Articles and Blogs

On November 27, 2013, the Centers for Medicare & Medicaid Services (“CMS”) issued the Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgical Center (“ASC”) Final Rule (“Final Rule”). In this Final Rule, CMS made some significant changes, including implementing a policy to combine outpatient clinic evaluation and management visit codes into one APC and allowing the…Read More

House and Senate Likely to Mark Up SGR Bills Both the Senate Finance Committee and House Ways and Means Committee tentatively announced they will mark up legislation to repeal and replace the Sustainable Growth Rate (“SGR”) formula before Congress leaves for Christmas break next week. If the Ways and Means Committee does mark up the…Read More

On November 27, 2013, the Centers for Medicare & Medicaid Services (“CMS”) issued the Physician Fee Schedule (“PFS”) Final Rule for calendar year (“CY”) 2014.  The Final Rule calls for a 20.1% reduction in payments to physicians for services rendered in CY 2014, although Congress may act to avoid this reduction.  Additionally, the Final Rule…Read More

On December 5, 2013, CMS issued a Medical Learning Network Letter noting that the deadline for physician-owned hospitals to report ownership and investment information as required by the Affordable Care Act (“ACA”) has been extended to March 1, 2014. 

Executive Summary On November 27, 2013, President Obama signed the Drug Quality and Security Act (“Act”) into law.  The Act was introduced primarily in response to longstanding issues highlighted by a deadly fungal meningitis outbreak that occurred last year.  The Act, which is aimed at ensuring providers and patients have access to safe compounded drugs,…Read More

IRS rules governing health flexible spending arrangements (“FSAs”) require cafeteria plans to forfeit unused amounts left in a participant’s health FSA at the end of a plan year. This so-called  “use-it-or-lose-it” rule was perceived as a significant barrier to health FSA participation by many employees, especially lower and moderate income employees.  They are more reluctant…Read More

The abundance of information available on social media websites has changed the landscape of discovery in civil trials. A simple Google search can indicate whether a person has a Facebook, MySpace, LinkedIn or other social medical account with little effort. Informally, using Google can yield not only publicly available information, such as stories about a…Read More

The OIG recently issued Advisory Opinion 13-15 disapproving of a part-time physician services agreement between an anesthesiologist group and a psychiatry group for the provision of electroconvulsive therapy (“ECT”) procedures at a hospital (the “Proposed Arrangement”).1  The OIG stated that because of an opportunity to generate a fee as a result of a referral, the Proposed…Read More

The Oregon Health Network (“OHN”) has appealed to the FCC an adverse ruling by USAC regarding whether health care provider service locations that are urban, but are not licensed bed hospitals (or other eligible entities), will qualify for funding under the Healthcare Connect Fund (“HCF”). The determination of this issue will clarify whether the scope of…Read More