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The American Dental Association (ADA) recently analyzed the legal implications for dentists advertising on Groupon or other social media companies. We discussed this issue in our recent post here. Continue reading » The final 2011-12 New York State budget (Chapter 59 of the Laws of 2011) requires a 2% across the board reduction to most Medicaid payments for dates of service on or after April 1, 2011. The reduction will remain in effect for dates of service through March 31, 2013. These provisions were enacted to meet the target of the Medicaid Redesign savings initiative authorized by New York Governor Cuomo. Continue reading » You have patients in the waiting room, two patients in exam rooms, your receptionists has a question for you, and right as your cell phone goes off, your assistant is asking you about a prescription. And when the sun sets, you are returning calls to patients and colleagues. OSHA compliance may not be at the top of your to-do list. Continue reading » According to the Environmental Protection Agency (EPA), 9 million people in the U.S. use sharps — needles, syringes and lancets — at home. This equates to more than 3 billion disposable needles and syringes and 900 million lancets each year. Often times sharps used at home are discarded in the waste disposal or toilets. Such inappropriate disposal of sharps at home, however, is putting people, including waste-disposal workers, housekeepers, family members and children, at risk of injury and serious infections. Continue reading » On September 8, 2011, the Occupational Safety and Health Administration issued its first directive on Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents. The directive provides guidelines and general policies and procedures that apply when OSHA investigators conduct an inspection under a national, regional or local emphasis program or in response to incidents of workplace violence. Continue reading » Many providers were disappointed to learn that on September 23, 2011, New York Governor Andrew Cuomo vetoed a bill that was previously passed without opposition by both houses of the New York State legislature (A.5686-A Gottfried and S.2184-A Little). According to the press release of one of the bill’s sponsors, “[t]he bill would set forth standards for the Office of the Medicaid Inspector General (OMIG) audit process in order to protect honest providers and the patients they serve.” The highlights of the bill are discussed here. Continue reading » Watch this Bloomberg TV report filed by Shannon Pettypiece titled “Groupon Deals on Botox, Lasik Eye Surgery?” It appeared on Bloomberg TV on the morning show of October 25th as part of Shannon’s daily “Stock Therapy” segment that examines how the latest health care trends are affecting the markets and the economy. Continue reading » More than a decade ago the Office of the Inspector General (OIG) issued Compliance Program Guidelines for Individual And Small Group Physician Practices, which are a set of voluntary guidelines for a small group physician practice or an individual practitioner. Nowadays, when federal and state governments are increasingly interested in cutting fraud, waste and abuse from their healthcare programs, they are aggressively looking to audit and investigate healthcare providers’ services. It therefore behooves providers to demonstrate to auditing and investigating agencies a practice’s adherence to applicable statutes, regulations and other program requirements through the creation and implementation of a written compliance plan. Continue reading » More likely than not, a physician or a dentist has at one point provided discounted or free healthcare services to some patients by waiving all or part of a fee or the copayment and/or coinsurance obligations as a “professional courtesy”. According to the Office of Inspector General’s (OIG) Compliance Program For Individual and Small Group Physician Practices guidelines, however, this practice may expose a physician to an investigation. Continue reading » In the last few years, many healthcare providers have come under increased scrutiny from federal and state investigative and auditing agencies. The recent USAToday article confirms that the federal government stepped up the prosecution of health care fraud. In fact, according to USAToday “[n]ew government statistics show federal health care fraud prosecutions in the first eight months of 2011 are on pace to rise 85% over last year due in large part to ramped-up enforcement efforts under the Obama administration.” Continue reading » A bill introduced in the New York Senate on February 10, 2011, and which passed both of the New York’s State legislative houses in June (A.5686-A Gottfried and S.2184-A Little), is awaiting Gov. Cuomo’s approval. The bill will impact the power of the Office of the Medicaid Inspector General (OMIG) and will address some of the practices viewed as unjust by the provider community. Many providers believe that OMIG’s aggressive auditing approach has been unfair and see the office as having “strayed far from the goal of rooting out fraud and encouraging appropriate accountability.” Continue reading » These days it seems like all aspects of a healthcare provider’s practice are under close scrutiny — including one’s repayment of student loans. Defaulting on a student loan may result in exclusion from the Medicare and Medicaid programs. The Office of Inspector General (OIG), a department within the U.S. Department of Health and Human Services (HHS), has the authority to exclude individuals and entities from Federally-funded health care programs pursuant to sections 1128 and 1156 of the Social Security Act and maintains a list of all currently excluded individuals and entities. While exclusion based on failure to repay student loans is permissive and not mandatory, given the current strict enforcement environment, this distinction should give the provider no sense of comfort. Continue reading » |
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