Telehealth On The OIG’s Radar

Telehealth is one of the fastest growing markets in health care, and with the ever-increasing availability and growth of technology, telehealth will continue to play a significant role in the future of health care. In an attempt to keep up with the dynamic and rapidly changing telehealth market, federal and state agencies have responded by developing a patchwork of different [...]

By |2018-02-27T08:54:45-07:00December 20, 2017|

Corporate Integrity Agreement Highlights Individual Accountability within Health Care Organizations

A physician-owned chain of family medicine clinics located in and around Columbia, South Carolina, Family Medicine Centers of South Carolina, LLC (“FMC”), has agreed to pay the United States $1.56 million, and its principal owner and former chief executive officer, Dr. Stephen F. Serbin, and its former Laboratory Director, Victoria Serbin, have agreed to pay $443,000, to resolve a False [...]

By |2017-11-08T10:10:41-07:00October 13, 2017|

CMS Emergency Preparedness Rule Takes Effect Nov. 15

In the wake of Hurricanes Harvey, Irma and Maria, the November 15, 2017 deadline for new Centers for Medicare and Medicaid Services regulations on emergency preparedness seems all the more critical. Hundreds of facilities were devastated by flooding and damage, leaving them without vital patient data and at risk of security breaches and Health Insurance Portability and Accountability Act violations. [...]

By |2017-10-13T10:37:21-07:00October 10, 2017|

Episode 4: Health Law Rundown Podcast Covers Criminal Impacts on Health Care Licensing

BOULDER—Aug. 1, 2017—Episode 4 of the Health Law Rundown, a podcast created by Caplan and Earnest attorney Matt Ullrich, is now available. Episode 4 includes a discussion with Caplan and Earnest attorneys Sheryl K. Bridges and Greg Lindquist about the health care issues and ramifications a practitioner providing Medicare or Medicaid services and licensed under the Colorado Medical Board or [...]

By |2017-11-02T09:31:09-07:00August 1, 2017|

Medicare Fraud Strike Force Sends Strong Message on Fraud and Abuse

Highlighting its continued focus on cracking down on Medicare fraud and abuse practices, the U.S. Department of Justice and the U.S. Department of Health and Human Services announced this month the largest ever health care fraud enforcement action precipitated by the Medicare Fraud Strike Force. As part of this national health care fraud takedown, the government charged 412 defendants with approximately $1.3 billion [...]

By |2017-10-10T13:03:18-07:00July 27, 2017|

New Legislation to Affect Colorado Medical and Dental Providers in August

Many health care professionals struggle with traditional models of patient care because of limitations on reimbursement imposed by insurance companies. When they are forced to rely on insurance companies and federally funded programs such as Medicare and Medicaid to determine coverage and reimbursement rates, these health care professionals are stretched thin. To cover overhead costs, they often schedule as many [...]

By |2017-06-28T13:09:12-07:00June 28, 2017|

Health Care and the 2017 Colorado Legislative Session

Note: Josiah Beamish, J.D., a health law clerk for Caplan and Earnest, was instrumental in compiling this information. The 2017 Colorado Legislative Session resulted in some key pieces of health care legislation, which allowed the legislature to address several long-term needs in the state’s health care system. One of the biggest developments this legislative session is the commitment to supporting [...]

By |2017-06-09T13:55:50-07:00June 6, 2017|

Understanding “Incident To” Billing

Section 1861(s)(2)(A) of the Social Security Act allows physicians to bill Medicare for patient services provided “incident to” a physician’s services. “Incident to” services are furnished incident to physician professional services in the physician’s office or in certain other locations.  These services are typically performed by non-physician practitioners (NPPs), such as a nurse practitioner or physician’s assistant.  The services, which [...]

By |2017-06-09T14:03:09-07:00June 1, 2017|

The Medicare Outpatient Observation Notice Goes into Effect

Beginning on Aug. 6, hospitals must notify Medicare patients in writing that they are being admitted as an outpatient, observational basis within 36 hours of beginning observational services. The Medicare Outpatient Observation Notice (more commonly known as “MOON”) is part of the NOTICE Act, which was signed by President Obama in August of 2015. The NOTICE Act was designed to [...]

By |2016-12-27T11:06:19-07:00August 15, 2016|

Recent Developments: Senate Considers Expanded Role for Telehealth in Medicare

Momentum appears to be building in Congress for expanding the use of telehealth under Medicare. Bills have been introduced in both houses following policy recommendations from a Senate working group. February 3, 2016: Bipartisan Group Introduces Bill Expanding Medicare Telehealth Services A bipartisan group of senators introduced a bill expanding coverage for telehealth services provided under Medicare. The (CONNECT) for [...]

By |2016-12-27T11:06:26-07:00April 7, 2016|