MedPAC Suggests Changes to Stark In-Office Ancillary Services

PDF Icon MedPAC Suggests Changes to Stark �In-Office Ancillary Services
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The Medicare Patient Advisory Commission (MedPac), who advises Congress on Medicare payment issues, is turning their focus on, what some claim is, the overuse and increasing costs of radiation therapy, outpatient rehabilitation services (physical and occupational therapy and speech-language pathology services), diagnostic imaging, and laboratory tests. The reform suggestions being considered by MedPac would greatly reduce the number of physician offices covered by the Stark Law In-Office Exception, and would reduce the overall market for MRI, CT, and PET imaging for Medicare patients. (Read more...)

OIG Releases �Free Pre-Authorization� Advisory Opinion
On April 30, 2010 the Office of the Inspector released Advisory Opinion 10-04 stating that while free pre-authorization arrangements by third parties may potentially violate anti kickback laws, OIG would not impose sanctions on this particular group, due to the low risk of abuse. The service providers, a group of diagnostic imaging centers, sought advice for whether providing free pre-authorization services would violate anti kickback legislation, which makes it a criminal offense to knowingly and willfully offer any remuneration to gain referrals for services reimbursable by a Federal health care program. (Read more...)

PDF Icon Small CMS Issues New ASC Guidelines
The Centers for Medicare and Medicaid Services (CMS) recently published clarifications and new proposals for existing Ambulatory Surgical Center (ASC) guidelines. In May 2010, CMS issued a clarification regarding the requirement that ASCs have separate waiting areas from other office space tenants and the possibility of a waiver for the requirement. CMS has also proposed an amendment to current patient rights disclosure guidelines that would waive the requirement to disclose patient rights prior to the date of the procedure in emergency situations. These new changes are proposed in an attempt to protect the health and safety of the patient. (Read more...)