Media Mentions
2012
“AHA Wants Medicare Measures Tied to Payroll Tax-Cut Legislation”
Modern Healthcare, January 22, 2012
Eric Zimmerman said that if Congress does not renew two programs that benefit Medicare-dependent hospitals and low-volume hospitals, the Medicare reimbursements for these generally smaller health care providers “could be pretty severely affected.”
Eric Zimmerman, Health, Health Care Law Reform
“Hospital Wage Index Formula Fix Delayed”
PoliticoPro, January 20, 2012
Eric Zimmerman, calling revision of Medicare’s index of hospital labor cost differences a “thorny problem without easy solutions,” noted that a reimbursement increase from the budget-neutral index for hospitals in high wage areas means “some of the hospitals win but many of the hospitals also lose.” He added that if Congress does not approve some financial help for the losers, “there are going to be a lot of disgruntled hospitals.”
Eric Zimmerman, Health, Health Care Law Reform
“Medicare Physician Pay Fix Extension to Dominate Congressional Action in 2012”
BNA Health Law Resource Center, January 13, 2012
Eric Zimmerman said that Medicare spending could again be targeted by Congressional budget reduction efforts. He noted that the failure of the joint committee on deficit reduction could mandate Medicare spending cuts of two percent or more, adding that because the mandated cuts would not take effect until 2013, Congress has time to alter them. Mr. Zimmerman also saw controversy over startup of the Independent Payment Advisory Board, saying “up to this point the IPAB has only been an idea,” but in 2012 “the administrative machinery that will enable the IPAB to operate” must be established, likely with controversy in Congress.
Eric Zimmerman, Health, Health Care Law Reform
“Supreme Court Ruling, Exchanges Top Issues for Health Insurers in 2012”
Bloomberg BNA Health Insurance Report, January 11, 2012
Eric Zimmerman cautioned health care stakeholders, “don’t expect much legislative change” to the Affordable Care Act in 2012 because the political situation in Washington, D.C., remains the same. “House Republicans may continue efforts to pick away at the law, and may approve some measures to repeal or scale back the law,” he said, “but those efforts are not likely to be enacted so long as Democrats control the Senate.”
Eric Zimmerman, Health, Health Care Law Reform
2011
“Life Support for Ailing Hospitals?”
Kaiser Health News, December 8, 2011
Eric Zimmerman said that possible cuts in federal spending to support small, rural “critical access hospitals” could result in hospital closures that “can have an outsized economic impact” on the towns where the hospitals are located. “Hospitals are like schools,” Mr. Zimmerman asserted. “Businesses aren’t going to locate in a town where there aren’t schools, and they aren’t going to locate in a town where there isn’t a hospital.”
“Budget Panel Fails to Reach Deal, Triggering Health Cuts in 2013”
BNA Health Law Resource Center, November 22, 2011
Eric Zimmerman warned that, although the congressional debt reduction panel did not agree on larger Medicare payment cuts than the automatic 2% reduction set for 2013, “Just because we have dodged the bullet for now does not mean we have dodged it for good.” Mr. Zimmerman said that physicians “ignore … at [their] own peril” the fact that Congress will continue to target health spending as the main driver of federal spending, resurrecting some of the same cuts discussed by the deficit panel.
Eric Zimmerman, Health, Health Care Law Reform
“Clock’s Ticking: Deadlock Leaves Industry Anxious”
Modern Healthcare, November 21, 2011
Eric Zimmerman suggested that the Supercommittee’s failure to agree on debt reduction provisions “doesn’t mean that other proposals can’t come together in either chamber in the month that’s remaining.” He added that once the clock starts ticking on automatic spending cuts on January 2, “Congress can come in any time before 2013 specifying how cuts can be made between now and then.”
Eric Zimmerman, Health, Health Care Law Reform
“As Health Lobby Looks Past Supercommittee, ‘Doc Fix’ Trumps Medicare Cuts”
The Hill, November 21, 2011
Eric Zimmerman predicted that, although Medicaid reimbursement to physicians is shielded from automatic cuts that kick in following failure of a congressional panel to agree on specific deficit reductions, “it’s just a matter of time before we’re back in the same kind of dialogue” on how to reduce payments to doctors.
Eric Zimmerman, Health, Health Care Law Reform
“Health Cuts Would Be Spread Over a Wide Variety of Programs”
Boston Globe, September 20, 2011
Eric Zimmerman said that an Obama Administration deficit reduction plan that includes Medicare and Medicaid cuts “will not likely advance as a package,” but stakeholders such as teaching hospitals and drug manufacturers “would dismiss it at their peril” because “individual aspects of it most certainly could advance.”
Eric Zimmerman, Health, Health Care Law Reform
“Industry to Supercommittee: Back Exchange Program”
Modern Healthcare, September 19, 2011
Eric Zimmerman criticized efforts by the Administration and Congress to squeeze cost savings from healthcare providers by attempting to crack down on alleged waste, fraud and abuse, “all for seemingly no reason than this is part of the oversight effort and fraud-crackdown effort – without errors and incidents that warrant that kind of scrutiny.” Noting that “politically, it’s easy to do” such investigations, Mr. Zimmerman warned that “at some point it adds to the cost of healthcare because of the administrative burden on the healthcare provider.”
“Potential Medicare Payment Cuts Alarm Doctors, Hospitals”
Boston Globe, August 3, 2011
Eric Zimmerman predicted “there will be a lot of hand wringing and anxiety over the next four months as we work through this process” of Congress considering modifications to the automatic Medicare cuts contained in the deficit-reduction act. “Health care providers right now are trying to weigh whether they would be better or worse off with the [automatic] cuts or whatever the [Congress] recommends,” Mr. Zimmerman noted, adding that Medicare providers feel they already gave “their pound of flesh” through reimbursement cuts in the health reform law.
“Debt Limit Deal Sets Up Year-End Battle Over Medicare Cuts”
Bloomberg News, August 2, 2011
Eric Zimmerman, speaking of a 12-member congressional panel that under the deficit-reduction law must recommend reductions to Medicare and other programs by year-end, noted that “Medicare is always on the table. We just spent the last six weeks battling over Medicare cuts, and now we’re going to be doing it for the next four months.”
“Benefit Recipient? Disruptions May Be Coming”
MSNBC, July 28, 2011
Eric Zimmerman commented on the deficit talks in Washington and the impacts of a possible interruption in Medicare reimbursements to hospitals and other providers. He noted that millions of claims come in to the federal government every day from health care providers for surgery, therapy and other services for Medicare beneficiaries. “It is possible that that could get suspended or disrupted in the event there are choices that have to be made about how limited federal dollars are going to go out,” Zimmerman said. “Every day that there is a disruption caused by the debt limit crisis, that’s a cash flow problem for hospitals, physicians and nursing homes, anyone who furnishes services to Medicare beneficiaries.”
“Medicare at 67: The Next Big Change?”
Politico Pro, July 27, 2011
Eric Zimmerman said that, although the healthcare coverage assured by the health reform law could make an increase in the Medicare eligibility age more acceptable, such a scenario “assumes a lot of things, including that all the changes in the reform law work as advertised.”
“Fight for Independence”
Modern Healthcare, July 18, 2011
Eric Zimmerman said that, although Congress relies on the “well-respected” Medicare Payment Advisory Committee (MedPAC) for ideas to reduce Medicare costs, those ideas are “merely recommendations.” By contrast, he noted, the Independent Payment Advisory Board established by the health reform law “has authority to put forth recommendations that, unless Congress acts, will become law. So it’s invested with enormous authority and additional powers that MedPAC does not have.” For that reason, he added finding IPAB members who will pass Senate scrutiny could be difficult.
“Hostile Reception: Value-Based Purchasing Changes Get Poor Reviews”
Modern Healthcare, July 11, 2011
Eric Zimmerman said that the Centers for Medicare and Medicaid Services' (CMS) new rule on outpatient reimbursement for ambulatory surgery centers (ASCs) may be difficult for some smaller or single-specialty ASCs to meet. “There’s a difficult and delicate balance that CMS needs to strike here,” he observed, noting that the rule is challenging to ASCs because it focuses more on hospital-related measures.
“Latest Draft of Hatch IVD Bill Contains New Regulatory Proposals”
GenomeWeb, July 6, 2011
Paul Radensky and Eric Zimmerman spoke about representing an industry coalition to clarify reimbursement reforms and incentives for innovative non-device diagnostic tests. “We’ve been looking at options to have a more predictable system in place to assign different payment rates and codes … so the payor actually knows what it is they’re paying for,” Mr. Radensky stated. Mr. Zimmerman added that “the current [reimbursement] system is not working well and that it does not appropriately incentivize the development of these tests.”
Paul W. Radensky M.D., Eric Zimmerman, Health
“Tenet, HCA Easier Targets Than Medicare in Biden’s Debt Talks”
Bloomberg News, June 2, 2011
Eric Zimmerman predicted that deficit reduction plans in Congress will likely seek to cut payments to or demand concessions from Medicare service providers, leaving the companies in a tough spot. “The bulk of what would be in any deal would affect those providers, and they should be concerned about what kind of exposure they have,” Mr. Zimmerman said. He added that he doubts the companies have “a great understanding or appreciation” of what they face.
Eric Zimmerman, Health, Health Care Law Reform
“Reform the Hard Way”
Modern Healthcare, April 11, 2011
Eric Zimmerman noted that the massive changes to Medicaid and Medicare in the U.S. House Republicans’ budget proposal are at this point high-level and general in nature. “Without detail we don’t know to what extent those would be eliminated,” he said of Medicaid requirements. “You could assume that the benefit and eligibility requirements would be left to states’ discretion.”
Eric Zimmerman, Health, Health Care Law Reform
“Most Influential Lawyers”
National Law Journal, March 28, 2011
Eric Zimmerman was one of just 34 influential lawyers singled out by readers and researchers as among those who “have clout … to shape the world and the way it works.” The NLJ called him “an expert in Medicare” who is “often at the top of their list” for hospitals and drug companies needing help in Congress. Mr. Zimmerman “was involved in shaping half a dozen targeted provisions” of the 2010 health care reform act according to the NLJ, and he himself added about the act’s impact that “it’s just the beginning, like Medicare in 1965.”
Eric Zimmerman, Government Strategies, Health
“White House Proposes Two-Year Medicare Physician Payment Remedy”
BNA’s Health Care Daily, February 15, 2011
Eric Zimmerman asserted that the Obama Administration’s FY 2012 budget proposal to cancel for two years the proposed Medicare reimbursement cuts to physicians “illustrates the need to address this problem comprehensively and permanently.” The cuts were first implemented by Congress in 2010 but have been postponed several times, and Mr. Zimmerman noted that “the escalating costs of annual postponements are becoming cost prohibitive and limit Congress’s ability to address other equally pressing Medicare program concerns.”
Eric Zimmerman, Health, Health Care Law Reform
“President Obama Renominates Berwick to CMS Administrator Post”
BNA’s Health Care Daily Report, January 28, 2011
Eric Zimmerman addressed the President Obama’s renomination of Donald Berwick, interim administrator of the Centers for Medicare and Medicaid Services, to permanently head CMS despite Republican opposition. Mr. Zimmerman noted that if Berwick is rejected, “the prospect of losing him at the end of the year and finding another administrator in an election year would be disruptive for the agency.”
“Republicans Seek to Bleed Obama’s US Health Reform”
Reuters, January 4, 2010
Eric Zimmerman observed that if congressional Republicans do not want to fund the start of implementing health care reform as part of a general budget vote, “they could just dig in their heels and refuse to pass a [spending] bill. We’ll have to see who is willing to succumb in that game of chicken and what the public thinks of that.”
Eric Zimmerman, Health, Health Care Law Reform
“New GOP House Majority Sets Sights on Repeal of Health Reform”
BNA’s Health Care Daily Report, January 4, 2011
Eric Zimmerman said the appointment of an interim head for the Centers for Medicare & Medicaid Services (CMS) shows that “the administration will either have to identify a candidate who is less polarizing and more acceptable to Senate Republicans or continue the course of recess appointments and acting administrators…. Without a congressionally approved leader, the agency and the administration’s health reform implementation objectives will suffer.” Mr. Zimmerman predicted “more short-term fixes” for CMS, because “comprehensive solutions are too expensive and elusive, and Congress missed its best opportunity – i.e., health care reform – to do something bold to address this problem.”
Eric Zimmerman, Health, Health Care Law Reform
2010
“Reform: Round Two”
Modern Healthcare, November 8, 2010
Eric Zimmerman said that even though the new Republican House of Representatives majority wants to overturn the health care reform act, a more plausible strategy would be to use “a variety of tools and parliamentary maneuvers available to try to create mischief. Some of those could include withholding funds” for more than 100 initiatives that require funding. Other possible tactics are using the Congressional Review Act or the Corrections Calendar to overturn regulations, or repealing the Independent Payment Advisory Board, but Mr. Zimmerman saw little prospect for their success – the former requires approval of both houses, the latter requires spending cuts to offset proposed savings.
Eric Zimmerman, Health, Health Care Law Reform
Eric Zimmerman commented for Modern Healthcare (May 3) on the health care reform law’s provision that enables hospitals to purchase discounted outpatient drugs through a government program, but that does not include an inpatient drug provision. “It’s not a hassle-free program,” he said, because “hospitals will need to take steps to ensure compliance,” such as separating outpatient and inpatient drug purchases. “This brings administrative challenges and complications,” he noted. However, Mr. Zimmerman added, because the program as a whole benefits hospitals, “there continues to be a great deal of interest in expanding inpatient drugs to the program. It’s appealing to large numbers of members in the House. It will certainly get another hearing.”
Eric Zimmerman, Health, Life Sciences & Medical Products
Eric Zimmerman spoke to BNA Health Care Daily Report on April 1 regarding a new Centers for Medicare and Medicaid Services (CMS) rule for reimbursement of ambulatory surgery centers (ASCs). The rule was intended to raise ASC reimbursement closer to that of hospital outpatient procedures, but Mr. Zimmerman said ASCs will still be paid only 62 percent of the hospital rate for the same procedure. In addition, some 350 procedures are subject to an ASC payments cap, which Mr. Zimmerman says means “there’s not a lot of payment incentive” to perform the procedures in an ASC. He that the new health care reform law requires CMS to work with ASCs on how to incorporate value-based purchasing (VBP) into ASC procedures, but “there’s no telling” if VBP will become a requirement for ASCs. “Congress is taking it one step closer,” he added.
Eric Zimmerman, Health, Life Sciences & Medical Products
Eric Zimmerman assessed the health care reform law’s implementation challenges in a March 29 Reuters dispatch. Speaking of Democrats and advocacy groups who are the law’s strongest supporters, Mr. Zimmerman said that “in order to win the public sympathy and win public support they are not only going to want the implementation to be smooth, but also for the public to recognize the benefits coming out of health reform,” adding, “It’s going to be a challenge.” Mr. Zimmerman also noted the opposition to require all persons to purchase or otherwise have health insurance, and said that if the coverage mandate is struck down it would “blow a gaping hole in the whole framework of reform.” Among the newspapers in which the story appeared was the Vancouver Sun.
Eric Zimmerman told Modern Healthcare on January 25 that he is “still confident that healthcare reform will be enacted. It’s too much of a priority for the administration, and Congress hasn’t sunk this much time into it” for it to fail. Mr. Zimmerman said he believes that House consideration of the Senate’s reform bill “remains the only possible pathway to getting reform done,” adding that he expects President Obama’s State of the Union address will give House members an incentive to vote for the Senate bill. “I think that the Democrats will realize that it is less desirable to do nothing, even if enacting health reform is not universally popular,” Mr. Zimmerman stated. Click here to view the full article.
Eric Zimmerman, Health, Life Sciences & Medical Products
AmLaw Daily interviewed Eric Zimmerman (January 21) regarding the prospects for passage of health reform legislation. "I'm very confident that health care reform will be enacted," he declared. "The question is what will it look like, and when will it be enacted." He based his belief on the effort expended on the legislation to date: "Health care reform...has consumed a great deal of time, attention and resources from Congress and the administration for the past year...at the expense of other issues, like the economy and jobs." Saying he did not "think it's likely" that reform will have bipartisan approval, Mr. Zimmerman stated that Democratic leadership will "figure out its strategy and pursue one." He added that McDermott will "help businesses navigate these shoals" once reform is passed.
Eric Zimmerman, Health, Life Sciences & Medical Products
Eric Zimmerman was quoted by BNA's Medicare Report (January 2010) concerning the impact that the current lack of a permanent administrator at the CMS will have as health care reform legislation is implemented. "The administration is going to have a lot at stake with the implementation [of reform], which will be almost as important politically as enacting reform in the first place," he said. "It is in the administration's interests that the implementation go smoothly, that deadlines be met, and that Congress be satisfied. That is a tall order without a permanent administrator." Zimmerman also noted as a key 2010 Medicare issue the outcome of a number of budget neutrality adjustment appeals regarding reimbursement, which are currently pending before the Provider Reimbursement Review Board. Click here to view the full article.
Eric Zimmerman, Government Strategies, Health
2009
Eric Zimmerman discussed how to influence the outcome of Centers for Medicare and Medicaid Services (CMS) regulations in an October 2 story by BNA’s Medicare Report. Noting that there are “many other points of entry” beyond the obvious of submitting comments and engaging Congress on rulemaking, Mr. Zimmerman advised contacting the right people at CMS even before the rulemaking process is too far developed. He recommended meeting with staff at all levels – career policy, senior political leadership, at the office of the secretary, and the office of the general counsel.
Eric Zimmerman was quoted in Modern Healthcare (July 13) concerning an agreement that three hospital lobbying groups reached with Congress and the White House to reduce hospital reimbursement during the next 10 years and to make changes in physician self-referral to hospitals in which they have an ownership interest. “It looks like a lot for a little,” Mr. Zimmerman said of the agreement. “Physician ownership has been the top priority for the hospital lobby. It’s always confused me why that’s the top priority. It’s a little confounding that they would sacrifice so much to get assurance on this issue.”
Eric Zimmerman commented on the Obama health care reform proposal in a June 22 blog post for Healthcarelawreform.com. He noted that many of the anticipated Medicare program payment reductions and revisions are absent from the initial proposal draft, but added that “providers should not draw too much comfort from that. President Obama has called for more than $600 billion in savings from Medicare, and … [p]roviders should still expect significant savings provisions to be added later.” Mr. Zimmerman added that the proposal means health care service providers will “face new systems, obligations and incentives that will dramatically alter how providers furnish services and interact with Medicare and its beneficiaries.”
Eric Zimmerman was extensively quoted in BNA's Daily Health Care Reporter on March 30 regarding final rules for the Centers for Medicare and Medicaid Services (CMS) to reimburse ambulatory service centers (ASCs). Mr. Zimmerman said the new rules "are really shaking up the industry" by more closely aligning ASC reimbursement with hospital outpatient surgical services. However, because of statutory budget constraints, CMS pays ACSs considerably less than hospitals. "It's outrageous to think that ACSs can furnish procedures for that little money," Mr. Zimmerman stated. ACSs seeking reimbursement must also submit quality and performance data, but Mr. Zimmerman noted that "there is no indication" that CMS will adopt industry suggestions for what this data should contain.
Eric Zimmerman, Health, Life Sciences & Medical Products, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the February 2 issue of Modern Healthcare in an article regarding physician-owned hospitals being worried about the priorities of the Federation of American Hospitals and the SCHIP bill that was passed. "It is likely that the House will take up the Senate bill – making a conference not necessary – and send it to the president. With that said, if this provision is not included in what is sent to the president, it will re-emerge again. Those who object to physician ownership of hospitals have made it clear that this is a priority and one they want to purse until they achieve their objective," Mr. Zimmerman said.
Eric Zimmerman, Health, Health Ventures/Physician Transactions
Eric Zimmerman was quoted in the January 9 issue of BNA’s Medicare Report in an article regarding Medicare legislation in 2009. "Congress will consider comprehensive Medicare legislation, including significant program payment reforms in 2009. There is enormous pent-up demand to address several systemic problems, including the physician payment update," Mr. Zimmerman said.
Eric Zimmerman was quoted in the January 5 issue of Modern Healthcare in an article with respect to physician-owned hospitals. "A physician-ownership provision could appear in the reauthorization of the State Children’s Health Insurance Program early in 2009, or perhaps in Medicare legislation later in the year," Mr. Zimmerman said.
Eric Zimmerman, Health, Health Ventures/Physician Transactions
2008
Eric Zimmerman was quoted in the January 18 issue of BNA’s Medicare Report in an article regarding the top Medicare issues to watch in 2008, specifically competitive billing. "Barring a stay on implementation or other substantial change to the program requirements or roll-out, competitive bidding will have a serious and negative impact on small DME suppliers," Mr. Zimmerman said.
2007
Eric Zimmerman was quoted in the July 20 issue of BNA’s Medicare Report regarding The Centers for Medicare & Medicaid Services releasing a new rule which sets new payment rates for ambulatory surgery centers (ASCs) in 2008. "The ASC final rule is the most significant and substantial change to how and how much Medicare pays ASCs since the inception of the program 25 years ago," Mr. Zimmerman said.
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health
Eric Zimmerman was quoted in a February 1 article in EndoNurse in regards to reimbursement for gastrointestinal (GI) procedures. "The march to the new payment system is definitely topic number one," Mr. Zimmerman said.
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the January 24 issue of BNA's Health Care Daily in regards to President Bush's proposal for potential new use of safety net payment. "It is hard to judge the impact of the proposal, because details of how it would work are sketchy. But a plan to replace DASH funds for hospitals with payments for providers from health insurance coverage could work," Mr. Zimmerman said.
Eric Zimmerman was quoted in the January 8 issue of BNA's Health Care Daily in regards to health care being a prominent figure in the work of the Democratically controlled 110th Congress. "I expect 2007 to be a big year for Medicare legislation. There is incredible built-up demand. It has been more than three years since Congress advanced major Medicare legislation, and there are many areas that cry out for attention. Anything Democrats try to do to the prescription drug benefit, Medicare Advantage (managed care) program, or physician fee schedule will serve as a vehicle for a variety of other provisions," Mr. Zimmerman said.
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the January 2007 issue of Today’s Surgicenter discussing the 4th Annual ASC Legislative Update. According to Mr. Zimmerman, the industry should focus on the reintroduction of bills such as these that cover the "conversion factor" for the new payment system. He also commented, "the ASC industry has a little under a year to lobby Congress for some kind of congressional intervention."
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health
2006
Eric Zimmerman was quoted in the July 21 issue of BNA's Medicare Report in an article about how a provision of the Deficit Reduction Act of 2005 will place a hold on Medicare payments for Part A and Part B claims for the last nine days of fiscal year 2006. Mr. Zimmerman noted that he told BNA that the payment delay is not something providers should be concerned about. "It may affect cash flow, but not significantly," he said. Mr. Zimmerman was also quoted saying, "It's an accounting trick that Congress used to contain the overall cost of the bill. By shifting some of the costs into later years, they were able to achieve the overall spending goals that they needed to be within."
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was mentioned in the June 2 issue of BNA’s Medicare Report in an article titled, "CMS Survey Seeks Financial Information for Specialty Hospital Report to Congress." Mr. Zimmerman was quoted saying that the survey is of a sensitive nature, seeking detailed information about physician investors in acute-care or specialty hospitals and about common joint venture arrangements between hospitals and physicians.
Eric Zimmerman was quoted by Surgicenteronline.com in their June 2006 issue regarding compensation for orthopedic surgeries. Zimmerman notes that the Centers for Medicare and Medicaid Services (CMS) is currently working on a proposal to re-base ambulatory surgery center rates, and that the agency is expected to come out with a proposal to implement new payment amounts for ASC services, probably by the end of the summer or early next fall.
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health, Managed Care
Eric Zimmerman was quoted in the May 15 issue of Modern Healthcare in regards to a CMS report that focused on payment revisions for hospital inpatient and ambulatory surgical center services. The report also defined what a hospital is and reviewed procedures for enrollment. "The most significant (aspect) is that it signals that CMS is not likely going to be making the types of changes that opponents had hoped for."
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the March 31 issue of BNA’s Medicare Report in the article "DRA's Medicare Reduction of $6 billion Reflects Reluctance to Reduce Spending." Regarding the Deficit Reduction Act of 2005 (DRA), Mr. Zimmerman said the budget resolution that is emerging from the Senate budget committee does not call for Medicare spending reductions. "Nevertheless, the House has not yet completed its resolution on the 2007 budget and may require Medicare to put spending reductions on the table," he said.
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the February 10 issue of BNA's Medicare Report in the article "Budget Bill: Hospitals Spared Cuts, Specialty Report Due." Regarding the new Deficit Reduction Act, Mr. Zimmerman said the specialty hospital provisions in the act are "really mixed." The bill demonstrates that Congress has rejected, or displayed its unwillingness to address, the specialty hospital issue from an ownership perspective, he said. "I think you have a lot of would-be developers looking at this as if not a green light, certainly amber. It's a cautious environment."
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the January 13 issue of BNA's Medicare Report in the article "Medicare Part D Drug Benefit Brings Significant Program Changes, Uncertainty." Regarding the new Medicare drug benefit, Mr. Zimmerman said, "Congress will be torn between wanting to create incentives in the program to entice beneficiaries to enroll and needing to contain program costs that are almost assuredly going to be higher than expected."
Eric Zimmerman, Health, Managed Care
2005
Eric Zimmerman was quoted in the December 20 issue of BNA’s Health Care Daily Report in an article about the House of Representatives voting on Dec. 19 to extend the current restrictions on the enrollment of new physician-owned, specialty hospitals. Mr. Zimmerman told BNA the bill contains a “healthy mix of things,” but noted that many of the Medicare provisions are in effect for only one year, requiring lawmakers to revisit the issues in 2006.
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the December 20 issue of BNA's Health Care Daily Report in an article about the U.S. House of Representatives voting on December 19 to extend the current restrictions on the enrollment of new physician-owned, specialty hospitals. Mr. Zimmerman told BNA the bill contains a "healthy mix of things," but noted that many of the Medicare provisions are in effect for only one year, requiring lawmakers to revisit the issues in 2006.
Eric Zimmerman, Health, Managed Care
Eric Zimmerman was quoted in the July 14 issue of BNA's Health Care Daily Report in the article "Ambulatory Surgical Centers Relieved by Recent Rule, but Want New Pay System." Regarding the Centers for Medicare & Medicaid Services' decision to expand the number of procedures Medicare will cover if performed in ASCs, Mr. Zimmerman told BNA "there was some degree of relief that CMS did not proceed with many of the proposed deletions from [November 2004], and that they also added more procedures" than originally proposed. He noted, however, that there was also a great deal of disappointment that many other procedures were not added.
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health
Eric Zimmerman was quoted in BNA's Medicare Report on June 10 in the article "Moratorium for Speciality Hospitals Ends; Providers Say Future Construction Unclear." According to Mr. Zimmerman, "under the former moratorium there were a number of ambiguities in the law that left ample room for would-be developers. The chances are that under a new moratorium, the ambiguities will continue to exist and developers may take advantage of them."
Eric Zimmerman was quoted in BNA's Health Care Daily Report on June 9 in an article regarding the June 8 expiration of the moratorium for new speciality hospitals. "Congress has sent a signal that there is a good likelihood that whatever extensions of the moratorium enacted will be retroactive. Developers should not look at this [the expiration of the moratorium] as a lapse period," Mr. Zimmerman said.
Eric Zimmerman was quoted in Modern Healthcare on May 30 in an article regarding the moratorium on physician self-referral to specialty hospitals that is set to expire June 8, 2005. "I think there are very clear signals that any extension of the moratorium is very much in doubt right now," said Mr. Zimmerman. "Making it permanent is highly unlikely."
Eric Zimmerman, Health, Health Ventures/Physician Transactions
Eric Zimmerman was quoted in BNA Medicare Reporter on May 13 regarding the proposed Hospital Fair Competition Act of 2005. "The bill effectively precludes specialty hospitals from whole hospital exception in the Stark physician self-referral law, but does not define specialty hospitals further than how they are defined in the 2003 Medicare law," he said. "The law remains vague about what defines a specialty hospital, and the Grassley-Baucus bill potentially leaves room for physician-owners to adjust their models to provide a greater number of services but essentially function still as single-specialty facilities, eligible for Medicare and Medicaid reimbursement." He added the bill "would have the intended effect of preventing specialty hospital developers from opening new facilities, at least in the short term, because Grassley and Baucus were clear in the legislation that they intended the bill to be enacted retroactively."
2004
Eric Zimmerman was quoted in the December 6 issue of Part B News in an article regarding how next year there may be 25 new procedures payable to the ASCs under a proposed CMS revision to the ASC list. Mr. Zimmerman believes the proposed changes could hurt single-specialty urology ASCs the most. He added that a number of the codes set to be taken off the list are urology codes often done in ASCs.
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health
Eric Zimmerman was featured in the December 2004 issue of Today's Surgicenter in an article entitled, "Who's Who in the Ambulatory Surgery Industry." The magazine's readers were asked to nominate outstanding individuals, facilities and organizations that serve the outpatient health care community. Mr. Zimmerman was chosen as a recognized Medicare law and policy authority who helps clients navigate federal legislative and regulatory processes, improve reimbursement and maintain compliance. Mr. Zimmerman stated, "I happened into health care, but the minute I got involved, I was hooked, and my interest and dedication have not wavered since."
Eric Zimmerman, Ambulatory Surgery Centers (ASC), Health
Eric Zimmerman was quoted in the November 24 issue of BNA's Daily Report for Executives in an article regarding how the Centers for Medicare & Medicaid Services has proposed to update the list of Medicare-covered procedures that are reimbursed when performed in ambulatory surgery centers. Mr. Zimmerman found the proposal "disappointing." Although CMS has received dozens of procedures to consider as additions, the agency has not undertaken a meaningful review in nearly a decade, he said.
Eric Zimmerman offered advice to the readers of Gastroenterology Coder's Pink Sheet (July 2004) on how to resolve the problem of improper pay for E/M and screening colonoscopies by stating "if a provider or physician becomes aware that they are in possession of an overpayment, CMS and the Inspector General believe that there is an obligation to make a repayment back to Medicare." Mr. Zimmerman also commented on the appropriate action time and how to go about refunding overpayments.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the April 2 issue of BNA's Medicare Report in the article, "Small Hospitals Get Payment Hikes As Required Under Drug Law, CMS Says." Mr. Zimmerman said that the payments for inpatient hospital services to rural and small urban areas will now be based on the same standardized amounts that are used to determine payments to hospitals in large urban areas.
Eric Zimmerman was quoted in the April 2004 issue of Outpatient Surgery on the significantly increased number of local lobbyist attacks on physician-owned surgical centers. "I've never seen this level of state activity in my 14 years," Mr. Zimmerman commented. He also added how "difficult to fight" and "disconcerting" these attacks are due to their variety of forms. Studies have shown that physician-owned surgical centers do "not lead to abuse, higher program costs or costs to the beneficiary;" however, "when the assault comes in the form of a CON," he added, "we have to respond in a different way."
2003
Eric Zimmerman was quoted in the August issue of Radiology Administrator's Compliance & Reimbursement Insider in an article about hospital provider-based status requirements.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the April 4 issue of BNA's Medicare Report in regard to the Centers for Medicare & Medicaid Services finalized changes to its list of Medicare-approved ambulatory surgical procedures.
Eric Zimmerman was quoted in the March 2003 issue of Ambulatory Surgery Compliance and Reimbursement Insider in an article regarding recent recommendations from the U.S. Department of Health and Human Services Inspector General regarding Medicare reimbursement for ambulatory surgery centers.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the January 20 issue of amednews.com, an online publication of the American Medical Association's "American Medical News," in an article regarding Medicare payments to ambulatory surgery centers.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the January 2003 issue of Ambulatory Surgery Compliance and Reimbursement Insider, a publication of Brownstone Publishers, Inc., in an article about the 2003 Outpatient Prospective Payment System Update.
Eric Zimmerman, Health, Health Ventures/Physician Transactions, Reimbursement/Fraud & Abuse
2001
Eric Zimmerman was quoted in the November 2001 edition of Same Day Surgery, an American Health Consultants publication, in regard to provided based status.
