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

Stat Law Update July 2009

CMS Warns Providers About Medicare Scam

CMS warned providers about fake Medicare faxes.  Evidently, the faxes request the providers to respond to a questionnaire within 48 hours and include provider numbers in the reply.  Many of the fake Medicare faxes have included the CMS logo or the Medicare Carrier logo.  Medicare warned providers to only send information to Medicare Carriers at the address indicated on the CMS website.

President Obama Addresses AMA

President Obama addressed the American Medical Association at its annual meeting in Chicago on June 15, 2009.  The President told the AMA that America’s current spending on health care could not be sustained and that reform of the health care system was necessary.  The President’s reform package, including a government run insurance plan to compete with private insurance met with mixed reviews.  Physicians are concerned that any government insurance plan would have low reimbursement rates similar to Medicare.

New Law Requires Insurers To Pay Out-Of-Network Doctors Directly

Governor Crist recently signed a new law that requires insurers to send payments directly to out-of-network doctors when the patient has assigned the right to receive payment to the doctor.  Out-of-network physicians have frequently gone unpaid when insurers sent payment directly to patients.  The amount of compensation due to out-of-network providers continues to be a source of debate. 

Prescription Drug Electronic Database

On Thursday, June 18, 2009, Governor Christ also signed Senate Bill 462, which establishes an electronic database system to monitor prescriptions for controlled substances.  The new law is intended to reduce the black market in prescription medications originating in South Florida. The database should also make it easier for healthcare providers and law enforcement to identify patients that doctor shop.  Additionally, the new law will limit some doctors from practicing in pain clinics.

Phony Swine Flu Cures

The Food and Drug Administration has ordered numerous web sites to stop advertising phoney swine flue treatments.  Shortly after the public health emergency was announced, numerous web sites began offering fake swine flu treatments.  The FDA reports that those numbers have dropped significantly.