Good news for private employers.  Today, May 14, 2012 the U. S. District Court for the District of Columbia ruled that the NLRB lacked a quorum when it took a final vote to issue it’s hotly debated “Quickie Election Rule”.  Consequently, the Rule that would have had the effect of drastically speeding up union elections in the private sector has been held to be invalid.  The Court in its opening paragraph said it best: (more…)

Background

Throughout the existence of the Medicare Part D program, the Office of Inspector General (“OIG”) has issued several reports concerning the vulnerability of the Medicare Part D program in regards to its potential for fraud and abuse.  On May 9, 2012, the OIG released a report identifying eight questionable billing practices of retail pharmacies throughout the country and making six recommendations to the Centers for Medicare & Medicaid Services (“CMS”) in order to strengthen the integrity of the Medicare Part D program (“Report”).  A full copy of the Report is available here.

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The Indiana Supreme Court heard argument on May 10, 2012, from two uninsured patients that claimed a non-profit hospital overbilled them. Specifically, they claimed the Hospital charged them more than insured patients for the same treatment. Both patients acknowledged signing contracts for payment in which they agreed to pay the Hospital’s bill if the “account is not paid by a private or governmental insurance carrier.” In response to the Hospital demand for payment, the patients argued, based on a long standing line of Indiana case law, that; where no specific price is specified in the contract for services, the law implies a promise to pay only a “reasonable charge” for the services. The patients argued unless the charge is specified in advance of the treatment a “reasonable charge” would be based on what is commonly charged to the majority of other patients in the community. (more…)

Normally a physician who is not actually “employed” by a hospital is not an employee who would be protected by anti-discrimination laws. But it’s not always that simple. In fact, it can be quite complicated and risky for a hospital if the relationship is not clearly established. If the relationship is not clear then a jury may ultimately be deciding whether or not a physician is entitled to proceed with sexual harassment and retaliation claims as an “employee”. (more…)

House Reconciliation Bill Cuts Health Care Spending

The House of Representatives voted along party lines Thursday to pass a bill that makes major cuts in Medicaid spending while allowing across-the-board Medicare cuts to take effect as scheduled. The budget reconciliation bill introduced earlier in the week by House Budget Committee Chairman Paul Ryan and adopted by the House without amendment blocks automatic cuts to the Pentagon budget that are part of last year’s debt-ceiling agreement and the looming sequestration. The legislation also repeals the Prevention and Public Health fund in the Affordable Care Act (ACA) and allows states to cut Medicaid enrollment. House Democrats refused to support the measure because it failed to seek additional tax revenue from those earning higher incomes. In the Senate, Republicans intend to offer a similar measure as an amendment to a military spending bill up for consideration next week. However, Senate Majority Leader Harry Reid has made clear that such a measure will not receive a vote by the full Senate without the addition of revenue generating provisions, and President Obama has pledged a veto.

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Wisconsin Physicians Service (WPS) will soon begin to serve as the Medicare Administrative Contractor (MAC) for Jurisdiction 8, which includes the states of Indiana and Michigan.  According to listserve communications, Indiana Part A providers and Michigan Part A providers will transition to WPS effective July 23, 2012.  Indiana Part B suppliers will transition to WPS effective August 20, 2012.  WPS is currently the Part B contractor for Michigan suppliers.

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