Articles and Blogs

Effective July 2011, the Centers for Medicare & Medicaid Services (CMS) adopted a revised Medicare Enrollment Application – Institutional Providers CMS-855A (CMS-855A).  Some of the more significant changes include a couple of additonal documentation requirements, significant changes to the ownership disclosure requirements, and an attachment for Physician-Owned Hospitals. The CMS-855A has been significantly reformatted which should…Read More

When the new hospice Conditions of Participation (CoPs) became effective in Decmeber of 2008 there was a provision in the CoPs stating a hospice must have an agreement with a nursing home if the hospice provides services in the nursing home.  While it was a standard business practice for hospices to have agreements with nursing homes prior to…Read More

Effective July 2011, the Centers for Medicare & Medicaid Services (CMS) adopted a revised Medicare Enrollment Application – Institutional Providers CMS-855A (CMS-855A). Some of the more significant changes are set forth below in italicized text: Formerly, page 1 of the CMS-855A stated, “WHO SHOULD SUBMIT THIS APPLICATION”; the revised CMS-855A states, “WHO SHOULD COMPLETE THIS APPLICATION.”Additional instructions…Read More

The Motion Picture License Corporation (MPLC) has reached an agreement with long-term care advocacy groups to exempt certain facilities from licensing fees when showing movies for residents. Under the United States Copyright Act, a “public performance” of copyrighted materials, including movies, traditionally requires a separate license.  The MPLC has reached an agreement with the American…Read More

Executive Summary. Section 135(a) of the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”) amended the Social Security Act to require suppliers of the technical component (“TC”) of “advanced diagnostic imaging services” paid under the Medicare Physician Fee Schedule (“MPFS”) to become accredited by January 1, 2012.   Suppliers not fully accredited by the…Read More

Background. Health care procedures and services often must be appropriately “supervised” to ensure quality of care and safety for patients. In recent years, the Centers for Medicare and Medicaid Services (“CMS”) has clarified its defined levels of supervision (general, direct and personal) applicable to the provision of hospital outpatient diagnostic and therapeutic services.  Under those…Read More

In response to the changes contained in the Patient Protection and Affordable Care Act (ACA) designed to address increasing lengths of stay in hospice programs, CMS added a “face-to-face encounter” requirement to the hospice certification requirements. Effective January 1, 2011, a hospice physician or nurse practitioner must have a “face-to-face” encounter with each hospice patient…Read More

On June 30, 2011, CMS published a Proposed Rule (“Proposed Rule”) to retract the November 29, 2010 Medicare Physician Fee Schedule Final Rule (“Final Rule”) that required a physician’s or non-physician practitioner’s (“NPP”) signature on all paper requisitions for clinical diagnostic laboratory tests paid on the basis of the Clinical Laboratory Fee Schedule.  CMS proposed…Read More

The year is half over, and there have been many developments in the employment and labor field that have us all talking and wondering what lies ahead.  The Supreme Court has made several rulings that will have a significant impact on employment litigation.  Most recent is the Wal-Mart decision that put an end to a…Read More

Recently, the Indiana State Department of Administration, on behalf of Indiana’s Family and Social Services Administration (FSSA), posted a Request for Proposals to contract with multiple attorneys for Indiana Medicaid estate recovery.  The Request for Proposals is at http://www.in.gov/idoa/proc/bids/rfp-11-84/ .  It appears Indiana plans to get much more aggressive in Medicaid estate recovery, including opening…Read More