It is not uncommon for providers to receive notification from an employer-sponsored health plan subject to the Employee Retirement Income Security Act of 1974 (ERISA) alleging that the plan has overpaid the provider and that the provider must immediately repay …
This article was published in Becker’s Hospital Review on January 22nd, 2013. FULL ARTICLE
California Gov. Jerry Brown has signed legislation to allow surgery centers to obtain pharmacy permits, according to an ASCA report. The bill, SB 1095, was strongly supported by the California Ambulatory Surgery Association, will take effect on Jan. 1, 2013. …
The Centers for Medicare & Medicaid Services (CMS) began publicly reporting hospital readmission rates in July 2009.[1]These reports highlighted the amount of resources wasted by reimbursing care provided for potentially avoidable readmissions and spurred many proposals to reduce hospital readmissions …
Last week, the Drug Enforcement Agency and Internal Revenue Service raided Oaksterdam, a medical marijuana trade school in Oakland, California.[1] The DEA said the raid was part of an ongoing criminal investigation.[2] According to San Francisco DEA spokeswoman Jocelyn Barnes, the reason …
The 2012 Office of Inspector General (OIG) Work Plan offers providers a helpful overview of Medicare enforcement priorities. With respect to skilled nursing facilities (nursing homes or “SNF’s), the Work Plan contains five “carryovers” from 2011 and three new areas …
The recent history of ambulatory surgery center regulation in California is confusing, to say the least. Are ambulatory surgery centers (ASC’s) required to be licensed? Accredited? Certified? What’s the difference? Who can do what where? 1. Licensing Licensing refers to …