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 …
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 …
Care Recipients’ Limited Right to Discriminate Based on Protected Characteristics of Care Provider
By David J. Houston Healthcare provider institutions including hospitals, clinics, medical practices, nursing homes and home health care providers (here, “Institutions”) are occasionally called upon to balance the preferences of Consumers against the interests or possible rights of their employee Care Providers. This may occur when Consumer complaints target assigned direct Care Providers – nurses, …
Tennessee Attorney General States that Physical Therapists Cannot Perform Trigger-Point Dry Needling
By Keith C. Dennen In an opinion released on June 19, 2014, the Office of the Tennessee Attorney General stated that Physical Therapists cannot lawfully perform Intramuscular Manual Therapy or Trigger-Point Dry Needling. Dry Needling therapy involves application of a fine, filiform needles to the neuromusculoskeletal system to restore movement, reduce pain, and address other …
Peer Review is not always Privileged
By Keith C. Dennen Hospitals, ambulatory surgery centers and independent diagnostic centers cannot exist without physicians and other medical providers. In order to practice at those facilities, the medical professional often is required to be “admitted” to the medical staff of the facility. Although admission to the medical staff provides privileges, it often requires that …
The Academic Laboratory Exception
By Scott Roberts Part One: Determining Eligibility The federal Resource Conservation and Recovery Act, usually referred to as “RCRA”, governs the storage and disposal of hazardous waste, including hazardous medical waste. In addition to generally applicable regulations, RCRA provides a set of alternative rules, called the “Alternative Requirements for Hazardous Waste Determination and Accumulation of …
Mississippi Governor Rescinds Executive Order Requiring Blue Cross of Mississippi to Grant “In Network” Status to Excluded Hospitals
By James M. Burns In early November, Mississippi Governor Phil Bryant rescinded an Executive Order (Executive Order 1327), issued only weeks earlier, that would have compelled Blue Cross of Mississippi to continue to offer “in-network” status to several Mississippi hospitals with whom Blue Cross had terminated its relationship as a result of a contract dispute …
Anti-Kickback Statute and On-Call Payments to Physicians
By Keith C. Dennen EMTALA requires hospitals to provide “appropriate” medical examination and treatment to individuals who come to the emergency room. Medicare requires hospitals to provide a list of doctors who are “on-call” to provide this treatment. Doctors, particularly specialists, are refusing to be “on-call” unless they are paid for this service. What does …
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Providers Must Enter into BA Agreements with Vendors who Transmit, Maintain, Use or Have Access to PHI
By Tatiana Melnik The Stage 2 Meaningful Use requirements make clear that the federal government is continuing its push to require healthcare providers to use information technology. The requirements also make clear, however, that patient privacy and security has not been sidelined. With this emphasis on making information available to patients online, providers must remember …