Mid-Atlantic Health Law TOPICS

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Did You Know? Fall 1997

Assignment of Medicare Payments. Did you know that the Health Care Financing Administration (HCFA) has announced that Medicare payments will no longer be made payable to emergency room staffing companies or other physician practice management companies for the services of physicians under contract? It is the doctor; and not the billing company that is entitled to the fee.

False Claims. Did you know that the U.S. Court of Appeals for the District of Columbia recently ruled that each billing form submitted to Medicare is a "claim" for the purpose of determining False Claims Act violations? This is an important decision, as the government had contended that each payment code on an invoice constituted a separate "claim." The court's decision could save health care providers hundreds of thousands of dollars.

Maryland Employers. Did you know that a new state law enlists Maryland employers to assist child support collections? Effective July 1, 1997, every Maryland employer is required to submit information regarding its new employees. The required information - name, address and social security number; date of employment, and employer's name and federal tax ID number - must be submitted to the State within 20 days of each new employee's first day of work.

Nursing Home Incident Reports. Did you know that a Pennsylvania court has ordered a nursing facility to provide the state health department with incident reports generated as part of the facility's internal investigative process? The facility argued unsuccessfully that the reports were protected by the federal law governing records of the facility's quality assurance committee. The court found that only documents generated by the committee were protected.

Virginia Home Health Services. Did you know that HCFA is providing funds to state survey agencies to obtain documentation for fraud investigations? This new federal initiative will apply to home health, nursing homes, labs and physical therapy facilities in selected states. The only Mid-Atlantic service on the current hit list is home health services in Virginia.


September 21, 1997




Rosen, Barry F.


Health Care