Posts Tagged Stark


Guest Author Attorney Jennifer Searfoss: Reading the Tea Leaves – New Cost Controls on Horizon for Medicare Advanced Imaging Services

It’s a stark reality – at this time in American history, we are at the (or near the) highest level of funding for health care. The Ryan Medicare proposal and continued debate inside the Beltway and by state lawmakers makes it clear that while experts estimate that by 2082 health care spending could be 49% of our gross domestic product, this is not a sustainable reality. Further, as baby boomers retire, the contribution of working aged people through taxes and direct employer contribution to health care costs will fall.

Thus, lawmakers have been investigating ways to reduce health care costs for America’s elderly. A report released by the non-partisan Medicare Payment Advisory Commission (MedPAC) last week includes a number of recommendations for reforms aimed at “explor[ing] every avenue for protecting the access of Medicare beneficiaries to high-quality care while reducing the rate of growth in Medicare expenditures.” Chapter 2 of the report addresses “Improving payment accuracy and appropriate use of ancillary services” with recommendations to the Stark law, interim payment reforms for imaging services and a requirement for “high-use practitioners to participate in a prior authorization program for advanced diagnostic imaging services.”


Posted in: Day-to-Day Operations, Medicare & Reimbursement

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Guest Author Jennifer Searfoss, Esq.: What Can an Attorney Do For a Medical Practice?

There are moments when the physician-centric world needs to engage an attorney. Please don’t hesitate to pick up the phone when the FBI shows up with a search warrant!

There are other moments when you and the physicians you work with do not need an attorney for boiler-plate contracts. How do you tell the difference?

What an attorney can do for you

Areas that an attorney can help your office include (but by no means are limited to):

  • Audit requests from RACs and insurers
  • Contractual and corporate organization documents
  • Human resource issues
  • Credentialing and privileging disputes
  • Ethical and disciplinary reviews
  • Quality, peer-review and risk management


Posted in: Day-to-Day Operations

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Misys, iMedica and a Cast of Thousands: Interesting Interview Worth the Read

HIStalk (an interesting healthcare IT blog written anonymously) has a great interview with Michael Nissenbaum, President and CEO of iMedica. Nissenbaum speaks about his 10 years in the field with Millbrook, GE and now iMedica, talks about Misys leasing the iMedica EHR product under the name MyWay, and gives an interesting rundown of some players in the ever-changing field of medical practice software.

I see a cycle that’s been in healthcare for years. Right now, it’s hospitals providing software to physicians under the Stark exemption. A year from now, when we have a new administration, God knows what the new rules are going to be. You and I both have seen it. We have seen centralization and de-centralization. – Michael Nissenbaum

Posted in: Innovation

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