Legal

According to a New York Times article, individuals, arranged by the federal government, were to pose as new patients, calling physicians' practices up to three times to ask for expedited appointments.

The West Virginia Supreme Court of Appeals ruled recently that the state's cap on medical malpractice pain and suffering damages is constitutional. The court approved a lower court's decision to reduce a lawsuit award from $1 million to $500,000, in accord with an amendment enacted by the state legislature in 2003.

Federal healthcare reform will result in more or fewer Americans receiving health insurance through their employers, depending on which studies you choose to believe.

To increase parity between specialists and primary care providers (PCPs) and address the growing shortage of PCPs, the American Academy of Family Physicians (AAFP) has called on the AMA/Specialty Society Relative Value Scale Update Committee (RUC) to change its structure to give greater representation to primary care fields.

The Centers for Medicare and Medicaid Services (CMS) gave physicians a break in its recently proposed rule on meaningful use requirements for electronic health records (EHRs). The revision would allow eligible providers (EPs) to ?continue to report clinical quality measure results as calculated by certified EHR technology by attestation? through 2012. Previously, CMS had required eligible providers (EPs) to start submitting quality measures electronically to CMS next year.

Overwhelmed by changing reimbursement models, emerging regulations and adopting new technology? You?re not alone. Respondents to a recent survey said four of the top five ?considerable or extreme challenges? they face relate to these operational issues.Three of the most troubling issues for practices had not even been on practice group leader?s radars in previous years.

Prescription drug abuse is the nation?s fastest-growing drug problem, and, unless primary care practices take appropriate precautions, it also could become one of their fastest-growing regulatory and liability issues. With increased regulation on the horizon, a new study recommends ways that physicians can improve prescribing practices for opioids and other often-abused drugs.

Money isn?t everything, but 35% of primary care physicians (PCPs) say it is the most important factor in changing practices. Compensation was 50% more important to PCPs in evaluating a professional move than location or quality of practice, the most significant factors for residents and fellows.

When patients seek your help in getting a device that can allow them live at home instead of having to move to a long-term care facility, you have to navigate through a confusing maze of Medicare regulations to submit the order, only to find out that you are being blamed for the latest government healthcare expense boondoggle. What is really behind a recent government report blaming physicians for insufficient documentation for power wheelchairs?

While the latest trustees report says Medicare is running out of money and time, the program's own actuary questions those projections. What is more certain is that, unless some decisive action is taken, reimbursements to physicians and other providers would be cut 10% by 2024, if not earlier.

State medical boards and legislatures are responding to public demands that information about disciplinary action against physicians be timely and easy to get by publishing disciplinary, criminal, and liability histories online. But what about the physicians' rights?

Does a primary care physician remain legally responsible for a patient after referral? The Delaware Superior Court recently determined the answer to be "No." As with all legal proceedings, however, it is important to discuss context.

Get your black bag ready. House calls could be in your future. While Medicare prepares to roll out the Independence at Home pilot program next year, commercial insurers have been testing variations on the concept for some time, especially to provide care to the sickest of the sick.

Fed up with the hours on the telephone to untangle claims issues with insurers? A new proposed rule could help. It requires insurers to use uniform transmission formats and standardized forms when they seek information or provide claims and coverage information to doctors.

Much of the hoopla has focused on a nearly 30% cut in rates in the proposed update to the physician fee schedule for 2012, even though Congress is likely to intervene to keep the reductions from being so severe. But, a provision calling for review of all of the evaluation and management (E&M) codes is likely to be more significant in the long term for primary care physicians.

Massachusetts badly needs to contain healthcare costs, according to two new state government reports.

Medicare's methods of calculating regional costs are inaccurate and need to be redone, according to a new report from the Institute of Medicine.

A proposed change to the Health Insurance Portability and Accountability Act would give people the right to see who has electronically accessed their protected health information.

The Centers for Medicare and Medicaid Services has extended the deadline to October 1 for implementing e-prescribing standards.

The technology requirements to be recognized as a PCMH now closely mirror those needed to prove "meaningful use" of health information technology under the new healthcare legislation.

As of January 1, over-the-counter medications other than insulin need a prescription to qualify for reimbursement from an employer-sponsored flexible spending account or health reimbursement arrangement.

Some U.S. Senators want an investigation of physician-owned distributorships (POD).

Despite today's uncertain economic climate, two recent, surprising reports show that mergers and acquisitions are on the upswing.

The Centers for Medicare & Medicaid Services (CMS) gave organizations interested in participating in the Pioneer ACO model a little longer to circle their wagons. Responding to concerns from provider organizations that there was insufficient time to assemble internal support and strong applications, CMS extended the deadline for applications to August 19 for those who submitted their letters of application by an extended June 30 deadline.

A new bipartisan proposal attempting to ?save? Medicare would impose a 3-year ban on further cuts to Medicare reimbursement to physicians. Other aspects of the plan make its future questionable, however. The proposal includes political landmines, such as raising the Medicare eligibility age and requiring more out-of-pocket payments from Medicare beneficiaries who can afford them.