American Medical News (11/25, Berry) reports that BCBS of North Carolina has backed away from a contract addendum it sent to physicians in September,” but it is “unclear whether a new draft will assuage physician concerns.”
Continue Reading December 8th, 2009
The U.S. Department of Health and Human Services (HHS) issued an interim final rule with request for comments today to strengthen its enforcement of the rules promulgated under the Health Insurance Portability and Accountability Act (HIPAA). The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was enacted as part of the American Recovery and Reinvestment Act of 2009, modified the HHS Secretary’s authority to impose civil money penalties for violations occurring after Feb. 18, 2009.
Continue Reading December 8th, 2009
The government won or negotiated approximately $1 billion in judgments and settlements during fiscal year (FY) 2008, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) said in its Health Care Fraud and Abuse Control (HCFAC) Program annual report released October 23.
Continue Reading December 8th, 2009
Join Healthcare Attorney Heather Skelton on Thursday, December 10 at 9 a.m. for an informational roundtable entitled “Your Practice’s Website & Email Use: Legal Do’s & Don’ts”. Heather will lead discussion on what must be included on your practices website and what should not be. Also how practices are using email, the risks and rules you need to know.
Continue Reading December 4th, 2009
Back by popular demand, Heather Skelton’s complimentary roundtables return in November month. Open to all medical practice professionals, these meetings offer an opportunity for area physicians and practice managers to discuss issues that affect their business on a day to day basis.
Continue Reading October 20th, 2009
After much discussion with physician advocacy groups, Aetna has determined that it will pay two E&M Codes on the same day, using the 100/50 “concurrency rule.” The preventive medicine visit will be considered the primary service payable at 100% of the allowable, and the eligible office (or problem-focused) E&M visit will be considered the secondary service payable at 50% of the allowable.
October 20th, 2009
In a recent ruling, Compliance Dispute Officer Martin Quinn has determined that the pricing policy and associated actions taken by Blue Cross Blue Shield of North Carolina did not violate key provisions in the BCBS Settlement Agreement. In his opinion, Mr. Quinn stated that BCBSNC provided adequate notice of its policy, and provided fee schedules upon request.
The North Carolina Medical Society (NCMS) and numerous physician practices signed affidavits disputing these and other contentions made by BCBSNC. NCMS will likely file a motion for reconsideration.
October 20th, 2009
A report (PDF – 49 pages) commissioned by the Physicians Foundation (PAI), a national health care organization that represents the interests of physicians, raises new questions about the role of socioeconomic determinants as they relate to access, quality, and cost of medical care in the United States. The report, prepared by a team of noted physicians and economists headed by Richard “Buz” Cooper, MD, Professor of Medicine and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania, was sent to the President and Congress today in order to contribute to the national health care debate.”It is essential that in order to pass meaningful health care system reform that the issues be fully debated with factual information,” PAI Treasurer and NCMS EVP, CEO Robert W. Seligson said. “Studies like this help put the debate at the forefront.”
Continue Reading October 20th, 2009
October 20th, 2009
For full agreement, go to:
http://www.oig.hhs.gov/fraud/cia/agreements/pfizer_inc.pdf
October 20th, 2009
