1. OIG updated provider self-disclosure protocol.
The Office of Inspector General has released updated provider self-disclosure protocol, which is entirely revised from the SDP published in 1998. The protocol instructs healthcare providers what to do if they discover actions violate federal fraud and abuse laws. Among the changes since 2008, the OIG narrowed the SDP's scope regarding the physician self-referral law, established a minimum settlement amount and established guidelines for providers' initial submissions in the disclosure process.
2. House bill would exempt elderly physicians from EMR penalties.
A bill introduced to the House of Representatives would offer an electronic health record penalty exemption to near retirement-age physicians who fail to adopt systems. Solo practitioners would also get a three-year extension before penalties kick in and specialists would be given bonuses to promote meaningful use.
3. CMS reduced minimum recovery audit records request.
In an effort to reduce administrative burdens on hospitals and other providers, CMS reduced the minimum medical record requests from Medicare Recovery Auditors — formerly known as Recovery Audit Contractors, or RACs. Under the new guidelines, RACs may request a minimum of 20 records in a 45-day period, down from the previous minimum of 35 records.
4. Maryland legislation would increase plastic surgery center oversight.
Legislation has been introduced in the Maryland legislature that increases oversight on cosmetic plastic surgery centers. The law would "close a regulatory gap that does not allow state health officials to proactively inspect and oversee plastic surgery centers," according to the report.
5. Georgia Senates passes pain management regulation bill.
A pain clinic regulation bill was passed by the Georgia Senate last week. The legislation aims at regulating pain management clinics and would require the owner of the clinic to be a physician. It would not, however, require physicians or pharmacists to use a state registry to track how much of a painkiller a patient is receiving.
6. House Republicans propose Medicare fee-for-service plan.
House Republicans have proposed a plan that would slowly shift Medicare reimbursement to a combination of fee-for-service and pay-for-performance. The newly revealed plan, which is not yet a bill, would give medical societies and other provider organizations the task of coming up with performance metrics to measure physician performance. The Republican plan would also repeal Medicare's sustainable growth rate formula.
7. Arizona Senate pushes for price transparency.
The Arizona Senate will once again look at a bill to provide medical pricing transparency after the original version of the legislation was vetoed last week by Republican Gov. Jan Brewer. The bill would require a listing of "direct pay" prices for 50 commonly used inpatient and outpatient procedures.
8. OIG issued fraud alert for physician-owned distributorships.
The HHS Office of Inspector General issued a special fraud alert focused on specific attributes of physician-owned distributorships the agency believes "produce substantial fraud and abuse risk and pose dangers to patient safety." PODs are physician-owned entities that derive revenue from selling or arranging the sale of implantable medical devices, which are ordered by the entities' physician-owners for use in procedures those physician-owners perform at their hospitals or ambulatory surgery centers.
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The Office of Inspector General has released updated provider self-disclosure protocol, which is entirely revised from the SDP published in 1998. The protocol instructs healthcare providers what to do if they discover actions violate federal fraud and abuse laws. Among the changes since 2008, the OIG narrowed the SDP's scope regarding the physician self-referral law, established a minimum settlement amount and established guidelines for providers' initial submissions in the disclosure process.
2. House bill would exempt elderly physicians from EMR penalties.
A bill introduced to the House of Representatives would offer an electronic health record penalty exemption to near retirement-age physicians who fail to adopt systems. Solo practitioners would also get a three-year extension before penalties kick in and specialists would be given bonuses to promote meaningful use.
3. CMS reduced minimum recovery audit records request.
In an effort to reduce administrative burdens on hospitals and other providers, CMS reduced the minimum medical record requests from Medicare Recovery Auditors — formerly known as Recovery Audit Contractors, or RACs. Under the new guidelines, RACs may request a minimum of 20 records in a 45-day period, down from the previous minimum of 35 records.
4. Maryland legislation would increase plastic surgery center oversight.
Legislation has been introduced in the Maryland legislature that increases oversight on cosmetic plastic surgery centers. The law would "close a regulatory gap that does not allow state health officials to proactively inspect and oversee plastic surgery centers," according to the report.
5. Georgia Senates passes pain management regulation bill.
A pain clinic regulation bill was passed by the Georgia Senate last week. The legislation aims at regulating pain management clinics and would require the owner of the clinic to be a physician. It would not, however, require physicians or pharmacists to use a state registry to track how much of a painkiller a patient is receiving.
6. House Republicans propose Medicare fee-for-service plan.
House Republicans have proposed a plan that would slowly shift Medicare reimbursement to a combination of fee-for-service and pay-for-performance. The newly revealed plan, which is not yet a bill, would give medical societies and other provider organizations the task of coming up with performance metrics to measure physician performance. The Republican plan would also repeal Medicare's sustainable growth rate formula.
7. Arizona Senate pushes for price transparency.
The Arizona Senate will once again look at a bill to provide medical pricing transparency after the original version of the legislation was vetoed last week by Republican Gov. Jan Brewer. The bill would require a listing of "direct pay" prices for 50 commonly used inpatient and outpatient procedures.
8. OIG issued fraud alert for physician-owned distributorships.
The HHS Office of Inspector General issued a special fraud alert focused on specific attributes of physician-owned distributorships the agency believes "produce substantial fraud and abuse risk and pose dangers to patient safety." PODs are physician-owned entities that derive revenue from selling or arranging the sale of implantable medical devices, which are ordered by the entities' physician-owners for use in procedures those physician-owners perform at their hospitals or ambulatory surgery centers.
More Articles on Billing and Coding:
10 Main Coding Errors Associated With Medicare Risk Adjustment
Report: $560B Can Be Shaved From U.S. Healthcare System in Next 10 Years
Get Paid in Full: 4 Experts on Maximizing ASC Patient Payment Collections