June Special Issue of Becker's ASC Review

Becker's ASC Review - Current Special Issue - June 2009

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Current Issue Articles

17 Key Legal Issues of 2009
There are a number of legal and regulatory issues that are impacting ASCs. These range from antitrust cases to safe harbor issues to new Conditions for Coverage, which place specific additional burdens on surgery centers, as well as several other issues. This article provides a short summary of 17 key legal issues.
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ASC Lawyers Discuss Current Critical Legal Issues Facing Surgery Centers
While ASCs face a variety of legal issues at their individual state levels, there are several national legal issues affecting the everyday affairs of a surgery center, according to ASC legal experts. The most critical are physician ownership, safe harbor requirements, out-of-network fees as well as recent updates to Red Flags laws and HIPAA.
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Mandatory Disclosure of Physician Ownership in ASCs Required by the Medicare Conditions for Coverage
The final Medicare Conditions for Coverage were published Oct. 30, 2008 and will become effective May 18, 2009. One of the most significant changes in the Conditions for Coverage is the requirement for ASCs to provide patients with certain verbal and written notification of rights and of ownership in advance of the date of the service. The notice must be provided in a language in any manner that the patient or the patient's representative understands.
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Publisher’s Letter
New Medicare Conditions for Coverage for ASCs; Increased Scrutiny of Physician- Hospital Relationships; Becker’s ASC Review E-Weekly; 16th Annual ASC Conference – Improving Profitability and Business and Legal Issues
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Checklist for the Changes in the ASC Medicare Conditions for Coverage
The following checklist was prepared by the ASC Association of Illinois for the changes in the ASC Medicare Conditions for Coverage (effective May 18).
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Conditions for Coverage Crosswalk
View a crosswalk grid illustrating the changes between the previous and new ASC Conditions for Coverage...
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The ASC Association: The Last 10 Years
The ASC Association, over the last 10 years, has done a better job of advancing and appropriately protecting the interests of its members than any other trade association that I am aware of.
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15 Medicare/Medicaid Anti-Kickback and Fraud and Abuse Statute Cases Making Headlines in 2009
This is a short summary of 15 anti-kickback and fraud cases and investigations that have made headlines in 2009.  The situations involve a range of participants including hospitals, device companies, physicians, payors and other suppliers.
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A Practical Compliance Plan Approach for ASCs
This article provides an overview list of the steps to be taken to implement a compliance plan for an ASC.
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HHS’ Inspector General Issues Advisory Opinion on Physician On-Call Coverage
The Department of Health and Human Services Office of the Inspector General issued an advisory opinion on hospital emergency room on-call coverage that determined a flat-fee payment schedule presented a low fraud and abuse risk.
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Bart Walker of McGuireWoods Discusses 6 Issues Affecting Loan Closing Costs
The current economic situation and other factors have limited the access ASCs and physician groups have had to loans. The process has also become longer and more costly. Here, Bart Walker, JD, of McGuireWoods in Charlotte, N.C., discusses six legal issues that are affecting loan closing costs.
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Protecting Your Facility and Physicians From Medicare Fraud Investigations: Q & A With Tom Pliura
Tom Pliura, MD, JD, an independent attorney specializing in healthcare issues for surgery centers and physician practices and founder of zCHART and the zCHART EMR, discusses the increase in physician fraud investigations and offers suggestions as to how physicians and administrators can protect themselves from these investigations.
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11 Key Concepts From the Stark Law
The Stark law prohibits physicians from ordering designated health services for Medicare patients from entities with which the physician, or a family member, has a financial relationship unless an exception applies. This article reviews 11 key concepts under the Stark Law, in the context of changes to the Stark law made by CMS.
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Will the Federal Government Shut Down Surgery Centers and Physician-Owned Hospitals
As the Democrats take control of the House, the Senate and the Presidency, many question the impact of such a change on ambulatory surgery centers (ASCs) and physician-owned hospitals. The most significant question is: Will the federal government shut down and/or restrict physician-owned hospitals and ASCs?
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Do Non-Procedural Sources of Income Apply to the One-Third Rule?
Q: Federal guidelines state "at least one-third of the physician's medical practice income from all sources for the previous fiscal year or previous 12-month period must be derived from the physician's performance of procedures." Does this exclude income derived from a "non-procedural" source?  An example would be ophthalmologists who own their own eye glasses shop. They receive a considerable income from the sale of eyeglasses, which adds up to more than one-third of their overall income. Are they not out of compliance with the federal guidelines as an owner of an ASC?
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