Health Reform: What's a Provider to Do?

What should health care providers be doing in anticipation of the likely passage of an historic health reform bill?  There are at least three possibilities: (1) Lament the passing of the good old days and oppose it; (2) Insist that it isn't good enough because it is lacking some key provision (tort reform; SGR replacement; […]

HITECH Act security breach rules now effective; federales give a six-month pass. Now's the time to kick compliance efforts into high gear

Two key Son of HIPAA rules mandated by the HITECH Act are now effective.  Both the FTC and HHS have finalized their security breach notification requirements and have assured the regulated community that they have six months to get their collective houses in order. Please take the time to peruse both the HHS Son of […]

Red Flags Rule: The FTC piles on, because HIPAA, ARRA and overlapping state laws just weren't enough

Update 5/28/10:  Red Flags? Nah … nothin' but blue skies.  The FTC delays implementation of the Red Flags Rule yet again, to December 31. Update 11/3/09:  The FTC announced that implementation of the Red Flags Rule will be delayed once more, this time until June 1, 2010.  The announcement came on the heels of losing […]

2009 MPFS final regulations

The 2009 Medicare Physician Fee Schedule regulation was released in final form yesterday (on display), and will be published in the Federal Register on November 19.  It is chock full of payment and policy changes, detailed in three CMS fact sheets: (1) payment policies and rates; (2) MIPPA-related changes; and (3) e-prescribing incentives and PQRI […]

Yes Virginia, the GAO points a finger at diagnostic imaging providers

“Round up the usual suspects!”  Once again, diagnostic imaging providers are singled out by the federales. This time the GAO says controls on diagnostic imaging utilization are needed — including (yikes!) prior authorization requirements — because diagnostic imaging costs have doubled between 2000 and 2006.  Sounds serious. Well, guess what?  While some advanced imaging costs […]

Medicare Physician Fee Schedule (2009 MPFS): Yes, there's a 5.7% cut, but it's packed with goodies like telehealth and gainsharing

Congress couldn’t be bothered to stop grandstanding before July 4th long enough to undo the latest SGR-driven physician pay cut (over 10%).  This week, CMS rolled out its 2009 MPFS with an SGR-mandated 5.7% cut in place, while at the same time advising physicians not to submit bills until Congress comes to its senses and […]