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 Senate Healthcare Reform
A U.S. Senate healthcare policy report which outlined upcoming healthcare reform legislation was released by Senators Max Baucus (D-MT) and Charles Grassley (R-IA) on April 29, 2009. The 49-page report included reimbursement (e.g., payment for meeting quality indicators; bundling of acute and post-acute payments; and, physician gainsharing with Medicare) and regulatory reforms (e.g., elimination of the whole hospital exception to Stark and information sharing to combat fraud in the Medicare program).
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Fraud Enforcement and Recovery Act of 2009 (FERA)
Both the Senate and the House have approved the Fraud Enforcement and Recovery Act (FERA) � a bill that increases government resources to combat fraud in the housing and mortgage arena and widens the scope of the False Claims Act (FCA). FERA expands the definition of "knowingly" required for FCA prosecution and reduces the government's burden of proof.
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Medicare Enrollment and Billing
The 2009 Medicare Physician Fee Schedule's restrictions on physician Medicare enrollment and retroactive billing went into effect on April 1, 2009. Under the new billing provisions, physicians will only have a 30-day window (changed from the original, 27 month window) in which they can retroactively bill for services provided before the physician receives a billing ID from Medicare. Both the AMA and MGMA criticize the shortened window, stating it penalizes physicians for delays in Medicare�s processing procedures.
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HCC Background
Founded in 1993, HCC has developed significant research resources; a staff of experienced professionals with strong credentials; a dedication to the discipline of process and planning; and, an organizational commitment to quality client service as the core ingredients for the cost-effective delivery of professional consulting services. HCC has served a diverse range of healthcare industry & medical professional clients in over 45 states including hospitals & health systems (both tax exempt & for profit); outpatient & ambulatory facilities; management services organizations; clinics, solo & group private practices in a full range of medical specialties, subspecialties & allied health professions; managed care organizations; biotechnology and pharmaceutical ventures; ancillary service providers; disease management firms; Federal and State agencies; public health and safety agencies; other related healthcare enterprises and agencies; and, these clients� advisory professionals, e.g., their consulting, legal and accounting firms.
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