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11 posts from July 2006

July 31, 2006

Court says medical residents' stipends may escape income and FICA taxes

A district court has held that there is no “per se” statutory rule that as a matter of law automatically prevents stipends paid by a hospital to medical residents from qualifying for the scholarship exclusion from income or the FICA student exclusion. However, the court also went on to say that whether these exclusions apply depends on the particular facts and circumstances in each individual case.

The district court held that whether the stipends are scholarships or eligible for the FICA student exception depends on the facts and circumstances of each case. First, the court rejected the IRS's argument that legislative history indicated that Congress intended that medical residents are covered by FICA and that such stipends can never be considered scholarships or eligible for the student exception. It also rejected that IRS stance that medical residents' stipends are not scholarships because a hospital extracts a quid pro quo from them.

A “qualified scholarship means any amount received by an individual as a scholarship...to the extent that the individual establishes that...such amount was used for qualified tuition and related expenses.” Thus, the court reasoned, the provision gives an individual an opportunity to prove that the amount received qualifies as a scholarship, rather than setting out a per se rule. The court stated that nothing in legislative history either stated or showed that Congress intended to make the stipends ineligible per se.

Finally, the district court also found the Internal Revenue Code (IRC Sec. 2121 (b)(10) unambiguous in that it didn’t categorically make stipends paid to medical residents ineligible for the exception.

For the FICA exception to apply the court ruled, the taxpayer or employer must only establish: (1) the service was performed in the employ of a school, college, or university; and (2) the service was performed by a student who is enrolled and regularly attending classes at such school, college or university.

July 26, 2006

NPI Number Reminder

When getting a National Provider Identification Number for your medical practice, remember that you only need to get one NPI for the tax identification number of the practice.

July 25, 2006

OIG 2006 Work Plan for Physician Practices

As a reminder, here is what the Office of Inspector (i.e. the government) plans to be looking at this year related to physician practices:

Billing Service Companies
Medicare Payments to VA Physicians
Care Plan Oversight
Ordering Physicians Excluded From Medicare
Physician Pathology Services
Cardiography and Echocardiography Services
Physical and Occupational Therapy Services
Payment to Providers of Care for Initial Preventive Physical Examination
Part B Mental Health Services
Wound Care Services
“Long Distance” Physician Claims
Potential Duplicate Physical Therapy Claims

More information can be found at the OIG's website.

July 20, 2006

New Human Resource Book for Physician Offices

For today's embattled medical practice managers, employee problems like these are the most time-consuming, costly, and difficult to resolve. Their effect can be devastating on your office environment, on your patients, and on your bottom-line.

Now there's help. HOW TO RECRUIT, MOTIVATE, AND MANAGE A WINNING STAFF isyour "what-to-do, what-not-to-do guide" to the healing powers of good medical practice staff management.

Author, speaker, and consultant, Laura Sachs Hills brings 20 years of experience helping medical practice professionals grow and improve their practices to every page of this practical book. In the no-nonsense style that is her trademark, Sachs Hills delivers :

Practical staff management advice Action checklists
Step-by-step instructions Field-tested examples
Sample dialogues And a CD-ROM full of ready-to-print-and-use forms and letters for every staffing circumstance that may arise.

With your copy of HOW TO RECRUIT, MOTIVATE, AND MANAGE A WINNING STAFF close at hand, you will have everything you need to know to develop and manage a first-rate professional staff.

Any Questions? (800)933-3711

July 19, 2006

Deficit Reduction Act of 2005 – Nine-Day Payment Hold

CMS Contractor Provider Education Resources Listserv and CMS JSM-06549, dated July 12, 2006 - A brief hold will be placed on Medicare payments for all claims during the last nine days of the federal fiscal year (Sept. 22 through Sept. 30, 2006). These payment delays are mandated by section 5203 of the Deficit Reduction Act of 2005 (DRA). No interest will be accrued and no late penalties will be paid to an entity or individual by reason of this one-time hold on payments. All claims held during this time will be paid on Oct. 2, 2006.


July 17, 2006

Ensure you receive the reimbursement you deserve

Conducting an E/M audit will help your practice enhance its compliance and revenue. Turn to Auditing Evaluation and Management Coding: A Step-By-Step Guide to Enhancing Your Practice’s Revenue and Compliance for the expert advice and guidance you need to perform an E/M audit at your practice.

This easy-to-follow book and CD-ROM will guide you through the entire E/M audit process from start to finish.

Click here to order or call 800/650-6787 and mention Source Code EZINEAD.

July 14, 2006

New Medicare provider-enrollment guidance issued

From the Medical Group Management Association (www.mgma.com):

In response to the new Medicare provider enrollment regulation and forms (CMS 855), the Centers for Medicare & Medicaid Services (CMS) has issued new guidance to contractors on provider enrollment.

The new guidance, located in the Medicare Program Integrity Manual (Pub. 100-08), Chap. 10, provides instructions to carriers on how to process the CMS 855 forms. The guidance contains some helpful information for providers and entities completing the CMS 855 forms. For instance, a group practice can avoid one reason for the return of a CMS 855I. For practices enrolled prior to 1996, administrators can avoid delay by submitting a CMS 855B. The practice may also need to submit new CMS 855Is and CMS 855Rs on behalf of any of its providers who enrolled in the Medicare program prior to 1996.

Read the provider education article.

July 13, 2006

Need a Physician Business Resource?

Don't forget to visit the healthcare resources of my website at www.rtacpa.com for articles, files to download, and flash presentations.

July 11, 2006


From the law firm of Vinson Elkins (V&E Health Mailings [healthmailings@velaw.com]):

In Advisory Opinion 06-08, the Department of Health and Human Services Office of Inspector General (OIG) reviewed whether a free clinic that is not enrolled as a Medicare provider and thus does not receive Medicare reimbursement, could dispense drugs to Medicare beneficiaries at no charge, even if the drugs are reimbursable under Medicare Part D. The clinic receives these drugs through various pharmaceutical manufacturer pharmaceutical assistance plans (PAPs). In determining that the relationship between the clinic and the PAPs did not pose any Anti-Kickback Statute risk, the OIG found it key that: (a) the clinic receives no remuneration from the PAPs; and (b) the clinic is not in a position to generate business for the PAPs reimbursable under Medicare and Medicaid. The OIG also concluded that there is no improper inducement to Medicare and Medicaid beneficiaries to use the services of the clinic in the form of free drugs because the clinic does not do any billing. Reporter, Andrew Ruskin, Washington, 202.639.6525 or aruskin@velaw.com.

July 07, 2006

Upcoming Physician Coding Seminar

Join HCPro Live for
Coder Productivity Challenges:
Strategies to improve retention, revenue, and HIM’s image

A 90-minute Audioconference on Friday, July 28, 2006 at 1:00 pm (Eastern)

Yes! I want to register—how do I sign up?