About JillM

This author has not yet filled in any details.
So far JillM has created 153 blog entries.

ON POINT WITH POs: Partnerships & Community Health Workers

By EWA MATUSZEWSKI
When you hear the name, Salvation Army, you think Red Kettle, right? As you should; but don’t just think about bell ringing at the holidays. Salvation Army, a faith-based, nonprofit organization dedicated to serving people in need without discrimination, can be an excellent partner to physician organizations and other healthcare groups seeking sustainable change in the community through grass roots efforts.

While I’ve been on the Metro Detroit Advisory Board of the of the Salvation Army since 2021, I was not asked to write about the organization. I just can’t help myself. Our working relationship started in 2020, when MedNetOne Health Solutions collaborated with the Salvation Army to bring [Read More]

ON POINT WITH POs: Partnerships & Community Health Workers2023-10-17T11:30:37-04:00

COMPLIANCE CORNER: OIG Announces Plan to Investigate Managed Care Contracts

By JENNIFER COLAGIOVANNI
Wachler & Associates, PC

In August 2023, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced its strategic plan for managed care oversight.  OIG’s plan involves rigorous oversight of managed care plans while also closely coordinating with the plans in the efforts to fight fraud, waste, and abuse. OIG’s plan will scrutinize Medicare and Medicaid managed care contracts from inception through enrollment, reimbursement, services, and renewal. In order to address fraud, waste, and abuse risks, the goal of OIG’s plan is to hold Medicare Advantage organizations (MAOs) and Medicaid managed care organizations (MCOs) accountable.

Currently, more than half of Medicare enrollees and [Read More]

COMPLIANCE CORNER: OIG Announces Plan to Investigate Managed Care Contracts2023-10-17T13:55:45-04:00

LEGAL LEANINGS: Value-Based Care Ushers In A New Era For Primary Care Providers

By ALLISON TUOHY & MARK E. WILSON
In an age of highly polarized opinions, there is a common consensus to address the rapidly rising health care costs in the United States. Research shows that the US average gross national product for health care costs is 17.1% while the rest of the world average is about 10.6%; the US missing that mark costs $1.7 trillion per year. There are numerous opinions and beliefs on how to achieve significant savings in health care without sacrificing quality of care.

Many believe that the current “fee-for-service” model simply incentivizes the health care system to treat “sick” patient symptoms rather than to practice preventative care. [Read More]

LEGAL LEANINGS: Value-Based Care Ushers In A New Era For Primary Care Providers2023-10-17T13:59:58-04:00

Remembering Pete Levine

When I started out as a reporter, I got to know the major players in healthcare in Michigan. Most came from Metro Detroit or Lansing. A few came from West Michigan. But there was this one guy who worked for a county medical society in the middle of the state who seemed to be involved in all of the major health policy debates and a bunch of obscure ones.

He was a bear of a man, tall and broad in stature with a booming voice and loud laugh that had the playful ring of childhood on the edges. He brought passion and caring to every issue on his docket. And he [Read More]

Remembering Pete Levine2023-10-17T11:08:11-04:00

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Immigrant Children, Pregnant Women Wouldn’t Need To Wait For Medicaid Under Bill

The five-year waiting period for immigrant children and pregnant women to be able to use Medicaid services in Michigan would be waived under a bill taken up by a House committee early this month.

Rep. Alabas A. Farhat (D-Dearborn) told the House Insurance and Financial Services Committee that HB 4740 would help the lives of immigrants while addressing infant mortality and children’s health issues.

“It’s transformational for some lives and helps ensure that there are safe patches for that child,” Farhat said.

Sara Ismail of the Arab Community Center for Economic and Social Services [Read More]

LANSING LINES2023-10-17T11:01:54-04:00

Abortion Restriction Repeal In Trouble In House

Six bills rolling back 30 years of abortion restrictions put on the books by Republican majorities moved through a House committee this morning, but their future in the full chamber is dubious after one Democrat came out against them and more may be on the way.

Rep. Karen Whitsett (D-Detroit) issued a press release two minutes before today’s House Health Policy Committee that she would not support the 11-bill Reproductive Health Act, which includes legalization of late-term elective abortions.

One piece of the package allows taxpayer money to fund elective abortions, which Whitsett said she could not support at a time when many seniors in her district live in poverty.

“Elderly citizens across our state are forced [Read More]

Abortion Restriction Repeal In Trouble In House2023-09-27T14:02:41-04:00

The Wows And Woes Of Healthcare Artificial Intelligence

By EWA MATUSZEWSKI

I’ve been hesitant to dip my toe into the artificial intelligence (AI) discussion in this forum because so much has been written about it in a short period of time. What can I add at this early juncture? I changed my mind after a healthcare tech colleague recently asked me to test out a platform using AI that helps clinicians access evidence-based guidelines or even determine if a patient needs to have a consult with a specialist. While I’m not a clinician, it’s not unusual for me to test products and services that may help our healthcare provider members in their quest to provide high quality care. Following [Read More]

The Wows And Woes Of Healthcare Artificial Intelligence2023-09-27T13:58:08-04:00

ADELMAN’S ANALYSIS: Evolving Marijuana Policy Is High On Questions, Low On Answers

By SUSAN ADELMAN, MD
As most might guess, marijuana is the commonest illegal drug in the United States. An estimated 48.2 million people used it at least once in 2019. The percentage of U.S. drivers with marijuana detected in their blood was 8.6% in 2007 and rose to 12.6% in 2013-14. Should marijuana be legalized nationally? For safety’s sake, are there legal blood limits for drivers?

Marijuana and hemp come from the Cannabis sativa plant.  Legally, hemp is defined as any part of the cannabis sativa plant that contains 0.3 percent or less of THC (tetrahydrocannabinol), while marijuana contains more than 0.3 percent THC. THC is the substance that causes a high. [Read More]

ADELMAN’S ANALYSIS: Evolving Marijuana Policy Is High On Questions, Low On Answers2023-09-27T13:53:49-04:00

COMPLIANCE CORNER: CMS Increases Scrutiny on Hospice Providers

By DANIEL AYYASH

Overview

At its core, hospice provides palliative care and support for terminally ill individuals and their families. People who elect to receive hospice care generally receive this care in the home setting by a team of professionals and caregivers who are specially trained to address the sensitive needs of those nearing end of life. In addition to meeting patients’ physical needs, hospices provide care for the “whole person,” which includes care that meets their emotional, social, and spiritual needs. Being able to provide beneficial, high-quality care is critical to the successful efforts of hospice providers. Recently, the Centers for Medicare & Medicaid Services (CMS) indicated that they have noticed [Read More]

COMPLIANCE CORNER: CMS Increases Scrutiny on Hospice Providers2023-09-27T13:48:02-04:00

LEGAL LEANINGS: Tax Issues in Issuance or Repurchase of Equity in Physician and Other Practice Groups

By RALPH Z. LEVY & CYNTHIA A. MOORE

Adverse tax issues can arise for physicians and other professional practice groups interested in issuing equity to attract and retain junior physicians.  If equity is issued at below fair market value, the new equity owner will incur significant federal income tax consequences on issuance.  If the new practice entity owner leaves the practice, the practice entity could experience difficulty in funding the amount needed to repurchase the equity from the departing professional.  These adverse tax and other consequences at buy-in and buy-out can be avoided by proper planning and a well-designed buy-sell agreement.

 Issues for the New Practice Owner

Federal tax law taxes income of [Read More]

LEGAL LEANINGS: Tax Issues in Issuance or Repurchase of Equity in Physician and Other Practice Groups2023-09-27T13:40:01-04:00
Go to Top