Half of Medicare Payments to Shift to Alternative Models by 2019

By | February 2, 2015

In news that affects hospital providers, the United States Department of Health and Human Services recently set goals and a timeline for shifting half of Medicare payments by 2019 to alternative models that are based on the quality, not quantity, of care that providers give patients.

HHS set the goal of tying 30 percent of traditional Medicare payments to quality through […]


Texting Patient Information: BTW, Do U Know the Risks?

By | January 13, 2015

Cindy Pechon also contributed to this post.

Does HIPAA allow health care providers to text protected health information (“PHI”) within an organization or to another health care provider? It is not expressly prohibited by HIPAA, but whether it is safe mostly depends on the adequacy of the controls used to safeguard PHI. Covered Entities, including health care providers, must comply with […]


Three Caplan and Earnest Attorneys Named to 5280 Magazine’s Top Lawyers List

By | January 13, 2015

BOULDER—Caplan and Earnest LLC health care law attorneys Linda Siderius, Sharon Caulfield and Jennifer Sullivan were named a 2015 “Top Lawyer” in 5280 Magazine’s debut listing of Denver’s best attorneys. The attorneys were three of only nine health care law attorneys honored in the magazine.

The listing includes 350 attorneys overall and is based on a rigorous peer-review process in addition […]


CMS Home Health PPS changes take effect Jan. 1

By | December 22, 2014

After proposing changes to the Medicare Home Health Prospective Payment System for 2015 this summer and receiving feedback in October, the Centers for Medicare & Medicaid Services (CMS) is set to implement the rule change on January 1, 2015. The HH PPS payment rates include continued implementation of the rebasing adjustments as required by the Affordable Care Act (“ACA”).

Some home […]


CMS Scrutinizing Hospital Use of New Modifier for ‘Clinically Unrelated’ Lab Billing

By | December 2, 2014

Officials from the Centers for Medicare and Medicaid Services announced recently that they are monitoring compliance in the use of the new L1 modifier when billing separately for “clinically unrelated” lab tests.

Use of the new modifier became effective July 1 and is intended for claims that are an exception to the typical Medicare packaging policy created for most outpatient lab […]


5280 Magazine Names Sharon Caulfield as Top Lawyer

By | September 15, 2014

BOULDER—Attorney Sharon E. Caulfield of Caplan and Earnest LLC was named a 2015 “Top Lawyer” by 5280 magazine in their debut listing of Denver’s best attorneys. Caulfield specializes in health care law.

The listing includes 350 attorneys and is based on a rigorous peer-review process in addition to research by the magazine’s editors.

Caulfield’s practice focuses on regulatory compliance and litigation for […]


Health Care and the 2014 Colorado Legislative Session

By | July 17, 2014

The 2014 Colorado Legislative Session resulted in some key pieces of health care legislation, thanks in part to the improving economy, which allowed the legislature to address several long-term needs in the state’s health care system.

Those needs included developing a strategic plan for enrolling intellectually and developmentally disabled persons into programs; encouraging in-home support services for persons with spinal cord […]


IRS Adopts New Taxpayer Bill of Rights

By | July 14, 2014

IRS Commissioner John Koskinen announced the adoption of the Taxpayer Bill of Rights on June 10, 2014.

The list of rights is as follows:

The Right to be Informed
The Right to Quality Service
The Right to Pay No More than the Correct Amount of Tax
The Right to Challenge the IRS’ position and Be Heard
The Right to Appeal an IRS Decision in an Independent […]


CMS Creates an Open Door for Provider Inquiries

By | June 9, 2014

Many healthcare providers have been frustrated at the Recovery Audit Process applied to the fee for service claims submitted by their hospital and long term care facilities. The scuttlebutt about the Recovery Audit Contractors has not been positive, leading CMS to issue a “Program Myths” paper on December 17, 2012. This Program Myths description addressed the complaints about RACs that […]


Security Risks Raise Liability Questions for Hospitals

By | May 27, 2014

Recent media coverage of security risks to hospital equipment and systems, and the possibility of incredibly costly liability issues associated with those risks, serves as a timely reminder to hospitals and other health care organizations to strengthen policies and procedures created to protect the privacy and security of their patients and maintain compliance with the Health Insurance Portability and Accountability […]