On March 25, 2011 significant new Federal regulations were implemented that have a direct impact on Medicaid enrolled providers. New information from the New York State Medicaid Program’s Medicaid Update confirms that the rules will be implemented shortly for New York providers.
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Whether a physician is advertising in a newspaper, disseminating a pamphlet about the practice, or using the internet, caution must be taken to avoid running afoul of the advertising regulations of the New Jersey Board of Medical Examiners (BME). The fact that physicians must prepare and maintain records is hardly news to anyone. It may have, however, been a while since a physician last reviewed the requirements for patient documentation in New Jersey that are imposed by the Board of Medical Examiners (BME). When a provider participates in the New York State Medicaid Program, a provider agrees to accept payment as payment in full for the provided services. The same applies to providers who accept Medicaid Managed Care or Family Health Plus (FHPlus) plans. The American Dental Association (ADA) recently analyzed the legal implications for dentists advertising on Groupon or other social media companies. We discussed this issue in our recent post here. The final 2011-12 New York State budget (Chapter 59 of the Laws of 2011) requires a 2% across the board reduction to most Medicaid payments for dates of service on or after April 1, 2011. The reduction will remain in effect for dates of service through March 31, 2013. These provisions were enacted to meet You have patients in the waiting room, two patients in exam rooms, your receptionists has a question for you, and right as your cell phone goes off, your assistant is asking you about a prescription. And when the sun sets, you are returning calls to patients and colleagues. OSHA compliance may not be at the According to the Environmental Protection Agency (EPA), 9 million people in the U.S. use sharps — needles, syringes and lancets — at home. This equates to more than 3 billion disposable needles and syringes and 900 million lancets each year. Often times sharps used at home are discarded in the waste disposal or toilets. Such On September 8, 2011, the Occupational Safety and Health Administration issued its first directive on Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents. The directive provides guidelines and general policies and procedures that apply when OSHA investigators conduct an inspection under a national, regional or local emphasis program or in response to incidents of Many providers were disappointed to learn that on September 23, 2011, New York Governor Andrew Cuomo vetoed a bill that was previously passed without opposition by both houses of the New York State legislature (A.5686-A Gottfried and S.2184-A Little). According to the press release of one of the bill’s sponsors, “[t]he bill would set forth Watch this Bloomberg TV report filed by Shannon Pettypiece titled “Groupon Deals on Botox, Lasik Eye Surgery?” It appeared on Bloomberg TV on the morning show of October 25th as part of Shannon’s daily “Stock Therapy” segment that examines how the latest health care trends are affecting the markets and the economy. You may have heard that Medicaid is a payer of last resort, a requirement that Medicaid providers bill other payers first when Medicaid enrollees have other forms of insurance, such as Medicare. But providers should note that Medicare is not always the payer of first resort. Groupon and other similar social sites, like Living Social and CoupTessa, are all the rage now. But is it legal for doctors and dentists to advertise their services on these websites? More than a decade ago the Office of the Inspector General (OIG) issued Compliance Program Guidelines for Individual And Small Group Physician Practices, which are a set of voluntary guidelines for a small group physician practice or an individual practitioner. Nowadays, when federal and state governments are increasingly interested in cutting fraud, waste and abuse More likely than not, a physician or a dentist has at one point provided discounted or free healthcare services to some patients by waiving all or part of a fee or the copayment and/or coinsurance obligations as a “professional courtesy”. According to the Office of Inspector General’s (OIG) Compliance Program For Individual and Small Group Providers may have heard that they are required to provide in certain instances Medicare beneficiaries with an Advanced Beneficiary Notice of NonCoverage (ABN) but the specifics of the requirements may not be known to everyone. In the last few years, many healthcare providers have come under increased scrutiny from federal and state investigative and auditing agencies. The recent USAToday article confirms that the federal government stepped up the prosecution of health care fraud. In fact, according to USAToday “[n]ew government statistics show federal health care fraud prosecutions in the first A bill introduced in the New York Senate on February 10, 2011, and which passed both of the New York’s State legislative houses in June (A.5686-A Gottfried and S.2184-A Little), is awaiting Gov. Cuomo’s approval. The bill will impact the power of the Office of the Medicaid Inspector General (OMIG) and will address some of These days it seems like all aspects of a healthcare provider’s practice are under close scrutiny — including one’s repayment of student loans. Defaulting on a student loan may result in exclusion from the Medicare and Medicaid programs. The Office of Inspector General (OIG), a department within the U.S. Department of Health and Human Services |
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