Analysis of New Timeshare Arrangement Exception to the Stark Law – Part 2

By Marki Stewart In a previous post, we analyzed the new Timeshare Arrangement exception to the Stark law that CMS proposed and went into effect on January 1, 2016. Here we give an example of how the new timeshare arrangement exception works as it relates to rental of office space. Client’s Block Lease A client …

Analysis of New Timeshare Arrangement Exception to the Stark Law – Part 1

By Marki Stewart On July 15, 2015, the Centers for Medicare & Medicaid Services (CMS) proposed a series of rules that would create new exceptions to the Stark law, in addition to clarifying other provisions of the Stark law. One of the newly created exceptions is for “Timeshare Arrangements.” (effective January 1, 2016). This exception …

Physician Compliance Programs: What you need to know about the Final 60-Day Rule

By Rose Willis The 60-Day Rule was enacted as part of the Affordable Care Act on March 23, 2010 and generally requires a person who has received an overpayment to report and return the overpayment by the later of (i) the date which is 60 days after the date on which the overpayment was identified; …

3 Things to Consider When Dealing with Bundled Payments to Providers

By Ralph Levy The Centers for Medicare & Medicaid Services (CMS) has traditionally paid health care providers separately for each of the individual services they furnish to beneficiaries for a single illness or course of treatment. This approach to payments rewarded a quantity versus quality of care and could result in fragmented care with minimal …

HIPAA Privacy Rule Amendment will Permit Very Limited Reporting of Mental Health Information to the NICS

By Rose Willis An amendment to HIPAA’s privacy rules will allow a limited subset of covered entities (such as, potentially, state agencies) to disclose information to the National Instant Criminal Background Check System (NICS). The amendment takes effect February 5, 2016, and will be most relevant in those states that do not already require reporting …

New Stark Law Exception Allows Hospitals, FQHCs, and RHCs to Assist Physicians with Engaging Non-Physician Practitioners

By Rose Willis The Centers for Medicare & Medicaid Services (CMS) recently released a new exception to the Physician Self-Referral Law (the “Stark Law”) intended to expand access to primary care and mental health services (the “NPP Recruitment Exception”). This exception would permit hospitals, federally qualified health centers (FQHCs) and rural health clinics (RHCs) to …

HHS’S New Anti-Discrimination Regulation Proposal Explained – Part 2

By Keith C. Dennen This is the second part in a two-part series about the HHS’s proposed anti-discrimination regulations Gender Identity. Another area addressed in the regulations is “gender identity,” which refers to an individual’s “internal sense of gender, which may be different from that individual’s sex assigned at birth.” The proposed regulations seek to …

HHS’S New Anti-Discrimination Regulation Proposal, Explained

By Keith C. Dennen This is the first part in a two-part series about the HHS’s proposed anti-discrimination regulations. In September, the Department of Health and Human Services (HHS) released proposed anti-discrimination regulations that, if adopted, change the playing field in which physicians and other healthcare providers practice. These regulations are significant because: They apply …

New CMS Proposed Rule Provides Who/What/When for Clinical Laboratory Reporting Requirements Starting January 1, 2016

By Rose Willis Clinical laboratories will see significant changes to their Medicare payments for clinical diagnostic laboratory tests (CDLTs) starting January 1, 2017, but the basis for new payment rates will come from “applicable data” reported by “applicable clinical laboratories” starting January 1, 2016. Failure to report data will subject the applicable laboratory to Civil …

Happy ICD-10 Day!

By Craig Phillips   Since 13,000 ways to be sick, injured, or mortally wounded were not enough, we now have about 70,000 ways.  This includes codes for “parrot bites” and “sucked into a jet engine.” There is also V97.33XD – “sucked into jet engine, subsequent encounter;” what patient was sucked into a jet engine, survived, …