recently settled its case against the former owners of a Los Angeles Medical Center. The former executives have agreed to pay over $10 million for paying kickbacks to recruiters to bring homeless people to the hospital facility for unnecessary medical services. View the U.S. Attorney’s statement related to this case.
January 25, 2010
Wisconsin to Receive Federal Matching Funds for Electronic Health Record Incentives Program
Read the January 21, 2010 press release here.
CMS recently announced that Wisconsin’s Medicaid program would receive approximately $1.37 million in federal matching funds for state planning activities necessary to implement the electronic health record (EHR) incentive program established by the 2009 American Recovery and Reinvestment Act (ARRA). EHR’s improve health care efficiency and quality, and make it easier for patients to access necessary information about their health.
January 19, 2010
DQA Publishes Guidance on Faxed Prescriptions
The Department of Health Services’ Division of Quality Assurance recently issued its November/December 2009 Pharmacy Capsule, which included recommendations regarding the faxing of prescription orders. Specifically, the DQA advises that, for controlled substances in schedule III, IV and V, a pharmacy can accept a faxed prescription as long as the fax prescription contains the requisite prescription components. For controlled substances in Schedule II, a prescription only may be faxed for nursing home residents and hospice patients, and only if the fax contains the requisite prescription components. With regard to hospice and nursing home orders, it is important to note that the fax may only be transmitted by the practitioner or the practitioner’s agent; recent DEA activity and interpretation indicates that nurses at nursing homes and/or hospices are not always practitioner agents. Read the November/December 2009 Pharmacy Capsule here.
January 14, 2010
The OIG Issues an Updated Special Fraud Alert on DME Telemarketing
The OIG has issued an updated Special Fraud Alert on telemarketing by DME suppliers. The updated Alert was apparently issued in light of information that some DME suppliers continue to use marketing firms to place unsolicited telephone calls to Medicare beneficiaries. The original alert was published in March 2003.
The Alert reminds DME suppliers that federal law generally prohibits DME suppliers from making unsolicited telephone calls to Medicare beneficiaries regarding the furnishing of DME, except in some limited circumstances. The rule applies even if another firm contacts the beneficiary on the DME supplier’s behalf. The Alert also reminds DME suppliers that claims for items or services generated from a prohibited solicitation could expose the DME supplier and the telemarketer to criminal, civil and administrative penalties. You can review the OIG’s Alert here.
First HIPAA Lawsuit Filed by State Attorney General
The first lawsuit by a state attorney general under HIPAA has been filed. This is big news because previous class action suits citing failure to protect private information have failed to gain traction for lack of damages (i.e. mere failure to protect was not enough). Using new enforcement powers under HIPAA, the state’s attorney general can bring charges for failure to protect and enforce under HIPAA. Download the entire news story.
January 12, 2010
OCI Bulletin to Insurers Regarding ARRA Premium Subsidy Benefit Extension
The Wisconsin Office of the Commissioner of Insurance (OCI) recently posted a bulletin to insurers concerning ARRA amendments extending the eligibility period and duration of the ARRA premium subsidy benefit. The amendments extended the eligibility period for an additional two months (through February 28, 2010) and extended the premium subsidy duration by an additional 6 months (from 9 to 15 months).
OCI issued the bulletin to inform insurers that, even if they are not subject to federal COBRA, OCI expects insurers to comply with the new ARRA premium subsidy provisions for group health plans with less than 20 employees who are required to comply with the Wisconsin continuation and conversion law, Wisconsin Statutes section 632.897.
Read OCI’s bulletin here. Wisconsin Statutes section 632.897 can be found here.
January 11, 2010
Minnesota CAH Settles False Claims Act Allegations for Almost One Million Dollars
The Justice Department recently announced a $846,461 settlement by a Minnesota critical access hospital and one of its physician’s to settle False Claims Act allegations. A former doctor at the critical access hospital filed a qui tam (“whistleblower”) action alleging that the physician admitted patients that did not need to be admitted, or kept other patients in acute care when doing so was not medically necessary, and ordered unnecessary testing. The whistleblower contended that he complained to the hospital about the physician’s alleged practices, but that the hospital did nothing. The government investigated the allegations, reviewing nearly 200 of the physician’s patient admissions. Several admissions were identified as not medically necessary under Medicare rules. Additionally, the investigation revealed that the physician generated more than $4 million a year in billings for the hospital, which is 10 times that of its other doctors. You may read the DOJ’s press release here.