Beard Audio Conferences

New Medicare Anti-Mark Up Rule: Big Changes for Diagnostic Service Billings

Location: Your office or conference room (no need to travel!)

Date : Audio CD Available

Time(s):

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Hosted By : Nightingale's Healthcare News and The Beard Group Law and Business Publishers

This conference will include:

The new 2008 Physician Fee Schedule released by CMS in November includes major and for some healthcare providers, profit shattering changes to the reimbursement rules for diagnostic tests.

The newly expanded Anti-Mark Up Rule affects a providers ability to bill Medicare for more than the cost of diagnostic tests that are either purchased by the provider or done in certain provider offices (such as one where the provider doesnt provide substantially the full range of the providers services).

Just as importantly, these new rules apply whether or not your practice meets the in-office ancillary services exception under Stark.

With this Audio CD (recorded in late November 2007), let a trio of the nations leading healthcare attorneys along with senior CMS representatives Donald Romano and Lisa Ohrin explain the new rules, answer your questions, and get you and your colleagues up to speed quickly on the changes, including

Whos covered by the newly expanded Medicare anti-mark up rule
When does the new rule take effect
Site of service as the key factor in determining mark up
New CMS definition of office when applied to physician organizations such as professional corporations or medical groups
Existing arrangements that will require restructuring
How the new reimbursement rates will be calculated
Addition of professional components as well as technical ones
Impact of employment status of test performers including independent contractors and part-time employees
Relationship of new rules to existing Stark requirements
CMS insights and perspectives about the new rules

Who Will Benefit:
Any provider of diagnostic ancillary services (including both imaging and lab) and managers, compliance personnel, in-house counsel, accountants, and other consultants involved in diagnostic ancillary services.

Speaker(s):

	Chairman: Norton L. Travis Garfunkel, Wild & Travis, P.C.
Norton L. Travis is a founding member of the healthcare law firm, Garfunkel, Wild & Travis, P.C. Since 1980, his practice has been devoted solely to representing health care clients, and has focused primarily on transactional matters, including mergers and acquisitions, joint ventures, and related corporate matters. As Chair of the firms Business Practice Group, Mr. Travis represents both regional and national companies active in diagnostic testing, managed care and other areas. He has also assisted many hospitals in joint ventures with outside businesses to maximize third-party revenue opportunities, while ensuring compliance with state and federal regulatory and tax exemption requirements. His role includes providing assistance on day-to-day operations and business strategies that support his clients growth and development. Mr. Travis also provides counsel on regulatory compliance (e.g., state and federal fraud and abuse, anti-kickback and self-referral laws), antitrust, and third-party reimbursement, as well as other key issues affecting health care businesses. Mr. Travis is listed in the 2006 and 2007 edition of The Best Lawyers in America under the specialty of Health Care Law as well as being recognized by the Chambers USA Guide.
	Donald H. Romano Centers for Medicare and Medicaid Services (CMS)
Donald Romano is the Director of the Division of Technical Payment Policy within the Center for Medicare Management, Centers for Medicare & Medicaid Services (CMS). His division is responsible for, among other areas, the agency's administration of the Stark law. Previously, he was a Senior Attorney in the Office of the General Counsel, CMS Division, in which he had litigation, program advice and program integrity responsibilities. He received his J.D. from the University of Baltimore in 1984, and his undergraduate degree in Music Performance from Towson State University in 1977. He is a member of the Maryland and Massachusetts bars.
	Hayden S. Wool Garfunkel, Wild & Travis, P.C.
Hayden S. Wool is a partner at Garfunkel, Wild & Travis, P.C., where his practice includes the structuring of hospital-physician relationships, physician group relationships, review of the structure of business transactions, and issues regarding proper reimbursement for healthcare activities. He has particular expertise in the application of federal and state laws governing self-referral (Stark Law), anti-kickback, fee-splitting, and professional misconduct.
	Lisa Ohrin Centers for Medicare and Medicaid Services (CMS)
Lisa Ohrin has practiced health law for 13 years in a variety of settings and specialties. She currently is the Director of the Division of Technical Payment Policy within the Center for Medicare Management at CMS. This division is responsible for developing policy and regulations related to the physician self-referral law, issuing advisory opinions regarding the same, overseeing enforcement of Medicare-approved transplant centers, and handling a variety of statutory and regulatory Medicare payment issues. Previously, Lisa worked for an integrated hospital system, national long term care provider, private law firm, the University of Maryland School of Law, and a Harvard teaching hospital, where she focused primarily on Medicare reimbursement issues. In addition to her health law practice, Lisa teaches law school courses and seminars on general health care law, the physician-patient relationship, Medicare law, long term care law, and the practice of health law.
	Steven J. Chananie Garfunkel, Wild & Travis, P.C.
Steven J. Chananie is a partner at Garfunkel, Wild & Travis, P.C., and the head of the firms Compliance and White Collar Defense Practice Group. In his practice, he represents many health care providers, helping them to set up comprehensive compliance programs and advising them on regulatory and fraud and abuse issues. His clients include hospitals, faculty practice plans, laboratories (both independent and hospital-based), physician practices, nursing homes, and home health agencies.

New Medicare Anti-Mark Up Rule: Big Changes for Diagnostic Service Billings


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