Relevant and realistic scary movies can create strong fears that linger for days. A recent settlement of a qui tam lawsuit is very relevant and realistic for thousands of physician-owned ambulatory surgery centers (ASCs). 

 Meridian Surgical Partners, a national ASC company, and litigation law firm Sanford Heisler, LLP, announced on September 10, 2014 that they have settled a qui tam lawsuit brought by a former employee at one of Meridian's centers for $5.12 million.  Read More

In an effort to lower health care costs there is an increase in the number of insurance companies and employers setting limits on specific medical services. 

Read More Plans Opt for Spending Limits by Michelle Andrews of Kaiser Health News

 

Medicare is cutting payments to hospitals because patients came back to the hospital too frequently. From Oct. 1, 2014 through Sept. 30, 2015 three-quarters of hospitals that are subject to the Hospital Readmissions Reduction Program are being penalized. This means that they will receive lower payments for those patients who are readmitted and also for every Medicare patient hospital stay.

Jordan Rau of Kaiser News reports "One reason for the higher and more widespread fines is that this year Medicare began evaluating readmissions of two new categories of patients-those initially admitted for elective knee or hip replacements, and those suffering lung ailments such as chronic bronchitis. Those patients were assessed along with the heart failure, heart attack and pneumonia patients Medicare has examined since the penalties began in October 2012."  Read More

The National Bone Health Alliance and National Osteoporosis Foundation were recently approved by CMS to launch an osteoporosis Qualified Clinical Data Registry (QCDR) for the CMS Physician Quality Reporting System (PQRS) 2014 program year. This new registry will allow eligible healthcare professionals to not only submit their performance data around PQRS and other measures but also drive performance measurement, benchmarking, population health management and practice improvement, while simplifying reporting for financial and professional incentive programs such as PQRS, Meaningful Use and Maintenance of Certification. A total of 14 quality measures (6 PQRS/8 non-PQRS measures) are included in the registry. Participants will be able to submit their quality measure results to CMS to meet their PQRS quality reporting requirements, which for the first time includes not only earning a 0.5% PQRS incentive payment this year but also AVOIDING A 1-2% DECREASE IN ALL MEDICARE REIMBURSEMENTS IN 2015 AND 2016. This registry will launch in early September 2014; in the meantime, visit www.medconcert.com/FractureQIR for more information or contact Debbie Zeldow, MBA, Senior Director, Clinical Programs, National Bone Health Alliance at debbie.zeldow@nbha.org or 202-721-6363.