Healthcare Law Briefs
March 5, 2004
CMS Finalizes Reassignment Rules
We reported
in our February 13, 2004 email newsletter that the Medicare Prescription
Drug Act of 2003 significantly changed the reassignment rules for
Medicare billing, but that the statutory change was subject to
regulations to be issued by the Department of Health and Human
Services. At the time the Prescription Drug Act was passed in December
2003, we were uncertain about how long it would take HHS to issues these
rules.
Fortunately, CMS has issued a rules change in unusually quick order. On
February 27, 2004, CMS issued Transmittal 111 providing guidance to the
carriers regarding the reassignment changes and adding the additional
safeguards mandated by the statute.
Transmittal
111 authorizes carriers to make payments to an entity which is already
enrolled in the Medicare program for services provided by physicians or
other providers "under contractual arrangements". This effectively
eliminates the prior reimbursement requirements that there either be a
W-2 relationship in order to enroll in the assignment account or, for
independent contractors, that the assignment account apply to health
care delivery systems/clinics, because Transmittal 111 allows
reassignment regardless of where the service is performed. The problem
with the prior independent contractor arrangement was that clinic was
defined as a facility owned and leased by the provider, thereby
significantly restricting joint venture arrangements.
With
respect to the safeguards, Transmittal 111 requires joint and several
liability by the billing entity and the provider and mandates that the
provider have unlimited access to the claims records.
If you have
any further questions about this, or would just like a copy of
Transmittal III, please contact Mike Cassidy at
mcassidy@tuckerlaw.com.
<Top
>For more information about the
topics presented in this newsletter please contact one of the
Healthcare
Attorneys:
Read
the December 2003 issue of our HEALTHCARE
NEWSLETTER.
 Tucker Arensberg,
P.C.
1500 One PPG
Place Pittsburgh, PA 15222 412/566-1212
<Back |
