Co-author: Ashley Ramm
In response to President Trump’s American Patients First Blueprint, the Centers for Medicare & Medicaid Services (CMS) sent a firm reminder to Medicare Prescription Drug Plan (Part D) sponsors that “gag clauses” are unacceptable and including such a clause would subject providers to CMS compliance actions. Read More ›
Co-author: Nathan Truitt
Ironically named the “Choice Demonstration,” the Centers for Medicare and Medicaid Services’ (CMS) latest claims review proposal essentially forces Home Health Agencies (HHAs) to participate. If HHAs choose not to participate, they will be saddled with 25 percent payment reductions. Read More ›
Depending on the state in which a nurse practitioner or physician assistant practices, he or she can likely prescribe controlled and non-controlled substances to patients, within the parameters of the applicable state’s regulatory scheme. Nurse practitioners and physician assistants, referred to here as “midlevel providers,” continue to provide excellent care to their patients and move in greater numbers into the role of primary care providers for Americans. Nurse practitioners currently account for one in four providers in U.S. rural practices, a significant 43.2 percent increase over the past 10 years according to research just published in Health Affairs. Understanding the qualifications and responsibilities of midlevel providers in the context of prescribing is, therefore, essential. Read More ›
This article will go into detail on surety bond requirements that may be imposed on providers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), on pharmacies and pharmaceutical dealers and suppliers, as well as specific requirements imposed by certain states. Read More ›
Ohio State Auditor David Yost has noted that Ohio has millions of dollars of unpaid obligations owed by Medicaid providers and has proposed the use of surety bonds to address the problem. Based on recent reports, auditors have identified over $33 million in alleged overpayments to more than 120 providers. Further analysis of a portion of those claims showed that only about 10% of the outstanding balances have been collected. Thus, Mr. Yost proposed the use of surety bonds as a means to recover some of these overpayments and to minimize the problem in the future. Introduced by Senators Lehner and Eklund, Senate Bill 218 is still pending before the Ohio Legislature at the time of this article's publication. Read More ›
This is the third article in a three-part series designed to inform physicians and other health care providers about proactive steps that can be taken to avoid licensure discipline by the Department of Health. Read More ›
“Grandma’s tremors appear to have gotten worse lately. She mentioned she wants to try medical marijuana oil; can she use that in the nursing home?” “Do you think those ‘special’ gummy bears could help mom’s chronic back pain?” Read More ›
SB 273 – New Limits on Opioid Prescriptions Change the Game for West Virginia Hospitals and Physicians
On March 27, 2018, Governor James C. Justice signed SB 273, which among other dramatic actions limits initial opioid prescriptions in emergency rooms and also subsequent prescriptions by physicians in West Virginia, effective as of June 7, 2018. Read More ›
Ohio doctors can now apply to become certified to recommend medical marijuana for treatment. The Ohio Medical Marijuana Control Program released a statement on Monday, March 19, 2018, stating that the State Medical Board of Ohio is now accepting applications for a certificate to recommend. Read More ›
This is the second article in a three-part series designed to inform physicians and other health care providers about proactive steps that can be taken to avoid licensure discipline by their respective state Department of Health. Read More ›
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Brian F. Higgins is an associate in FBT's regulated business group with a focus on health care, and he has a history as corporate counsel to Medpace, Inc., a pharmaceutical clinical research organization.