Final Medicare Anti-Markup & IDTF Changes for 2009: What Labs, Pathologists & Imaging Providers Need to Know

The final 2009 Medicare Physician Fee Schedule rule, published in the Federal Register November 19, contains several provisions important to clinical laboratories, pathologists, and diagnostic imaging providers.

Perhaps most significant is a provision limiting how much Medicare can be billed for diagnostic testing services that are not considered to have been performed by a physician sharing a practice with the billing entity, including tests performed in a physician office or within a group practice and tests ordered by pathologists and radiologists.

The Centers for Medicare and Medicaid Services (CMS) had twice before proposed to apply anti-markup rules to such testing, but had delayed action (except for pathology services performed in a centralized building, which is already in effect). Under the final rule, the anti-markup provision takes effect January 1, 2009.

While CMS decided not to implement its proposal to require physicians, non-physician practitioners and their practice entities furnishing diagnostic testing services to enroll as independent diagnostic testing facilities (IDTFs), it is extending the IDTF enrollment requirement to mobile diagnostic imaging providers and is requiring these mobile IDTFs to bill directly for their mobile diagnostic Medicare services.

Join us during this national 90-minute webinar to find out just what these changes will mean for you and your organization.

During this program, you’ll:

Find out what CMS finalized as part of the 2009 Medicare physician fee schedule rule
Understand how these provisions affect your ability to bill Medicare for your diagnostic testing services
Determine whether you need to modify any billing arrangements to comply with the anti-markup regulation
Get insight into how laboratories, pathologists, and imaging providers feel about the changes

You’ll also have the opportunity to ask questions in our interactive Q&A portion of the program. Take this hassle-free approach to learning about final Medicare changes for 2009 and what they mean for you. And you can invite your entire staff—for one low fee.

FEATURED SPEAKER:

Robert Mazer, Esq.
Ober/Kaler

Rob Mazer is a principal in Ober|Kaler's Health Law Group. He represents hospitals, clinical laboratories and other diagnostic services providers, and physicians, particularly with respect to third-party payment, self-referral and fraud and abuse issues, and related business arrangements. Rob advises health care providers how to comply with reimbursement and regulatory requirements for diagnostic services while meeting their legitimate business objectives. He also assists providers facing government investigations and demands for the return of alleged overpayments made by government and private third-party payers.

Julie Kass, Esq.
Ober/Kaler

Julie Kass’ practice focuses on the fraud and abuse aspects of Medicare and Medicaid, including the Stark and anti-kickback laws and civil money penalties. She also has a vast knowledge concerning reimbursement issues. Her clients are from across the country and involve the spectrum of health care providers. A sample of her clients includes associations, hospitals, large physician groups, durable medical equipment suppliers, physical and occupational therapists, and long-term care facilities. Ms. Kass was named among the nation’s “Outstanding Young Healthcare Lawyers – 2004” and one of the “Outstanding Fraud and Compliance Lawyers for 2006.” Ms. Kass was formerly Senior Counsel, in the U.S. Department of Health and Human Services, Office of Inspector General. She is admitted to practice in the District of Columbia, Maryland and Pennsylvania. Education: University of Pennsylvania, (B.A., cum laude, 1991); University of Pennsylvania, (M.A., 1991); Case Western Reserve University School of Law, (J.D., summa cum laude, 1994). Member: American Bar Association; District of Columbia Bar Association; American Health Lawyers Association.

Host & Moderator:

Kimberly Scott
Senior Editor, Washington G-2 Reports

Kimberly Scott has primary responsibility forDiagnostic Imaging Intelligence ReportandG-2 Compliance Report.She has 25 years experience covering health care issues, both on a national and local level. she has worked as a medical reporter for a daily newspaper, as as editor for several health care publications, includingU.S. MedicineandRegulatory Affairs Focus, the monthly journal of the Regulatory Affairs Professionals Association. Since joining Washington G-2 Reports in 2001, Kim has focused primarily on health care compliance and business issues, with an emphasis on clinical laboratories and diagnostic imaging. She is author of Diagnostic Imaging Strategic Outlook and has contributed to a number of other reports published by Washington G-2 Reports.