Compliance & Legal

While a referral arrangement reversal has upset the applecart for some, most providers are taking it in stride.

Late last week, the Health Resources and Services Administration released the results of its FY 2012 audits of covered entity compliance with 340B drug discount program rules. The agency discovered several "recurring critical areas of non-compliance" for healthcare facilities.

The proposal for next year's Medicare inpatient payments to hospitals continues the pressure on them, and doubles down on a controversial policy.

Hospitals of all sizes are looking for partners. But the quest to increase market share by acquiring physician groups or other hospitals is drawing critical analysis from regulators, particularly if a merger results in eliminating a competitor.

Hospitals are educating their staff and reworking their processes to comply with Medicare's two-midnight rule, which will likely reduce hospital revenue by shifting patients from inpatient to outpatient status.

Last week's ruling in the case of ProMedica Health System vs. the Federal Trade Commission offers key lessons for CFOs about how hospitals and health systems should proceed with mergers or acquisitions.

There's a lot of buzz in the healthcare community about the right path to choose for accreditation and deemed status with CMS. For many years, The Joint Commission has been the number one choice, but Det Norske Veritas, a newcomer in 2008, is gaining significant ground.

The newly available data on Medicare physician reimbursement may bolster would-be whistle-blowers, but health systems and medical practices can get ahead of the issue.

It's not particularly helpful, but the Centers for Medicare and Medicaid Services has finally addressed the impending ICD-10 delay.

It is now official: you must wait until 2015 to use ICD-10 code W6112XA -- struck by macaw. But it's no laughing matter: President Barack Obama has indeed signed the SGR patch legislation, which includes another delay of ICD-10 implementation.