President Directs Quick HHS Action To Implement Physician Medicare Payment Restoration

June 30, 2010

President Obama on June 25, 2010 signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962), which grants physicians temporary relief from cuts to Medicare reimbursements to physicians until November 30, 2010.

The provisions of H.R. 3962 delay a scheduled 21.3% cut to Medicare physician payments until Nov. 30, 2010.

Coincident with his signature of H.R. 3962, President Obama also directed the Secretary of Health and Human Services to take steps to minimize any disruption to, or administrative burden on, Medicare physicians and other affected providers and to minimize any disruption in the ability of Medicare beneficiaries to access necessary services by:

  • Directing the Medicare claims administration contractors to immediately implement the legislative update to the physician fee schedule conversion factor;
  • Providing all appropriate resources for the Medicare claims administration contractors to ensure the update is implemented as rapidly as possible;
  • Directing the Medicare claims administration contractors to automatically reprocess, to the extent feasible, any claims reflecting the 21.3 percent fee schedule reduction, in order to relieve the administrative burden on physician practices;
  • Take all necessary steps, to the extent permitted by law, to protect Medicare beneficiaries from any disruption to their access to services that may be occasioned by the reprocessing of claims; and
  • Reopen the 2010 Annual Participation Enrollment Program through July 16, 2010, to allow physicians and other affected providers an additional opportunity to participate in Medicare.

While H.R. 3962 provides welcome relief for physicians, the 6-month period of the delay means physicians will again face Medicare reimbursement cutbacks later this year unless Congress can be persuaded to enact a more permanent extension.  The Medical Group Management Association and other physician organizations are continuing to urge physicians to encourage Congress to enact this more permanent relief.  See here.

The author of this update, attorney Cynthia Marcotte Stamer, has extensive experience advising and assisting health care providers and other health industry clients with reimbursement, compliance, public policy, regulatory, staffing, and other operations and risk management matters. You can get more information about her health industry experience here.   If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

Other Recent Developments

If you found this information of interest, you also may be interested in reviewing some of the following recent Updates available online by clicking on the article title:

For More Information

We hope that this information is useful to you.  If you need assistance evaluating or responding to the Health Care Reform Law or health care compliance, risk management, transactional, operational, reimbursement, or public policy concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (469) 767-8872, cstamer@Solutionslawyer.net.

Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 23 years experience advising health industry clients about these and other matters.  A popular lecturer and widely published author on health industry and human resources matters, Ms. Stamer continuously advises health industry clients about these and other related concerns.  Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, and other operations and risk management concerns.  Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.  

You can review other recent health care and internal controls resources and additional information about the health industry and other experience of Ms. Stamer here.  If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here. To unsubscribe, e-mail here.

©2010 Solutions Law Press.  All rights reserved.

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Proposed Medicare Rules Will Require Hospitals Honor Patient Visitation Preferences

June 23, 2010

A new Condition of Participation rule proposed by the Centers for Medicare & Medicaid Services (CMS) would require hospitals to protect and honor patients’ rights to choose their own visitors during a hospital stay.  The new proposed rule will implement an April 15, 2010, Presidential memorandum directing HHS to develop standards requiring Medicare- and Medicaid-participating hospitals (including critical access hospitals) to allow patients to choose who may visit them when they are inpatients of a facility.

The proposed rule would add the new requirement as an addition Condition of Participation for Medicare- and Medicaid-participating hospitals and critical access hospitals.  To meet the Condition, the proposed rules would require every hospital to have written policies and procedures detailing patients’ visitation rights, as well as instances when the hospital may restrict patient access to visitors based on reasonable clinical needs.  Among other things, the proposed rule specifically would require:

  • Visitors chosen by the patient (or his or her representative) be able to enjoy visitation privileges that are no more restrictive than those for immediate family members; and
  • Require hospitals and critical access hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, or a domestic partner (including a same-sex domestic partner), as well as the right to withdraw such consent at any time. 

The proposed rules expected to be published in the Federal Register this week will be available for public comment for 60 days.  CMS plans to finalize the proposed rule after CMS has read and considered the comments.  More information about the proposed rule see CMS’ website here and here.

The proposed new requirement would add to the already existing safety and other Conditions of Participation that hospitals must meet to participate in Medicare and would operate in addition to otherwise applicable patient’s visitation rights standards imposed by Joint Commission and other rules.  The author of this update, attorney Cynthia Marcotte Stamer, has extensive experience advising and assisting hospitals and other health care providers to estalish and administer patient’s rights and other policies to comply with Conditions of Participation and other applicable laws, regulations and standards. You can get more information about her health industry experience here.   If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

Other Recent Developments

If you found this information of interest, you also may be interested in reviewing some of the following recent Updates available online by clicking on the article title:

For More Information

We hope that this information is useful to you.  If you need assistance evaluating or responding to the Health Care Reform Law or health care compliance, risk management, transactional, operational, reimbursement, or public policy concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (469) 767-8872, or e-mail here.

Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 22 years experience advising health industry clients about these and other matters.  A popular lecturer and widely published author on health industry and human resources matters, Ms. Stamer continuously advises health industry clients about these and other related concerns.  Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, and other operations and risk management concerns.  Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.  

You can review other recent health care and internal controls resources and additional information about the health industry and other experience of Ms. Stamer here.  If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here. To unsubscribe, e-mail here.

©2010 Solutions Law Press.  All rights reserved.

Leave a Comment » | Conditions of Participation, Consumer Driven Health Care, Health Care, Health Care Finance, Health Care Fraud, Health Care Provider, Health Care Quality, Hospital, Hospital, Medical Licensure, Medicare, Medicare Advantage | Permalink
Posted by Cynthia Marcotte Stamer