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Firm News


Presentation - Laws and Rules & Risk Management


On March 12, 2016 Steven Ballinger will provide 2 hours of Podiatric CME on Risk Management and Florida Laws and Rules at the 26th Annual Agnes Seminar presented by Barry University School of Podiatric Medicine in Miami Shores.




Presentation - Risk Management in Mental Health Practices Overview


On May 30, 2015 Steven Ballinger spoke at the Broward Association for Marriage and Family Therapy (BAMFT) Expo in Davie, Florida.




Presentation - Genetics and the Law


On October 23, 2014 Steven Ballinger spoke at the 4th Annual Shannon J. Shaw Memorial CLE/CME Seminar on Cancer Issues in Albuquerque, New Mexico.




Presentation - Laws and Rules & Risk Management


On February 15, 2014 Steven Ballinger provided 2 hours of podiatric CME on Risk Management and Florida Laws and Rules at the 24th Annual Agnes Seminar presented by Barry University School of Podiatric Medicine in Miami Shores.




12 Years at NSU


This June Mr. Ballinger will finish teaching the Law of Accreditation and Licensing for the twelfth year with the Nova-Southeastern University Shepard Broad Law Center's Master's in Health Law program.




Latest Insights


OIG Fraud Alert for Doctors and Hospitals


On June 9th, the OIG issued a written fraud alert warning hospitals and doctors of certain schemes that they see as potentially illegal. This is only the fourth time in five years that the OIG has issued a written fraud alert.


The OIG (Office of the Inspector General) enforces healthcare laws including the Stark Law and Anti-Kickback statute.  Violations of those laws can occur, according to the OIG, in situations where a physician receives any benefit designed to induce admissions and specifically mentions questionable medical directorship and reimbursement of office staff expenses.


According to the Department of Health and Human Services, doctors who enter into compensation arrangements (such as medical directorships) must ensure that those arrangements reflect fair market value for services actually provided. Even if a compensation package is otherwise legal, it can still violate the law if just one of its purposes is designed to compensate the physician for bringing in Medicaid or Medicare patients.


In light of the OIG's stated focus on such arrangements, it may be wise to have any such arrangements carefully reviewed by legal counsel




Meaninful Use Hardship


The Centers for Medicare & Medicaid Services (CMS) is reminding physicians who did not attest to meaningful use (MU) of electronic health records (EHR) in 2013 that they have until July 1 of this year to apply for a hardship exception so they can avoid a financial penalty in 2015.

 Physicians who attested in previous years but don't attest to MU stage 2 this year have until July 1, 2015, to apply for a hardship exception to sidestep a penalty in 2016. Hardship exceptions are valid for one year and then must be renewed.






CMS will grant hardship exceptions to eligible professionals (EPs) who live in an area with insufficient Internet access or lack of broadband, are new in practice, have had to deal with a natural disaster or other "unforeseen barrier," don't interact with patients, don't have access to EHRs in all practice sites, or have technology issues. In the latter category are the inability of the EP's vendor to obtain 2014 certification or the inability of the EP to implement meaningful use because of certification delays.




Do you have a compliance plan?


Medical practices, skilled nursing facilities and pharmacies alike are now all targets for the alphabet soup of medicare auditors -- RACs, MICs, and ZPICs. In fact, the federal government has reported a return in investment of over $7.00 for every $1.00 spent in fraud detection and enforcement. It is imperative that all providers have, USE and update their compliance plans. Modern plans should address things such as privacy, coding and documentation, billing and industry-specific legal risks such as Controlled Substance dispensing for pharmacies. For more information, contact the Law Offices of Steven R. Ballinger.




The ACA and your Practice


Recently, the MGMA conducted a research study to better understand the impact of the Affordable Care Act (ACA) exchange implementation on practices. To see the results:




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