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Recent Physician Billing Developments

Recent Medicare developments in the area of physician billing include:

Supreme Court Leaves Hospitals Exposed for Medical Training Costs

The U.S. Supreme Court has ruled in favor of federal regulators with respect to graduate medical expenses. The Court's 6-3 decision in Regions Hospital v.

Did You Know? - Spring 1999

Third-Party Payments: Did you know that the Department of Justice has settled charges brought against an Ohio health care insurer's practice of requiring hospitals not to charge lo

Dentist Who Refused to Treat AIDS Patient Loses Again

Earlier in 1998, the United States Supreme Court ruled, in a case involving dental services, that an individual who is HIV positive, but who has no symptoms of AIDS, is disabled and protected again

Heads, the Hospital Wins...Tails, the Physician Loses

A recent decision by Maryland's intermediate appellate court sheds some light on a physician's hearing rights when a hospital terminates the doctor's medical staff privileges as the result of a "bu

Did You Know? - Winter 1998

Home Health Compliance. Did you know that the Office of Inspector General of the Department of Health and Human Services has issued a model voluntary compliance plan directed at ho

Husband's IRA Defeats Wife's Medicaid Eligibility for Nursing Home

The New Jersey Supreme Court has recently held, contrary to popular belief, that a husband's individual retirement account (IRA) must be included as a resource for purposes of determining his wife'

Maryland Attorney General Ventures into the Muddy Waters of Fraud and Abuse

At the request of a member of Maryland's General Assembly, the Maryland Attorney General recently ventured into the various State and federal laws that comprise the murky waters of health care frau

How Specific Should a Health Plan's Appeals Policies Be?

A recent federal appeals court case, Killian v.

OIG Releases Guidance Regarding Voluntary Fraud Disclosure

The Department of Health and Human Services' Office of the Inspector General (OIG) issued guidelines on October 21, 1998, relating to the voluntary disclosure of "health care fraud." These guidelin

The Duties of Corporate Directors

Everyday, another hospital merger is announced, but what are the duties of hospital directors in approving such a merger?

Physicians Selling Vitamins

Many physicians around the country are selling or considering selling vitamins to their patients.

Practice Management Agreements Draw Fire

The Office of the Inspector General of the Department of Health and Human Services (OIG) has recently issued an advisory opinion raising serious questions concerning the legality of many agreements

Maryland Regulatory News - Fall 1998

1. In July, the Health Services Cost Review Commission (HSCRC) denied Union Memorial Hospital's request for a 3.89% rate increase as generated by the HSCRC's Inflation Adjustment System.

Monetary Penalties For the Violation of Agreements Not to Compete

When physicians enter into employment agreements they often are asked to agree to covenants not to compete.

Is It Too Late To Bill?

Health care providers understand that they should send their bills out within a certain time period from the date services are rendered, but what is that time period?

Did You Know? - Fall 1998

Health Planning Authority.

A Securities Law Primer

Doctors are increasingly finding themselves owners of interests in various health care companies. For example, some doctors are trading their practices for stock in practice management companies.

JCAHO Sentinel Event Policy Stirs Controversy

The Joint Commission on Accreditation of Healthcare Organization (JCAHO), a private organization that accredits the nations' health care institutions, has adopted a new policy that encourages all a

1998 Maryland Legislative Session

The Maryland General Assembly appears to have adopted a "do no harm" strategy in 1998. Although many health care measures were proposed, few were enacted.

Did You Know? - Summer 1998

Disclosure of Insurance Payments to Providers. Did you know that pursuant to Maryland legislation passed in 1997, the Insurance Commissioner and the Health Care Access and Cost Commission

Taxpayer Relief Act of 1997 Impacts Tax-Exempts

The federal Taxpayer Relief Act of 1997 (the Act) contains several provisions of importance to tax-exempt health care organizations.

Voluntary Hospital Compliance Programs May No Longer Be Voluntary

On February 11, 1998, the Office of the Inspector General (OIG), of the Department of Health and Human Services, released the long awaited "Compliance Program Guidance for Hospitals" to help hospit