CMS Delays Controversial Stark Provision

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<http://www.medicalnewswire.com/06.asp> 	Tuesday, December 04,
2001	
Tuesday, December 04, 2001	
Headlines	Subscribe <http://www.medicalnewswire.com/subscribe/> 	
CMS Delays Controversial Stark Provision
Recognize Signs Of Mental Illness To Avoid Survey Blues And Worse
Congress Considers New Repayment Tactics … You Should Too
Slide Under The PPS Training Wire
	Fast Track Education For Medical Product Development
Professionals
OIG Sails Toward Safe Harbors 
DOJ Intervenes In Experimental Device Suit 
	

CMS Delays Controversial Stark Provision	
BALTIMORE, MD (Medical Newswire) The Centers for Medicare & Medicaid
Services is putting on hold a controversial provision of the Stark
regulation that would have imposed an overwhelming burden on hospitals
and academic medical centers.

In a Dec. 3 Federal Register notice, CMS says it will postpone the
effective date of a single sentence in its Jan. 4, 2001 physician
self-referral rule that deals with percentage compensation arrangements
and the definition of "set in advance." 

Many of the exceptions to the Stark rule that apply to compensation
arrangements only apply if the amount of compensation is set in advance
- and CMS had earlier concluded that percentage compensation deals could
be automatically excluded from those exceptions. 

That interpretation, however, could spell disaster for many teaching
hospitals and other facilities, since certain kinds of percentage
compensation deals are routine in the hospital industry. CMS is delaying
the effective date of one sentence in the rule from Jan. 4, 2002 to Jan.
6, 2003 in order to give the agency time to "reconsider" the provision. 

To see the notice, go to
http://www.access.gpo.gov/su_docs/fedreg/a011203c.html. 

*	http://www.access.gpo.gov/su_docs/fedreg/a011203c.html

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Recognize Signs Of Mental Illness To Avoid Survey Blues And Worse	
RESEARCH TRIANGLE PARK, NC (Medical Newswire) More and more individuals
with mental illnesses are flooding the country’s skilled nursing
facilities - but the Centers for Medicare & Medicaid Services has
instructed surveyors to bring the hammer down on facilities that don’t
know how to care for residents with special mental health needs.

And it’s not just the surveyors who will be cracking down on nursing
homes that accept patients with mental illnesses without proper
screenings - the HHS Office of Inspector General says such facilities
will be a target for fraud investigations.

With CMS and the OIG putting their weight behind tougher surveys and new
protocols, nursing homes can't afford to rely on guesswork. That's why
Eli Research has re-introduced the Long-Term Care Survey & Certification
Guide. 

Organized into 22 easy-to-read chapters and appendices, the 2426-page
Guide is a must-have resource for complying with new CMS survey
regulations. Everything you need to know to survive the survey process
is between these covers, says attorney and editor in chief, Ari
Markenson, with Abrams, Fensterman, Fensterman & Flowers.

Highlights from the Long-Term Care Survey & Certification Guide include
chapters on survey tasks and protocols, specialized rehabilitation
services, dental services. The Guide also covers infection control, the
federal appeals process and the use of survey-related findings in fraud
and civil actions. Markenson has marshaled a broad-based legal and
clinical team to explain the convoluted survey regs. “Your facility will
benefit from the authors’ combined clinical and operational expertise,”
comments Markenson.

For more information about registration and pricing, call 1-800-874-9180
or visit: 

*	http://www.eliresearch.com/surveyguide.html

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Congress Considers New Repayment Tactics … You Should Too	
RESEARCH TRIANGLE PARK, NC (Medical Newswire) The debate on overpayments
is roiling on Capitol Hill, as Congress debates new policies that could
keep CMS from demanding repayment while a provider appeal is in the
works. Some proposals would allow repayment over extended periods of
time in cases of severe financial hardship. And other changes may be on
the way…

That's why you need our experts to guide you through the minefield of
handling overpayments. Assuming that inconsistencies will always “come
clean in the wash” can be a grave mistake, says Ankur Goel, a partner
with Washington-based McDermott, Will & Emery. “At the same time, the
government is considering provisions that will spell relief for some
providers,” adds attorney Heidi Kocher with Brown & Fortunato in
Amarillo, TX.

Goel and Kocher will help you find the strongest financial ground -
while remaining compliant - at Eli Research’s audio seminar, “Medicare
Repayments: Whether, When and How to Make Them.” The conference will
take place on Tuesday, Dec. 11, 2001 from 1 to 2:30 p.m. “This realistic
approach will get all your decision-makers on the same, correct page,”
comments Goel.

Program highlights include seven tough questions you must answer before
making the decision to repay; how to distinguish between situations
calling for repayments and those requiring disclosures; an in-depth
exploration of the mechanics of repayments; and practical tips for
integrating repayment and disclosure decisions into your compliance
plan. “We’ll show you how to make good decisions during the repayment
process,” promises Kocher.

Nursing home administrators will earn CEU’s at this seminar.

For more information about registration and pricing, call 1-800-874-9180
or visit: 

*	http://www.eliresearch.com/repayments.html

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Slide Under The PPS Training Wire	
RESEARCH TRIANGLE PARK, NC (Medical Newswire) The Inpatient
Rehabilitation Facility Patient Assessment Instrument (IRF PAI) hits the
streets January 1, 2002. That’s just around the corner. The best way to
avoid a New Year’s headache - in advance - is to know that your facility
will be reimbursed for the true cost of caring for your patients. 

If you didn’t make it to one of the Atlanta or San Francisco-based
training sessions sponsored by the Center for Medicare & Medicaid
Services, it’s not too late to prepare your IRF staff with the skills
needed to score the new PAI. From now on, your entire staff will have an
impact on the amount of reimbursement your facility receives, says Ann
Lambert, with Portland, ME-based Baker Newman & Noyes. “That’s why a
well-trained, knowledgeable staff is more vital than ever before,” adds
Lambert.

Ms. Lambert will draw on real-life case studies from her national base
of clients to illuminate the IRF-PAI at Eli Research’s audio seminar,
“Hot IRF-PPS Issues: Improving Coding Accuracy and Compliance.” The
conference will take place on Thursday, Dec. 13, 2001 from 1 to 2:30
p.m. “Accuracy and compliance are your keys to unlocking the best
possible reimbursement results,” comments Lambert.

Program highlights include scoring impairment groups, how to manage case
mix groups effectively, co-morbidity codes, quality indicators and staff
training tips. Ms. Lambert will also reveal to approach the ethical and
financial dilemmas of patients who exceed predicted reimbursement.
Course materials include tools designed just for this event. “Your
facility will be able to use these worksheets throughout the next year,”
promises Lambert.

Coders, nurses, physical and occupational therapists will earn CEU’s at
this seminar.

For more information about registration and pricing, call 1-800-874-9180
or visit: 

*	http://www.eliresearch.com/IRFPAI2002.html

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Fast Track Education For Medical Product Development Professionals	
IRVINE, CA (Medical Newswire) UC Irvine Extension’s certificate program
in Medical Product Development offers professionals quality education in
an accelerated environment. Most courses in this program are only four
meetings- giving professionals the tools they need in a timely and
effective manner. 

The program fulfills a recognized training need for professionals in the
design and development of medical products. The program format allows
participants the flexibility to choose courses that meet their specific
needs as they relate to their work environment or career transition.

The Medical Product Development certificate program is designed for
industry professionals seeking to enhance their current knowledge of
contemporary practices in the design and development of medical
products. Students in this program will gain knowledge in the core
competencies needed in the development of modern medical products. They
will also learn the essential FDA regulatory practices and issues,
develop an understanding of medical device manufacturing procedures, and
become knowledgeable of medical device engineering.

University of California, Irvine Extension, the continuing education arm
of the University of California, Irvine, offers over 1,600
university-level professional and personal enrichment courses, including
45 certificate programs and specialized studies every year. It serves
over 12,000 students annually; most of who already have college degrees.
For the convenience of working adults, most courses are held evenings
and weekends on the UC Irvine campus, the UC Irvine Learning Center in
Orange and online. 

The program also provides custom education and training programs at
business sites worldwide. Instructors for all courses are highly
qualified UCI-approved leading industry experts. UC Irvine Extension is
financially self-supporting, deriving income primarily from course
enrollment fees without the assistance of state funds. For more
information regarding University of California, Irvine Extension courses
and programs, call (949) 824-5414.

*	http://www.unex.uci.edu/
*	Click here to email for more information
<mailto:unex@uci.edu?subject=Medical Newswire Inquiry> 

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OIG Sails Toward Safe Harbors 	

WASHINGTON, DC (Medical Newswire) The HHS Office of Inspector General
plans to finalize three safe harbor regulations by next spring,
according the Department of Health and Human Services' Semiannual
Regulatory Agenda. Published in the Dec. 3 Federal Register, the
document lays out anticipated rulemaking for all HHS agencies. 

The OIG says it will finalize the shared risk exception to the
anti-kickback safe harbor provisions by next March, while a safe harbor
for ambulance restocking programs is due in December. The watchdog
agency also plans a civil monetary penalty safe harbor to protect the
payment of Medicare and Medigap premiums for end stage renal disease
beneficiaries.

To see the semiannual agenda, go to
http://www.access.gpo.gov/su_docs/fedreg/a011203c.html. 

*	http://www.access.gpo.gov/su_docs/fedreg/a011203c.html

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DOJ Intervenes In Experimental Device Suit 	
WASHINGTON, DC (Medical Newswire) Medical device salesman Kevin Cosens'
whistleblower suit charging more than 100 hospitals of improperly
billing for experimental medical devices has reeled in nearly $30
million from 15 facilities since its inception - and a recent move by
the Department of Justice raises the stakes of the case for two more
California facilities. 

The DOJ Nov. 29 intervened in the case against Scripps Memorial Hospital
in La Jolla, CA and Green Hospital of Scripps Clinic in San Diego,
charging the facilities with knowingly collecting millions of dollars
worth of Medicare reimbursement for procedures involving experimental
devices that weren't reimbursable. 

Executives of hospitals previously targeted in the probe have noted that
Centers for Medicare & Medicaid Services billing rules for experimental
devices were confusing and sometimes contradictory during the time
period covered in the lawsuit.

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