Legal

As of January 1, over-the-counter medications other than insulin need a prescription to qualify for reimbursement from an employer-sponsored flexible spending account or health reimbursement arrangement.

Some U.S. Senators want an investigation of physician-owned distributorships (POD).

Despite today's uncertain economic climate, two recent, surprising reports show that mergers and acquisitions are on the upswing.

The Centers for Medicare & Medicaid Services (CMS) gave organizations interested in participating in the Pioneer ACO model a little longer to circle their wagons. Responding to concerns from provider organizations that there was insufficient time to assemble internal support and strong applications, CMS extended the deadline for applications to August 19 for those who submitted their letters of application by an extended June 30 deadline.

A new bipartisan proposal attempting to ?save? Medicare would impose a 3-year ban on further cuts to Medicare reimbursement to physicians. Other aspects of the plan make its future questionable, however. The proposal includes political landmines, such as raising the Medicare eligibility age and requiring more out-of-pocket payments from Medicare beneficiaries who can afford them.

Just in case you or your front desk staff had plans to take a vacation this summer, you may want to rethink that. Medicare has rolled out a major advertising campaign to get patients to visit you for an annual wellness visit and free preventive services. Since fewer than 20% of eligible patients used those services in the first half of the year, expect an onslaught of request for appointments.

The controversy may have been focused on the government plan to use mystery shoppers to surreptitiously check how many physician offices were open to Medicare and other public insurance patients. But the bigger problem is acceptance of private insurance by medical practices that have to jump through hoops to get paid, according to a new study.

This special report covers the spectrum of ACO topics of interest to the primary care physician.

Lack of capital, integrated systems and evidence-based treatment protocol data all play into the difficulty of creating an accountable care organization (ACO).The biggest challenge, however, is a personnel issue, and how physicians and hospitals will work together to resolve it.

The U.S. Supreme Court said that a Vermont law prohibiting sale of prescription data to drug companies interfered with the pharmaceutical industry's First Amendment right to market its products. A recent survey suggests that the decision will not come as good news to many physicians who feel as if their privacy is being invaded.

The Patient Protection and Affordable Care Act gives new impetus to form accountable care organizations to better coordinate the care of their patients, especially those with chronic diseases, and to ensure a continuum of care.

Know how to protect patients' information with billing companies.

To many physicians, the current healthcare environment is complex and overwhelming. From accountable care organizations, global capitation, and value-based purchasing to episode payments, episode groupers, and bundled payments, the terminology seems to be addressed to larger organizations than small primary care groups.

Federal pilot programs established to use health information technology to improve patient care and reduce costs are having a hard time meeting the latter goal.

Since the Centers for Medicare and Medicaid Services asked for comments on the much-anticipated regulations for accountable care organizations in late March, the proposed rules have been under constant attack.

The proposed accountable care organization regulations arrived on March 31 and have caused much strife and speculation in the medical and legal communities in recent months.

When patients request copies of their electronic health records from your practice, the clock starts ticking. This Q&A gives you the new information on the minimum information required and how quickly you must provide it. Also find out why you soon may have to inform patients when their health information is viewed.

Location, location, location doesn?t just apply to real estate; it also is a factor in how Medicare calculates payments to your practice. But how accurate and consistent is that process? Not very, according to a recent Institute of Medicine Report. Find out what the IOM recommended and what they?re proposing to improve accuracy.

Likely coming to a state near you: Medical malpractice reform. Why have malpractice case filings dropped more than 45%?nearly 70% in Philadelphia?since two significant rule changes implemented by the Pennsylvania Supreme Court? And what has been the effect of a Texas proposition that put a cap on noneconomic damages in medical malpractice claims?

The Centers for Medicare and Medicaid Services (CMS) wants to publicize data about the care you?re providing as a primary care physician so that consumers and business could compare your cost and quality to other providers. The claims data would be derived from both Medicare and private sector insurers. Find out more while there?s still time to influence the final rule.

The certificate of need process required to open a new medical facility has evolved into an arena where providers complete service-line dominance and market share, according to a new study.

The Medicare Trustees Report released in May shows that Medicare will remain solvent longer than expected prior to passage of the Patient Protection and Affordability Care Act, but challenges remain for the long term.

A bill introduced recently by Sen. Jay Rockefeller would require physicians and other healthcare providers seeking to obtain or renew a U.S. Drug Enforcement Administration registration number to complete CME related to responsible opioid prescribing practices.

Learn whether to notify CMS if a partner leaves a practice.

Years ago, pharmaceutical companies used to market directly to prescribing doctors, not on TV directly to patients, nor to insurance companies. Pharmaceutical sales representatives came to each doctor's office to discuss their products.

Time was when violating the Health Insurance Portability and Accountability Act got you little more than a warning letter from the U.S. Department of Health and Human Services.

Learn the ins and outs of long-term care insurance.

The continuing pressure on the primary care system will be significant if so-called RomneyCare in Massachusetts is a harbinger for national healthcare reform, as some critics have claimed. Read on to see how primary care physicians there have coped.

Last week, the Centers for Medicare and Medicaid Services mailed the first Medicare checks to physicians who had attested that they had achieved meaningful use of their electronic health records (EHRs). What effect will these payments have on you and your colleagues? Will everyone rush out to buy EHRs now or will they let this opportunity pass them by? Read on to find out.

The National Committee for Quality Assurance will release its rules for ACOs in July.