Healthcare Fraud, Medicare Exclusion, and Federally Funded Healthcare

The Department of Health and Human Services, Office of the Inspector general is producing a series of informative videos on compliance issues pertaining to Medicare and Medicaid. Here is one such video on Exclusion Authorities and Effects of Exclusion.  If a physician is excluded from participation in any federally funded healthcare program, they cannot accept federal funds or practice in a similar setting where such funds are received.  This video also defines the differences between mandatory exlucisions and permissive exlusions.  Exclusion from medicare or other federal programs doesn't just apply to licensed clinicans, but also includes unlicensed personnel, corporations and their officers.  Length of exlusion can be for a set term or indefinitley.  Minimum term for mandatory exlusion is 5 years; reinstatement is not automatic after the end of the term.

Great tool from the American Medical Association - 2009-2010 RBRVS Calculator

Though a bit dated, the AMA has a cool resource which you can download from their website. I just came across it, so maybe I'm the one who's dated!! It's an RBRVS calculator showing the SGR cut without passage of H.R. 3961.

From their website:

Download the 2009-2010 RBRVS Calculator
"Find out how the 2010 SGR cut will affect you if Congress does not pass H.R. 3961, the “Medicare Physician Payment Reform Act of 2009”. This free software program, developed by MIT Solutions, Inc., reports individual RVUs and calculates adjusted and unadjusted totals as well as calculating the Medicare allowable. This program performs both a complete RBRVS analysis for the 2009 database as well as a practice- or physician-specific Medicare financial impact analysis by comparing RVU, conversion factor and Medicare frequencies for 2009 data to 2010 data."