Some Hidden Gems in the Patient Protection and Affordable Care Act

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Given the wordiness of the Patient Protection and Affordable Care Act, it is no surprise that some surprises lurk deep within. A few selected pearls:

  1. Providers must return any Medicare overpayment within 60 days after identifying such an overpayment. An overpayment not returned during the 60 day period can be deemed a violation of the False Claims Act, whether or not the doctor intended to overcharge Medicare. Our take: It is probably not good to be on the receiving end of any allegation related to the False Claims Act.
  2. Regulations are being prepared to address updated Stark Law components of the health reform law. To wit, if you refer a Medicare patient for CT or MR in which he has an ownership interest, you will likely have to (a) get the patient’s signature on notification which (b) identifies names and contact info for competing CT scanners and MR imaging services within 25 mile radius. Our take: Don’t hold your breath to see if this provision is expanded for suppliers of non-medical goods to the federal government.

And one that affects not just doctors, but all small business owners. If you have aggregate legitimate business expenses over $600 with any individual entity, you will have to send that entity a year-end 1099 form. How hard could that be? Well, that could include restaurants, airlines, and arguably the corner gas station (if you have a favorite). Even the IRS has stated this provision is burdensome. When the IRS takes the side of the taxpayer, can’t everyone just agree the provision needs to evaporate?

1 thought on “Some Hidden Gems in the Patient Protection and Affordable Care Act”

  1. The 1099 rule already applies to farmers. They have to get their returns to the accountant by December in order to get all the 1099’s out on time. I probably have 20 venders that I can think of off the cuff that will require a 1099.

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Jeffrey Segal, MD, JD
Chief Executive Officer & Founder

Jeffrey Segal, MD, JD is a board-certified neurosurgeon and lawyer. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country's leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

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