See below for the CMS (Centers for Medicare & Medicaid Services) Announcement on July 10, 2024 proposing a reduction in the Medicare Conversion Factor payment from $33.29 to $32.36, i.e. 2.8%...more
CMS proposed several telehealth changes in the 2025 Medicare Physician Fee Schedule Proposed Rule, issued July 10, 2024....more
The Press has announced that the Merger Agreement between UPMC and Washington Health System was approved by the Pennsylvania Attorney General with certain conditions, one of which was that UPMC would honor existing employment...more
The Allegheny County Medical Society has reported that the Pennsylvania House of Representatives has passed a bill to bar non-compete agreements in healthcare employment....more
The 2024 Consolidated Appropriations Act passed and signed on Saturday, March 23, 2024, increased of Medicare Conversion Factor from $32.7442 to $33.2875, an increase of slightly over $0.54....more
During the American Bar Association’s 39th National Institute on White Collar Crime, the most senior executives of the DOJ (Attorney General Merrick B. Garland and Deputy Attorney General Lisa Monaco) delivered remarks...more
The healthcare sector is particularly vulnerable to cybersecurity risks and the stakes for patient care and safety are particularly high. Healthcare facilities are attractive targets for cyber criminals in light of their...more
1/16/2024
/ Biden Administration ,
Cyber Attacks ,
Cyber Incident Reporting ,
Cybersecurity ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Facilities ,
OCR ,
Popular ,
Ransomware
When negotiating physician compensation issues, hospitals frequently rely upon the premise they must pay fair market value compensation in order to comply with the provisions of the Stark Act prohibiting referrals in exchange...more
CMS issued the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023, for payments to be effective on or after January 1, 2024. Fee Schedule Link The overall payment rates under the PFS will be...more
As reported earlier in the MedLaw Blog (August 9, 2023), a federal District Court vacated portions of the No Surprises Act federal regulations. Thereafter, CMS halted the arbitration process for resolving disputes regarding...more
CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows...more
The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75....more
Since the private equity issue was last addressed in the Bulletin in the Summer of 2022, the volume of healthcare private equity deals has subsided somewhat, according to statistics presented at the March 2023 Pennsylvania...more
5/1/2023
/ Acquisitions ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Corporate Practice of Medicine ,
Health Care Providers ,
Hospitals ,
Investment ,
Investors ,
Motor Vehicle Safety Whistleblower Program (MVSWP) ,
Private Equity ,
Private Equity Firms
On January 5, 2023, the Federal Trade Commission (FTC) took a dramatic step by proposing a new rule that would prohibit companies from entering into non-compete agreements with its workers. The proposed rule, if approved,...more
2/3/2023
/ Employment Contract ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Independent Contractors ,
Non-Compete Agreements ,
Nonprofits ,
Physicians ,
Proposed Rules ,
Public Comment ,
Restrictive Covenants ,
Unfair Competition
The final “2023 Omnibus Bill” which is the spending bill passed by Congress and signed by President Biden at the end of 2022, provides partial relief from the scheduled Medicare Physician Fee Schedule Conversion Factor cuts. ...more
Both the federal government and the Pennsylvania state government are taking steps to reform the prior authorization process. Attached is the Pennsylvania Insurance Department Press Release, issued November 3, 2022, touting...more
The US Office of Inspector General (OIG) released another in a series of Special Fraud Alerts on July 20, 2022, this one directed to potentially fraudulent telehealth, telemedicine, and telemarketing service fraud schemes,...more
On July 7, 2022, CMS released its proposed Medicare Physician Fee Schedule for 2023, which proposes physician fee schedule reductions via the Medicare Conversion Factor. ...more
The Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA), was passed as part of the consolidated Budget Act for 2022, which also included the telehealth provisions.
The definition of “covered entity” in the...more
HHS sent notices to noncompliant physicians and facilities on March 10, 2022 giving them 30 days to return funds paid to healthcare providers who have not complied with the agency’s reporting requirements....more
The President and Congress extended Medicare telehealth coverage in the Consolidated Appropriations Act, which also included additional Ukrainian relief.
On Tuesday, March 15, 2022, President Biden signed the Consolidated...more
There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings.
As originally proposed, and starting in January 2022, if the service was shared among...more
There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas:
..The use of fraudulently obtained COVID relief funds in both healthcare and in general, but specifically as...more
1/20/2022
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Personal Liability ,
Physicians ,
Relief Measures ,
Yates Memorandum
The Pennsylvania Senate announced on October 26, 2021 that it has passed Senate Bill 705, and a copy of the Senate Press Release can be found here.
A previous telemedicine bill was passed in Pennsylvania in July of 2018,...more
In the August 12, 2021 MLN Connects News, CMS announced resumption of TPE Program.
...more