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This publication explains the Social Security information that is free and should not be paid for.
Social Security: If You're Self-Employed

This fact sheet explains the process of reporting self-employed earnings to the government.
OIG Challenges Hospital Ã‚â€“ Physician "Gainsharing" Arrangements What Is Left For Hospitals?
John Oakes 1 of Paul, Hastings, Janofsky & Walker LLP
This Client Alert considers the implications of the Summary of the Office of the Inspector General (OIG) Bulletin regarding Gainsharing agreements.
What is Medicare
Estate Planners of Arkansas, P.A.
Medicare is a government program for people over 65. The program is divided into two parts.
Stark II: What it Means for Group Income Distribution Plans
Deborah W. Larios of Waller Lansden Dortch & Davis LLP
For many medical groups, revenues from ancillary services make up a substantial portion of the group's profits. Inc.
Legal Rights Of Senior Citizens

This article tells you about some of your legal rights as a senior citizen and it explains how you can protect those rights.
The Interaction of Workers' Compensation Benefits on Medicare
Susan R. Wasserman of Law Offices of Susan R. Wasserman
Reprinted with permission of California Workers' Compensation Enquirer, June, 1992 There exists two separate an.
Arent Fox Alerts: The Medicare, Medicaid, and SCHIP Refinement Act
Allison Weber Shuren
This article reviews some of the key provisions of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999.
Florida Legislature Amends Patient Self-Referral Act
Broad and Cassel
In the dying minutes of the 1999 session , the Florida legislature amended the Florida Patient Self-referral Act (t.
OIG Issues Guidelines for Voluntary Disclosure of Health Care Fraud
Dykema Gossett PLLC
On October 21, the Department of Health and Human Service's Office of Inspector General (OIG) released its Provider.
How Durable is Your Supply Business? -- New HCFA Rules Put it to the Test
Patricia Powers Boujoukos of Waller Lansden Dortch & Davis LLP
Business already is plenty complicated for durable medical equipment (DME) suppliers; the federal government has ju.
OIG Publishes Draft Compliance Guidelines For Hospices
Connie A. Raffa,Deborah Randall 0,Susan Kayser 1,Larri Short 2 and Robert Wanerman 3 of Arent Fox LLP
This Alert looks at draft guidelines for Hospices seeking to develop internal compliance programs to prevent and detect violations of federal and state law.
CMS Loosens Restrictions on Medicare Billing Reassignment of Physician Fees
Susan L. Fine of Davis Wright Tremaine LLP
Medicare now permits an entity to submit Medicare bills and receive payment for services furnished by a physician with whom it has a contract, regardless of where the services are furnished or whether an employer-employee relationship exists. This new rule greatly enhances flexibility for hospital-physician contracting.
Social Security: Your Payments While You Are Outside The United States
Social Security Administration
This publication explains how to receive benefits while living outside the U.S.
New Health Options Available Under Medicare+Choice
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which describes new Medicare options available to consumers under the Medicare+Choice plan.
Georgia Medicaid Law--1999
Ruthann P. Lacey, P.C.
The costs of long term health care can be staggering. For many people, being prepared to meet them can be an even .
Social Security: Your Taxes Ã‚Â… What You're Paying For and Where Your Money Goes
Social Security Administration
This publication explains what the Social Security Administration does and what the money is used for.
EEOC Announces Relief For Employers Providing Retiree Health Benefits
Lisa C. Chagala of Littler Mendelson, P.C.
On April 22, 2004, the EEOC approved a final rule that would permit employers to provide lesser benefits to retirees who are eligible for Medicare than to retirees who are not yet eligible for Medicare. This final rule would provide employers the opportunity to maintain certain retiree health programs, such as Medicare bridge programs and Medicare carve-out programs, with reduced risk of violating the EEOC's policy on the Age Discrimination in Employment Act ("ADEA").
Beware of What You Wish: D&O Allocation, Entity Coverage, and Bankruptcy
Boris Feldman of Wilson Sonsini Goodrich & Rosati
This article discusses fundamental changes in Director and Officer (D & O) liability insurance policies over the last few years.
HHS Audit and Investigation Priorities in 1999
Scott D. Godshall of Pepper Hamilton LLP
This article examines the HHS's focus on compliance programs and qui tam litigation in 1999.
Update: Corrections To Proposed Privacy Rule
Mark Tatelbaum 0 and Robert Waters 1
This article contains corrections to the Department of Health and Human Services proposed rule for Standards for Privacy of Individually Identifiable Health Information.
HCFA clarifies -- somewhat -- self-referrals The (Charlotte) Business Journal
Joel M. Leander of Womble Carlyle Sandridge & Rice, PLLC
New proposed regulations recently published by the Health Care Financing Administration, the federal agency respons.
Fraud In Managed Care Part I
Cadwalader, Wickersham & Taft LLP
This is the first of several columns that will analyze the emerging issue of fraud in the world of managed care. .
The Many Faces of Health Care Fraud

In previous columns, we have explored the federal government's increasingly aggressive war on health care fraud and.
Department of Health and Human Services Advisory Opinion: Arrangement for the Provision of Back-Up Emergency Ambulance Services
Dept. of Health and Human Services
Advisory letter from the Department of Health and Human Services which discusses whether an arrangement for the provision of back-up emergency ambulance services constitutes prohibited remuneration within the meaning of the anti-kickback statute, section 1128B(b) of the Social Security Act.
Private Contracts with Practitioners Who Do Not Provide Services Through the Medicare Program
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which describes Medicare payments to medical practitioners under private contract in the Medicare program.
Medicare Definition of Fraud
Dept. of Health and Human Services
Brochure produced by the Department of Health and Human Services which describes the definitions of fraud under Medicare in connection with entitlement or payment under the Medicare program.
How to Report Medicare Fraud and Abuse
Dept. of Health and Human Services
Brochure for consumers from the Department of Health and Human Services which provides the steps to take when reporting Medicare fraud.
Medicare Fraud Tips
Dept. of Health and Human Services
List of tips prepared by the Department of Health and Human Services which will help consumers detect fraud in their Medicare services.
Program of All-Inclusive Care for the Elderly: Questions and Answers
Dept. of Health and Human Services
Brochure from the Department of Health and Human services providing answers to questions regarding the program of all-inclusive care for the elderly.
OIG Publishes Final Rule Concerning Exclusion of Indirect Provides
Broad and Cassel
Recently, the Office of Inspector General of the Department of Health and Human Services (the "OIG") published its .
Office of Inspector General Releases 1999 Work Plan
Perling, Lester J. 1 of Broad and Cassel
The Office of Inspector General of the Department of Health and Human Services ("OIG") issues a Work Plan for each .
Client Alert: APRIL 2000
Kenneth J. Yood of Paul, Hastings, Janofsky & Walker LLP
This article reviews the new regulations issued by the Health Care Financing Administration (HCFA) setting forth the requirements to obtain and maintain provider-based status under the Medicare Program.
Social Security: How Its Financed

This publication explains how Social Security is Financed.
Social Security Benefits And Disability Programs For Those Battling With Kidney Disease
Law Offices of Susan R. Wasserman
The following questions are those most frequently asked by persons who are surviving one of the many forms of kid.
Nursing Homes May Challenge Medicare and Medicaid Regulations
Tydings & Rosenberg LLP
A federal appellate recently ruled that nursing homes have standing to challenge Medicare and Medicaid regulations .
Frequently Asked Questions: What is Medicare
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which answers frequently asked questions from consumers about Medicare.
Where Managed Care Plans Have Decided Not to Renew Their Medicare Contracts
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which outlines for consumers their options when a health care providers decides to non-renew a Medicare contract.
U.S. Tax Considerations for International Medical Students and Physicians
Paula Noyes Singer of Vacovec, Mayotte & Singer, LLP
I. Introduction A. The U.S. tax federal tax laws are the most complex body of law in the world. The t.
Health Care Financing Administration Issues Proposed Stark II Regulations
Gabriel L. Imperato of Broad and Cassel
Recently the Health Care Financing Administration ("HCFA") issued proposed regulations interpreting the Stark law. .
Medicare Revises Incident-to Rule
Lester J. Perling of Broad and Cassel
Medicare recently revised its rule pertaining to the provision of incident-to services (services and supplies that .
Medicare Overpayments and Income Tax Deductions
Steve Lawrence Waserstein of Broad and Cassel
A person or entity is entitled to deduct from income for tax purposes a repayment of Medicare reimbursements to a M.
Provider-Based Entities
Jodi B. Laurence of Broad and Cassel
The Health Care Financing Administration ("HCFA") recently clarified its policy regarding provider-based designatio.
Long Term Care
Connie A. Raffa of Arent Fox LLP
As our population ages, increasing numbers of individuals will require long term health care services. Services provided by home health agencies allow elderly individuals to receive medical and supportive assistance while remaining at home. Assisted living facilities serve those who cannot live on their own, i.e. , they require assistance with bathing, dressing, ambulating and the other activities of daily living. For those who require more complex or round-the-clock health services, nursing homes may be the best alternative.
Office of Inspector General Issues New Advisory Opinions
Lester J. Perling of Broad and Cassel
Since our last newsletter, the Office of Inspector General ("OIG") has issued several advisory opinions, which rela.
HHS Office Of Inspector General Publishes New And Revised Anti-Kickback Safe Harbors
Arent Fox LLP
On November 19, 1999, the HHS Office of Inspector General (OIG) published a final rule amending its existing anti-kickback safe harbors, and adding new safe harbors. This Alert outlines the new and revised safe harbors created by the final rule.
Safe Harbors for Ambulatory Surgical Centers
Bruce D. Armon of Saul Ewing LLP
Physicians now have a Safe Harbor if they wish to invest and expand their practice into an ambula.
In the Wake of the Tenet Investigation, CMS Issues Program Memorandum on DRG Outliers
Robert G. Homchick of Davis Wright Tremaine LLP
Last month, federal regulators launched a review of Medicare "outlier" payments to Tenet hospitals. An outlier is an inpatient case that is so expensive it exceeds the anticipated cost thresholds established by the Medicare Program. As a consequence, instead of paying the hospital on the diagnostic related group (DRG), the Medicare Program pays the hospital at a higher or outlier rate.
The 2003 Medicare Prescription Drug, "Improvement" And Modernization Act Provides Increased Revenue Opportunities

Signed into law on Dec. 8, 2003, the Medicare Prescription Drug, Improvement and Modernization Act, P.L. 108-173 (the "Act"), with close to 200 major sections, has been called the largest overhaul to the Medicare Program since its inception. The Act not only creates a historic prescription drug benefit, but makes significant payment changes to Medicare Part A and Part B, and Medicaid. Congress has hailed the Act as correcting existing payment "inequities."
Program of All-Inclusive Care for the Elderly (PACE) History
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which describes the history of the All-Inclusive Care for the Elderly program under Medicare and Medicaid.
Fact Sheet: Protecting Medicare Beneficiaries After HMOs Withdraw
Dept. of Health and Human Services
Fact sheet prepared by the Department of Health and Human Services which describes how Medicare beneficiaries benefits are protected when an HMO withdraws its existing Medicare contract.
Florida Legislature Yields to DCS's Interpretation of Florida Patient Self Referral Act
Michael P. DeVoe of Broad and Cassel
During the 1998 legislative session, the Florida legislature declined to override the First District's highly criti.
Fraud In Managed Care Part II
Cadwalader, Wickersham & Taft LLP
This is the second of three columns that discuss fraud in managed care programs. The first, published on Sept. 30,.
New Outpatient PPS Regulations and Provider-Based Status
Robert B. Ramsey of Buchanan Ingersoll & Rooney PC
On April 7, 2000, the Health Care Financing Administration (HCFA) issued final regulations regarding the P.
Medicare + Choice
Railroad Retirement Board
Brochure from the Railroad Retirement Board which discusses how Railroad retirement beneficiaries, like social security beneficiaries, are being offered additional health care options under the new Medicare + Choice Program provided by the Balanced Budget Act of 1997.
New Liability Concern for Providers
Jane Hyatt Thorpe of Waller Lansden Dortch & Davis LLP
Check Medicare Status of Contractors Hospitals and physicians now face yet another concern when entering into co.
Reassignment Rules may Confuse Physician
Stephen L. Page of Waller Lansden Dortch & Davis LLP
The Health Care Financing Administration (HCFA) is stepping up efforts to address the abuse of physician billing nu.
Medicare Hospice Benefits
Dept. of Health and Human Services
Information on hospice benefits under Medicare hospital insurance from the Department of Health and Human Services.
Health Care Fraud and Abuse and Voluntary Disclosure
Gabriel L. Imperato of Broad and Cassel
The increased enforcement efforts of the state and Federal governments against those providers and suppliers who al.
PSOs: A New Opportunity for Providers
Jodi B. Laurence of Broad and Cassel
For many years, hospitals and physicians have been lobbying to be able to contract directly with Medicare beneficia.
Home Health Agencies Learn That Nothing is Constant But Change
Dykema Gossett PLLC
The year 1997 has been a busy regulatory year for home health agencies ("HHAs") that transact business .
Provider-Based Status: Proposed Rules Require Advance Determination
Patricia Owen Powers of Waller Lansden Dortch & Davis LLP
The Health Care Financing Administration (HCFA) proposed rules on Sept. 8 for the payment of hospital outpatient se.
Recent District Court Decision May Hamper Employers’ Ability to Reduce Retiree Health Care Programs for Medicare-Eligible Retirees
Steven J. Friedman and Lisa C. Chagala of Littler Mendelson, P.C.
In AARP v. Equal Employment Opportunity Commission, the U.S. District Court for the Eastern District of Pennsylvania blocked the EEOC from issuing a final rule that would permit employers to provide lesser retiree health benefits to retirees who are eligible for Medicare than to retirees who are not yet eligible for Medicare.
OIG Issues Special Advisory Bulletin on Contractual Joint Ventures
Robert G. Homchick of Davis Wright Tremaine LLP
The Special Advisory Bulletin issued on April 23, 2003, by the Office of Inspector General is raising concerns throughout the health care industry about the legality of a variety of provider joint ventures. The suspect arrangements involve a health care provider expanding into a related service line by contracting with an existing provider of that service to serve the Provider's existing patient population.
Health Law Advisory Bulletin: Changes to Prescription Drug Benefits Under New Medicare Act
Marissa A. Olsen of Davis Wright Tremaine LLP
The Medicare Prescription Drug, Improvement and modernization Act of 2003 contains the most extensive changes to Medicare since the program was enacted in 1965. Historically, Medicare has provided only a limited outpatient prescription drug benefit under Medicare Part B. Under the new law, eligible beneficiaries will be able to purchase drug discount cards starting in June 2004 and enjoy comprehensive prescription drug coverage under a new Medicare Part D beginning in January 2006.
Selecting an e-Discovery Service Provider in an Uncertain Market
Laura Webster, Solution Design Architect, Fios, Inc. 1
In today's economy, corporations and law firms can incur significant risk if they rely on e-discovery vendors that are not financially stable. Loss of data access due to provider bankruptcy or system shutdowns can be fatal to a case. To help clients evaluate the viability of your current or future service providers, Fios has developed the following “e-Discovery Service Provider Due Diligence Checklist”
Department of Health and Human Services Advisory Opinion: Discounted Ambulance Services

Advisory letter from the Department of Health and Human Services which discusses certain arrangements for discounted ambulance services provided to residents of Medicare skilled nursing facilities under the anti-kickback statute, section 1128B(b) of the Social Security Act.
Unitization--A Mathematical Formula To Calculate Redeterminations
Andrew B. Derman and Andrew B. Derman of Thompson & Knight LLP
Unitization equity redeterminations cause nightmares for those working in the upstream sector. The concept is not the problem; the process is. The typical equity redetermination process is ambiguous and contentious, often resulting in arbitration and/or litigation.
Gainsharing Arrangements with Physicians
Broad and Cassel
Since the hospital prospective payment system ("PPS") was introduced in the mid-1980s, hospitals have been trying t.
Clarifications of Designated Health Services and Other Definitional Clarifications Under the Regulations
Broad and Cassel
Designated Health Services The proposed regulations, unlike the Stark law, specifically define each item lis.
Health Care Financing Administration Issues Payment Suspension Rules
Broad and Cassel
The Health Care Financing Administration ("HCFA") recently issued final rules, effective January 2, 1997, governing.
Summary Provision
Broad and Cassel
The Stark law was unclear with regard to its application to Medicaid services. Because only services reimbursed by.
Coverage For State And Local Government Employees
Social Security Administration
This publication explains the two ways state and local employees may be subject to social security.
OIG Sets Provider Self-Disclosure Protocol
Michelle Bellamy Marsh of Waller Lansden Dortch & Davis LLP
What do you do if, during your compliance activities, you discover an overpaymen.
HCFA Clarifies Private Contracting Position
Deborah W. Larios of Waller Lansden Dortch & Davis LLP
The Fall 1997 Health Law Newsletter reported on a provision in the Balanced Budget Act which, when read literally, .
Prospective Payment System Final Rule Benefits Device, Pharmaceutical, and Biological Industries
Bruce D. Armon of Saul Ewing LLP
On April 7, 2000, the Health Care Financing Administration (HCFA) published its final regulation (65 FR 18,434 et s.
Prospective Payment System Final Rule Implementation Delayed
Bruce D. Armon of Saul Ewing LLP
Shortly after the June 2000 issue of Update went to print, the Health Care Financing Administration (HCFA) announce.
Draft Physician Compliance Program Released by Office of Inspector General
Saul Ewing LLP
On June 12, 2000, the Department of Health and Human Services' Office of Inspector General ("OIG") issued a draft g.
Prospective Payment System Final Rule For Hospital Outpatient Services Released-April 2000
Saul Ewing LLP
The Health Care Financing Administration ("HCFA") published its final regulation regarding the outpatient prospecti.
Electronic Health Records and the National Health Information Infrastructure
Paul T. Smith of Davis Wright Tremaine LLP
A broad-based public and private initiative is promoting the development of a national system of interoperable electronic health records (EHRs). This initiative raises challenging issues for health care providers, public health authorities, consumers and regulators.
Social Security: Household Workers
Social Security Administration
If you hire someone to work in your home, such as a cleaning person, a cook, a gardener or a baby sitter, there's important information to know about paying Social Security and Medicare taxes.
Medicare Has More To Offer
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which generally describes new benefits to consumers under Medicare.
Fraud Alert: Physicians Ordering of Certain Items and Services for Their Medicare Patients
Dept. of Health and Human Services
Fraud alert issued by the Department of Health and Human Services regarding the legal and programmatic significance to physicians of certifications they make in connection with the ordering of certain items and services for their Medicare patients.
Top Twenty Medicare/Medicaid Questions
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which answers for consumers the top twenty 20 questions most frequently asked by callers to the Medicare + Choice toll free line.
Operational Policy Letter: Transition from 1876 Risk to Medicare+Choice Enrollment and Disenrollment Policies
Dept. of Health and Human Services
Operational policy letter from the Department of Health and Human Services which provides answers to questions regarding the transition from ?1876 risk to Medicare+Choice enrollment and dis-enrollment policies.
Operational Policy Letter: Transition from 1876 Risk Members to Medicare+Choice Plans
Dept. of Health and Human Services
Operational policy letter from the Department of Health and Human Services which provides guidance regarding the transition to Medicare+Choice plans.
Medicare Supplemental Insurance
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which provides detailed information about Medicare supplemental insurance (also known as Medigap).
Medicare Contract Non-Renewal Questions and Answers
Dept. of Health and Human Services
Brochure from the Department of Health and Human Services which provides answers to some common questions about recent health care plans' decisions to non-renew their Medicare contracts in certain areas. The document is based on questions received from beneficiaries, members of Congress, state officials, beneficiary advocates, and others.
Operational Policy Letter: Notice of Discharge and Medicare Appeal Rights
Dept. of Health and Human Services
Operational policy letter from the Department of Health and Human Services which provides model language for Notice of Discharge and Medicare Appeal Rights (Formerly known as the Notice of Non-coverage - NONC).

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