CMS Issues Final Rule Regarding Stark’s IOASE Disclosure Requirement

By Adrienne Dresevic, Esq. and Carey F. Kalmowitz, Esq.

December 2010–As summarized in past Regulatory Review columns, the PPACA imposed a new disclosure requirement under the IOASE, while the CMS issued its proposed rule on this requirement in June. Last month, CMS issued its final rule in the Federal Register regarding satisfying this new disclosure requirement. This final rule is less onerous than the proposed rule.

Ten Facts You Should Know About Medicare ACOs

By Adrienne Dresevic, Esq., Carey F. Kalmowitz, Esq., and and Kathryn Hickner-Cruz, Esq.

November 2010–One aspect of the Patient Protection and Affordable Care Act eliciting significant interest among healthcare providers is the Medicare Shared Savings Program, under which ACOs that meet certain quality performance standards will be eligible to receive Medicare shared savings payments.

Proposed New Screening Requirements for Enrollees

By Adrienne Dresevic, Esq. and Carey Kalmowitz, Esq.

October 2010 — In an effort to reduce fraud, waste, and abuse in the Medicare system, CMS proposes to establish a three-tiered system in which providers and suppliers are categorized into one of three risk levels: limited, moderate, or high. Each tier is associated with different enrollment screening procedures.

The New Face of Physician Compliance Programs: Physicians Must Manage New Stark Law Risks under the Health Care Reform Act

By Adrienne Dresevic, Esq. and Carey F. Kalmowitz, Esq.

September 2010–There are a number of provisions contained in the healthcare reform legislation that strongly urge healthcare providers/suppliers to take a proactive approach to compliance with the Federal Stark Law. All healthcare providers should begin implementing steps to revisit their existing compliance programs to ensure that areas of potential risks under Stark are evaluated, incorporated, and factored into such programs.