Most individuals who endure the years of schooling and training it takes to become a full-fledged medical doctor do so because they want to help people. As with many professionals, despite all of their professional training, physicians are often ill-prepared for many of the realities that come with the job. Along with the physical, mental…
For individuals who are age 65 and older or who are permanently disabled, Medicare provides vital health insurance coverage to help pay for doctor visits, medical procedures, hospital stays, physical therapy, prescription drugs and medical equipment. According to The Henry J. Kaiser Family Foundation, during 2014, Medicare spending totaled $597 billion and accounted for 14…
According to the National Alliance on Mental Illness, annually, 20 percent of the U.S. adult population “experiences mental illness.” Whether a mental health condition like depression is related to a specific event or is a genetic and chronic condition; mental health conditions are disabling and can also be difficult to treat. For an individual who…
The Stark Law prohibits a physician who has a “financial relationship” with a provider of designated health services[i] (“DHS Entity”) from referring Medicare patients to that DHS Entity. It also bars DHS Entities from receiving Medicare payments based on these prohibited referrals. Under Stark, a physician has a “financial relationship” with a DHS Entity if…
An announcement by the Supreme Court could be good news for health care providers. It might not. What legal observers seem to agree on is that regardless of the outcome, it should give providers a better understanding of when they run the risk of violating the federal False Claims Act. For those who may be…
Medicare pays practitioners for “incident to” services at the applicable Medicare payment rate as if the practitioner personally furnished the service. For example, if billed by a physician, they are paid at 100 percent of the fee schedule amount, and if billed by a nurse practitioner or clinical nurse specialist, they are paid at 85…
Business transactions in the health care field are moving at a record pace in 2015. Analysts say the driving forces behind the robust merger and acquisition activity are many. Low interest rates get some of the credit. But the desire for scale is important, too. As a recent report in The New York Times observed,…
The health care industry in New York and the rest of the country is undergoing something of a renaissance. Some call it good. Others call it bad. Regardless of what side of the fence you might be on, the one thing that is certain is that the economic trend in health care is in flux….
The 2010 Patient Protection and Affordable Care Act (Obamacare) encourages a “medical home” model of care, which aims to improve patient access and quality of care through increased communication between physicians and patients and increased care coordination, while simultaneously reducing costs. In an effort to jump start this model, starting in 2016, Medicare will pay…
New York Hospitals, clinics and practices and the doctors, nurses and support personnel they employ, can find that the environment in which they operate changes quickly. Under an amendment to the New York Public Health Law enacted this week, starting in April of 2016, NY hospitals will be required to allow patients over the age…