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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Stat Law Update February 2010

TEMPORARY FIX FOR PHYSICIAN REIMBURSEMENT CUT

President Obama signed the Department of Defense Appropriations Act, 2010 into law on December 19, 2009.  The law delays the 21% reduction in Medicare physician reimbursement until March 1, 2010.  The 21% reduction in physician reimbursement was set to go into effect on January 1, 2010. 

MEDICARE FRAUD TASK FORCE EXPANDING OPERATIONS TO TAMPA

The joint Department of Justice-Health and Human Services task force that has been targeting Medicare fraud in Miami, Los Angeles, Detroit and Houston is expanding its operations to Tampa, Brooklyn and Baton Rouge.  According to the Department of Justice press release, the three new fraud task forces will allow the Department to focus its resources on “criminal hubs” where significant Medicare fraud occurs.  Since its inception, the strike forces have indicted more  than 460 individuals and organizations.  Those individuals and organizations are accused of collectively billing more than one billion dollars in false claims.

PAIN MANAGEMENT CLINICS

The Board of Medicine and Board of Osteopathic Medicine have been conducting joint meetings to establish rules for pain management clinics.  The new requirements apply to any physician practice or clinic that advertises in any medium for any type of pain-management services, or employs a physician who is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications.  The proposed rules include numerous requirements that pain practices and clinics must meet.  Every physician practicing pain-management should consult with their health law attorney to ensure they are in compliance with these new requirements.

JOINT COMMISSION PROPOSED STANDARD MS.01.01.01

In December 2009, the Joint Commission released proposed standard MS.01.01.01, which replaced MS.1.20.  MS.01.01.01 deals with medical staff governance and includes a lengthy list of requirements that must be included in the medical staff’s bylaws.  The Joint Commission is accepting comments on MS.01.01.01 until January 28, 2010.