Medical Economics – March 16, 2009. This material originally appeared in the March 6, 2009, issue of Health Lawyers Weekly, a publication of the American Health Lawyers Association (www.healthlawyers.org). On February 27, the Florida District Court of Appeal, First District, found that an insurance carrier forfeits its right under state law to contest the medical […]

HHS/CMS — April 6, 2009. CMS ANNOUNCES 2010 PAYMENT INFORMATION FOR PART C MEDICARE ADVANTAGE PLANS AND PART D PRESCRIPTION DRUG PLANS The Centers for Medicare & Medicaid Services (CMS) today issued the Announcement of Calendar Year (CY) 2010 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies.  The Announcement updates and […]

Analysis of 2003-2004 Medicare claims data reveals that almost one-fifth (19.6 percent) of Medicare beneficiaries in the FFS program discharged from a hospital were rehospitalized within 30 days, and more than one-third (34 percent) were rehospitalized within 90 days, according to an article in the April 2 issue of the New England Journal of Medicine. […]

Federal Health Architecture Delivers Free, Scalable Solution Helping Organizations Tie Health IT Systems into the NHIN The Federal Health Architecture is making software available as a first step to help public and private health information technology systems communicate to the Nationwide Health Information Network (NHIN), a federal initiative to facilitate the electronic exchange of health […]

CCH® Medicaid – April 1, 2009. In November 2008, CMS issued the first changes in conditions for coverage for ambulatory surgical centers (ASCs) since 1982 (see ¶180,745). The new rules go into effect May 19, 2009. At the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues on March 24th, Claire Miley, of […]

CCH® Medicaid — March 30, 2009. The Fifth Circuit Court of Appeals dismissed a class action by Medicaid recipients to enforce a right to reasonably prompt access to services under federal Medicaid law. The court rejected the recipients’ contention that Soc. Sec. Act §1902(a)(8), stating: [A] state plan for medical assistance must provide … that […]