The Department of Health and Human Services, Centers for Medicare and Medicaid (“CMS”) issued a final rule on February 2, 2016 regarding the requirements for a face-to-face encounter for patients receiving home health services payable by Medicaid. In order to ensure that states and providers appropriately implement the provisions in the final rule, CMS revised
On February 12, 2016, the Department of Health and Human Services, Centers for Medicare and Medicaid Services (“CMS”) promulgated the final rule on the requirement that providers and suppliers receiving funds under the Medicare program report and return overpayments by the later of sixty (60) days after the date on which the overpayment was identified
On June 9, 2015, the OIG issued a new Fraud Alert, cautioning physicians who enter into compensation arrangements such as medical directorships to ensure that the arrangements reflect fair market value for bona fide services that the physicians actually provide. The OIG reiterated that a compensation arrangement could violate the Anti-kickback Statute if even one
The OIG issued Advisory Opinion 15-3 to address an arrangement proposed by a licensed offeror of Medicare Supplemental Health Insurance (“Medigap”) policies (the “Requestor”), in which the Requestor would indirectly contract with a preferred hospital organization (“PPO”) having contracts with a national network of hospitals (the “Network Hospitals”) for discounts on otherwise-applicable Medicare inpatient deductibles
The Louisiana Department of Health and Hospitals (“DHH”) adopted provisions to establish the Recovery Audit Contractor (“RAC”) Program, effective November 20, 2014, as required by the Affordable Care Act. The new RAC program provides yet another mechanism by which DHH, through its contractors, can conduct post-payment audits of claims submitted by providers enrolled in Medicaid.
On September 20, 2014, the Department of Health and Hospitals (“DHH”) published its notice of intent to promulgate a rule to continue the provisions of a March 20, 2014 Emergency Rule regarding the prohibition on provider steering of Medicaid recipients to select a particular health plan. DHH had previously promulgated an Emergency Rule on this
To participate in the Louisiana Medicaid Program, providers have been required to ensure that their current and potential employees, contractors and other agents and affiliates were not excluded from participation in the Medicare or Medicaid Programs. Providers have been instructed to check the Department of Health and Human Services’ Office of Inspector General’s website for
CMS published its notice of intent in the July 29, 2014 Federal Register to expand the demonstration regarding prior authorizations from DME suppliers seeking payment for Power Mobility Devices from the original seven states to an additional twelve states. Louisiana is one of those states.
The original states included in the demonstration were California, Florida,
CMS issued a proposed rule on May 28, 2014 designed to reduce the rate of medically unnecessary DMEPOS items supplied to beneficiaries. According to CMS, reports issued by GAO and HHS OIG, including Comprehensive Error Rate Testing (CERT) reports, show that DMEPOS claims had a 66% improper payment rate, accounting for approximately 20% of the
The Louisiana State Board of Medical Examiners (the “Board”) published proposed rules and regulations governing the practice of polysomnography and the licensure of polysomnography technologists and technicians. The Board will accept comments on the proposed rules until 4 p.m. on October 21, 2013.
An individual who does not hold a current license as a polysomnograhic technologist or a permit as a polysomnographic technician is prohibited from engaging in the practice of polysomnographic technology in Louisiana. However, the prohibition does not apply to anyone who is: acting under a license issued by any licensing agency of the state of Louisiana whose scope of practice includes polysomnography; employed as a polysomnograhic technologist by the U.S. Government when acting exclusively within the course and scope of employment; licensed by the Board to practice respiratory therapy; or pursing a course of study in a CAAHEP accredited polysomnograhic technology education program while acting within the course of study.
Polysomnographic technology is the allied health specialty practiced under the direction and supervision of a physician involving the attended monitoring and testing of individuals suffering from any sleep disorder as classified in the International Classification of Sleep Disorders. Procedures are conducted only upon written prescription or verbal order of a physician, which is based on the physician’s clinical evaluation of the patient, and under his direction and supervision. A polysomnographic technologist is an allied health professional who possesses a current license issued by the Board to practice polysomnographic technology to perform both diagnostic and therapeutic polysomnograms under the direction and supervision of a physician. A polysomnographic technician is an allied health professional who possesses a current permit issued by the Board to practice polysomnographic technology under the direct supervision of a physician or qualified allied health professional currently licensed by the Board whose scope of practice includes polysomnography. A supervising physician is a qualified physician who provides direction and supervision to an individual who is licensed or direct supervision to an individual who holds a permit, to practice polysomnographic technology in Louisiana.