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U.S. Supreme Court Hears Oral Argument in Phoebe Putney Hospital Merger Challenge Print E-mail
Written by   
Monday, 10 December 2012 10:18

In oral argument in FTC v. Phoebe Putney Health System, Supreme Court Justices focused on whether the state legislature clearly articulated a state policy to displace competition with regulation, in a case challenging the application of the state action doctrine to a hospital merger to monopoly.

Read the full article here.

Last Updated on Monday, 17 December 2012 09:13
MedPAC Site-Neutral Payment Proposal Could Level Outpatient Reimbursement Playing Field Print E-mail
Written by Todd Rodriguez   
Friday, 30 November 2012 09:32

It's no secret that Medicare pays significantly more for certain services when they are performed in a hospital outpatient department than when they are performed in a physician office. In fact, this is one of the reasons privately practicing physicians have been folding up shop in favor of hospital employment. Hospitals can make more from these services than physicians and, therefore, can generally pay physicians more than they could earn in private practice.

The Medicare Payment Advisory Commission (MedPAC) has taken notice of the discrepancy and recommended last month that the Centers for Medicare and Medicaid (CMS) consider adopting a policy of site neutrality when setting payment for outpatient services. This means the payment would be the same regardless of where it is performed. Presumably, however, the payment rates would gravitate to the lower of the levels rather than the higher ones.  Not surprisingly, the American Hospital Association is none too happy about the proposal (see MedPAC considers equal outpatient pay to hospitals, doc offices on  

Although there is no telling whether CMS will adopt the proposal, physicians considering selling or joint venturing with a hospital to take advantage of the outpatient payment differential should consider the potential implications such a change would have on the future viability of these arrangements.

Mr. Rodriguez is a partner at Fox Rothschild, LLP. Click HERE to learn more. 

Last Updated on Monday, 17 December 2012 09:14
Florida Board of Medicine Set to Tackle Telemedicine Issue Print E-mail
Written by Source: Jeffrey L. Cohen's Blog   
Friday, 23 November 2012 17:31

Florida laws that pertain to telemedicine are precious few. In fact, there is really only one regulation dead on target, and that requires face to face physician contact with a patient in order to write a prescription. The impact of the hormone replacement therapy (HRT) providers was pretty immediate, but the legal issues related to telemedicine are just not currently addressed in Florida law... 

...The Board of Medicine is set to dip its toe into the telemedicine pond as it considers a recently filed request for declaratory statement. Dr. Stephen Haire petitioned the Board to see how the only clearly applicable law (64B8-9.014, F.A.C.) affects his practice's plans to provide telemedicine services. Here are the pertinent facts-

1.     Dr. Haire is an emergency physician and a member of a practice.

2.     His practice wants to enter into contracts with companies to provide telemedicine services for employees of the companies on a 24/7 basis.

3.     The services will not involve urgent medical issues.

4.     The only medicines they expect to prescribe are antibiotics, antihistamines and over the counter medicines, but they are not insisting on the right to prescribe anything.

The Board will address the arrangement and is also considering broader regulations regarding telemedicine at this time.

Click HERE to read the entire post. 

Last Updated on Friday, 30 November 2012 09:50
Medicare and Medicaid Reforms Coming in a Second Obama Administration Print E-mail
Written by   
Monday, 19 November 2012 09:06

While Mitt Romney and Paul Ryan campaigned on the promise to repeal the U.S. Patient Protection and Affordable Care Act, and to reform Medicare and Medicaid, their defeat does not mean the health industry should expect no change in 2013.  A combination of factors, including the impending year-end fiscal cliff, the necessity of revisiting the debt ceiling and the overwhelming imperative to address the growing federal debt, is expected to require lawmakers to substantially alter the Medicare and Medicaid programs in a manner that could be disruptive to the health sector.  This newsletter predicts the changes to Medicare and Medicaid that are likely to be considered in 2013, and discusses their implications for various segments of the health and life sciences industries.

The United States faces a daunting long-term federal debt problem. According to the Congressional Budget Office, the federal budget deficit in Fiscal Year (FY) 2012 will total $1.1 trillion, marking the fourth year in a row with a deficit of more than $1 trillion (Congressional Budget Office, An Update to the Budget and Economic Outlook: Fiscal Years 2012 to 2022, at III, August 2012). This deficit is rapidly inflating the federal debt, which now equals 73 percent of the gross domestic product-the highest level since 1950.

It is widely appreciated that the growing deficit and debt are strangling federal budgets and creating a drag on the economy. Compounding the outlook and complicating solutions are a number of revenue and spending changes scheduled to take effect at the end of 2012 (collectively referred to as the "fiscal cliff") that will lead to economic contraction if unaddressed.

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Last Updated on Friday, 30 November 2012 09:34
CMS: $7.7 billion in EHR payments through September Print E-mail
Written by Sources: CMS/Modern Healthcare   
Monday, 19 November 2012 09:02

More than 300,000 physicians and other eligible professionals have signed up to participate in the federal electronic health-record system incentive payment programs, while more than 4,000 hospitals have enrolled in the Medicare EHR incentive program, the Medicaid incentive program or both, according to the latest CMS data.

In total, $7.7 billion has been paid out in what has been estimated will be $27 billion in incentive payments through the lives of the two programs. The increase to 303,072 enrolled physicians and other eligible professionals, is listed in the CMS' report through September.

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