Dear Clients and Friends:
The field of health law is a constantly evolving system of rules and regulations which have a great impact on all involved in the business of Healthcare. Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP is dedicated to keeping not only ourselves up-to-date on the most recent changes, but also our friends and clients. We would like to take this opportunity to inform all of you of several new developments which may affect your healthcare practice.
FINANCIAL INCENTIVE NOW AVAILABLE FOR ELECTRONIC PRESCRIBING
The CMS website describes E-Prescribing as "a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care". In a program which began on January 1, 2009, eligible professionals may participate in an E-Prescribing Incentive Program by submitting information required by the E-Prescribing measure on their Medicare Part B claims. In order to receive incentive payments, an eligible professional must report one e-prescribing measure in at least 50% of the cases in which the measure is reportable by the eligible professional during 2009. The incentive bonus equals 2% of the total estimated allowed charges for professional services covered by Medicare Part B and furnished during that calendar year. Beginning in 2012, financial penalties will be imposed on eligible professionals who are not e-prescribers. For more information on the E-Prescribing Incentive Program, visit the CMS website here
OBAMA SELECTS KANSAS GOVERNOR FOR SECRETARY OF HHS
Gov. Kathleen Sebelius has been selected by President Obama for the position of Secretary of Health and Human Services. If confirmed, Gov. Sebelius would take over the running of a large and complicated department with 65,000 employees and a $700 billion budget. Strong opposition to the confirmation is expected from Republicans who have traditionally differed with Gov. Sebelius on key issues, such as abortion and extending health care coverage to the uninsured.
NEW CMS REGULATION WILL REPLACE OUTPATIENT DIAGNOSIS CODES IN 2013
CMS recently announced that the current set of outpatient diagnosis codes, the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM), will be replaced by a tenth edition (ICD-10-CM) on or before Oct. 1, 2013. ICD-9-CM is currently the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States. Information on the current set of standards can be found on the CDC website HERE and information relating to the new standards can be found HERE.
HHS ANNOUNCES NEW HIPAA ELECTRONIC TRANSACTION STANDARDS
Recently the Department of Health and Human Services published final rules relating to health insurance reform which included modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards. CMS has set January 1, 2012 as the date for compliance with the new ASC X12N 5010 standards which will replace the current ASC X12N 4010A1 standards. In order to come into compliance, medical practices may have to update or replace software and might also have some training to do with clinical and administrative staff in addition to other requirements. For a full text of the new regulations, visit the HIPAA website or simply click HERE.
FTC STANDS FIRM THAT "RED-FLAG" RULES APPLY TO HEALTHCARE PROVIDERS
The so-called "Red-Flag" rules were originally interpreted by the FTC as to require creditors who maintain "covered accounts" to implement ID theft prevention programs. The ID theft prevention programs are required to use "Red-Flags" which indicate possible risks. Recently, the FTC announced that health care providers who do not require payment immediately at the time of service are considered creditors within the meaning of the Red-Flag rules and hence, must fully comply with the regulations. Despite challenges to this interpretation by the American Medical Association and others, the FTC recently re-affirmed its position that as of May 1, 2009, healthcare providers must have a "Red-Flag" compliance program in place. In so doing, it indicated that the new rules would not be a significant burden to place on doctors because the level of sophistication which is required is determined by the risk involved and many health care practices are considered "low-risk".
CMS ANNOUNCES INCREASE IN 2009 PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI) INCENTIVE AMOUNT
The Centers for Medicare and Medicaid Services recently announced that there would be another self-nomination process which would allow additional registries (who had not previously been qualified to submit data on behalf of eligible professionals in 2008) to potentially be approved for submitting quality measures data for the 2009 PQRI. Under the updated system, eligible professionals who, to a satisfactory level, report at least three applicable quality measures will be paid an incentive of 2% of estimated allowable charges submitted not later than 2 months after the end of the reporting period. This is an increased amount from the 1.5% which was in place during the 2008 PQRI. Additionally, in circumstances where fewer than three PQRI quality measures apply to an eligible professional, he or she may still qualify for the 2% PQRI incentive payment by submitting the required information for all procedures which are applicable to that professional. For a full set of details on the 2009 PQRI, please visit the CMS website HERE.
ABRAMS, FENSTERMAN OBS WORKSHOP
On April 22nd Abrams Fensterman will be co-hosting a workshop entitled "Countdown to Accreditation: The Office-Based Surgery Roundtable" in Manhattan. Senior Partner, Scott Einiger, as well as a number of experts on the new Office-Based Surgery law will be discussing in detail how this new law will affect physicians and their offices.
If you or any of your clients would like to attend this event please contact Daniel Kobak.
For more information on any of the information discussed above, please contact the law offices of Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP at 516-328-2300.
