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Medicare introduces major overhaul of clinician compensation

The Centers for Medicare & Medicaid Services made headlines last Friday with the official unveiling of a comprehensive new regulation that will introduce major changes in the way in which clinicians -- physicians, nurse practitioners, physician assistants and therapists -- are compensated under the Medicare program.

The regulation, measuring almost 2,400 pages long, is designed to implement bipartisan legislation, the Medicare Access and CHIP Reauthorization Act, passed by Congress and signed by President Obama just last year. Although the regulation will take years to roll out and its success has yet to be determined, it nevertheless represents one of the single biggest reforms in the 50-year history of the Medicare program.

Major changes ahead for Florida's trauma centers

If asked where a person who suffers critical or life-threatening injuries would be taken by paramedics, most people would automatically identify the emergency room. While this is technically correct, the reality is that they would likely be taken to a trauma center, which is typically located within the emergency room.

Indeed, these facilities are staffed by skilled surgeons who use state-of-the-art equipment to help save the lives of those involved in everything from motor vehicle crashes and burn accidents to violent incidents and other "traumatic" events.

New study gives low marks to Florida's healthcare system

Back in July, our blog discussed how the Centers for Medicare & Medicaid Services released a controversial set of quality ratings for U.S. hospitals, awarding one to five stars based on 64 measures of quality. Overall, the state of Florida's performance in the ratings was largely mediocre, with five stars being awarded to only two hospitals.

Interestingly enough, the financial website WalletHub recently released the results of a study ranking the 50 states and the District of Columbia on their respective healthcare systems and, once again, the Sunshine State did not fare especially well.

There's an app for that . . . but should doctors use it?

As we've discussed in previous posts, the U.S. healthcare system is currently undergoing something of a seismic shift regarding physician compensation. Specifically, the model of paying physicians per appointment, per test ordered, etc. is slowly being replaced with one in which physicians are being compensated for keeping their patients healthy.

This reality, in turn, has physicians looking for efficient and effective ways to remain in regular contact with their patients outside of the traditional office appointment. One option that is generating considerable interest is secure messaging apps, which facilitate instant communication between patients and physicians via smartphones, laptops and tablets. 

Which home health care providers need to be licensed by the AHCA?

While we tend to think of health care as being provided solely in places like hospitals, clinics and doctor's offices, the reality is that it is frequently provided in the comfort of people's own home. By way of example, consider the burgeoning field of telemedicine, which enables people to see a physician or nurse practitioner via the internet, and, of course, home health care providers.

For those unfamiliar with home health providers, they are the individuals or entities that provide both medical-related services in the residences of everyone from the elderly and the disabled to those who are gravely ill and those who are recovering from hospitals stays.

CMS releases its controversial new hospital ratings

The Centers for Medicare & Medicaid Services made headlines yesterday with the release of its much anticipated -- and highly controversial -- quality ratings for 3,617 U.S. hospitals.

For those unfamiliar with these first-of-their-kind ratings, they award hospitals anywhere from one to five stars based on 64 measures of quality published on the CMS' Hospital Compare website, including patient reviews, infection rates and mortality rates.

Are changes finally coming to the Stark Law?

Earlier this week, the Senate Finance Committee held a hearing to discuss the Stark Law, an endeavor that saw medical professionals, health law attorneys and business executives from across the U.S. voice similar concerns that the law has become needlessly complex and wholly unnecessary.

For those unfamiliar with the Stark Law, it essentially prohibits physicians from referring patients to providers with whom they have existing financial connections and/or facilities where they have ownership interests (i.e., imaging centers and labs). Its original purpose was to remove financial considerations from the medical decision-making process, and, by extension, curb Medicaid and Medicare overutilization.    

HHS proposes changes to eliminate backlog of Medicare appeals

In the event a Medicare claim is denied, the Department of Health and Human Services provides applicants with a five-level appeals process, including redetermination, reconsideration, hearing before an administrative law judge, review by the Medicare Appeals Council and, lastly, judicial review in a federal district court.

As orderly as this process may seem to the uninitiated, the HHS has recently come under fire from beneficiary advocacy groups, medical providers and even the Government Accountability office for both the glacial pace of the appeals process and its inability to reduce the appeals backlog, which has now grown to over 700,000 cases.

Why medical professionals must be careful with online reviews

Thanks to the proliferation of smartphones and the unprecedented growth of wireless internet access over the last decade, most of us now have instant access to our social media accounts and a treasure trove of information on virtually any topic.

This wealth of information, of course, includes online reviews of virtually every service provider you can imagine from hotels and restaurants to contractors and cab companies. Indeed, the explosion of online reviews has now carried over to the medical profession, such that with just a few keystrokes or swipes of the finger, a person can access patient reviews of everyone from doctors to dentists.

State appeals court rules on surgery and the need for parental consent

Physicians must do everything in their power to ensure that they remain complaint with federal rules and regulations governing everything from referrals to reimbursement. This also holds true at the state level, particularly when it comes to such matters as privacy and patient consent.

The failure to abide by state law in this latter category can expose physicians to certain professional consequences, including reprimands from the Florida Board of Medicine, as well as potential liability. In light of this reality, it's imperative for all physicians to be aware of any developments in this area of the law.