Michael Cassidy

Michael Cassidy

Tucker Arensberg, P.C.

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Basic Contract Issues for New Physician Contracts

When physicians have finally completed the medical education journey, many are confronted with a “physician employment contract,” usually from a hospital or medical practice, which could define the essential terms of their...more

7/28/2016 - Employee Benefits Employer-Owned Intellectual Property Employment Contract Hospitals Malpractice Insurance Physician Compensation Arrangements Physicians Restrictive Covenants Termination Clauses Trade Secrets

CMS Posts Open Payment Data – $7.52 Billion in 2015

CMS published the 2015 Open Payment Data on June 30, 2015. CMS has presented tables in its press release showing the highest paid specialties and highest paying companies. ...more

7/7/2016 - CMS Genentech Manufacturers Medical Devices Novartis Open Payments Pharmaceutical Industry Physicians Reporting Requirements

Final 60 Day Overpayment Rule

CMS has issued the final regulations to implement that section of the Affordable Care Act amending the Social Security Act to provide that retention of identified overpayment could be a false claim and be subject to both the...more

2/22/2016 - 60-Day Rule Affordable Care Act Civil Monetary Penalty CMS False Claims Act (FCA) Final Rules Overpayment

Progress on Medicare Payment Reform

HHS is gearing up to design and implement a revised Medicare payment system. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has designated a merit based incentive payment system (MIPS) as a goal. CMS is...more

2/3/2016 - CMS HHS Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS

10 Significant Physician Contracting Mistakes

1. Failure to Begin with the End in Mind. The most important provisions of your employment contract will be the provisions governing your termination rights, for two reasons. First, if the relationship goes well, chances are...more

1/21/2016 - Contract Drafting Employment Contract Hiring & Firing Malpractice Insurance Physicians Restrictive Covenants

Physician Practices Face Anti-Trust Risks, Too

On December 18, 2015, the Federal Trade Commission (FTC) announced a settlement with Keystone Orthopaedic Associates Specialists and Orthopaedic Associates of Reading, LTD, which were two of six orthopedic practices in Berks...more

1/12/2016 - Anti-Competitive Consent Order FTC Physicians Settlement

FTC and Pennsylvania Challenge Penn State Hershey’s Planned Merger with PinnacleHealth System

BNA has reported the planned merger of Penn State Hershey Medical Center with PinnacleHealth System will be challenged in federal court by federal and state officials. The Federal Trade Commission and Pennsylvania’s...more

1/5/2016 - Anticompetitive Agreements Attorney Generals FTC Healthcare Costs Hospital Mergers Injunctive Relief

Medical Records Fees for EHR

You might have not noticed in the last blog post that there is a provision in the Pennsylvania Notice regarding electronic health records. The Notice does not establish a fee for electronic health records. ...more

12/22/2015 - Electronic Medical Records Health Care Providers

2016 Pennsylvania Medical Record Fees

Effective January 1, 2016, the following fees may be charged by a health care facility or health care provider in response to a request for production of medical charts or records...more

12/18/2015 - Document Productions Health Care Providers Medical Records Processing Fees

Summary of UPMC/Highmark Resolved Issues

The following issues have been resolved over the last month, at least through June 30, 2019, which is the expiration date of the Consent Decrees entered into with the approval of the Commonwealth Court by the parties in June...more

12/3/2015 - Consent Decrees Continuity of Care Highmark Medicare Medicare Advantage PA Supreme Court

UPMC/Highmark Continuity of Care Settlement

PBGH just recently sent out a client alert regarding UPMC/Highmark Continuity of Care Settlement as follows: UPMC and Highmark have announced a settlement agreement that addresses the Consent Decrees’ Continuity of Care...more

11/13/2015 - Consent Decrees Continuity of Care Health Care Providers Highmark Settlement Agreements

SGR Fix Already Revised and Hospital Outpatient Department $$ Reduced

The ink was barely dry on the Medicare Physician Sustainable Growth Rate (SGR) fix, and it has already been changed. One component of the SGR fix, which was just passed in April of this year, was freezing Medicare...more

11/4/2015 - Healthcare Hospitals Medicare Physician SGR Formula Sustainable Growth Rate (SGR)

OCR Announces HIPAA Security Settlement with Cancer Care Group, P.C.

In September, 2015, OCR and HHS issued a press release announcing a Resolution Agreement with the Cancer Care Group, P.C., which included entry into the agreement, the adoption of a robust compliance plan, and the payment of...more

10/28/2015 - Data Breach HHS HIPAA OCR PHI Risk Assessment Security and Privacy Controls

IRS Levy Against Medicare Payments Increases to 100% Effective October 16, 2015

The Internal Revenue Code was amended in April 2015 as part of the Medicare Access and CHIP Reauthorization Act of 2015 to increase allowable IRS levies against federal payments, such as Medicare receivables, from 30% to 100%...more

10/2/2015 - Amended Regulation CHIP Internal Revenue Code (IRC) Levies Medicare

Department of Justice Issues Guidance on Corporate Investigations and Executive Accountability

On September 9, 2015, Sally Quillar Yates, Deputy Attorney General of the Department of Justice (DOJ) issued a memo entitled “Individual Accountability for Corporate Wrongdoing” to address the issue of incentivizing...more

10/1/2015 - C-Suite Executives Chief Compliance Officers Compliance Corporate Misconduct DOJ Government Investigations Yates Memorandum

Blue Cross of Northeastern Pennsylvania Denied Peer Review Protection

The Pennsylvania Superior Court has decided the Pennsylvania Peer Review Protection Act does not apply to alleged peer review activity conducted by Blue Cross of Northeastern Pennsylvania, because Blue Cross is not a...more

9/2/2015 - Blue Cross Health Care Providers Healthcare Hospitals Peer Review

CMS Stark Proposals Allow “Holdover” Arrangements and Signature Window

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions. The full text of these proposal and CMS comments and explanations is available below....more

8/20/2015 - Anti-Kickback Statute CMS Exceptions Health Care Providers Healthcare Physicians Proposed Regulation Stark Law

CMS Limits Scope of Review for MACs

CMS issued a special edition MLN Matters meant to be effective August 1, 2015. The guidance reflects CMS instructions to Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) regarding the...more

8/20/2015 - Administrative Appeals CMS Healthcare MACs QICs

CMS Clarifies Written Agreement Requirement

CMS has acknowledged that arrangements among providers to satisfy the Stark exceptions need not be created in a single document. Although a single written document memorializing the key facts of an arrangement could provide...more

8/17/2015 - CMS Contract Drafting Health Care Providers Healthcare Stark Law

CMS Proposes New Stark Exceptions: Timeshare Lease

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions. Over the next few days, I will post comment on what I consider the most significant new...more

8/14/2015 - Anti-Kickback Statute CMS Exceptions Healthcare Hospitals License Agreements Physician Ownership Stark Law

CMS Proposes New Stark Exception: Recruitment of Non-Physician Practitioners

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions. Over the next few days, I will post comments on what I consider the most significant new...more

8/13/2015 - CMS Health Care Providers Healthcare Hospitals Nurse Practitioners Nurses Recruitment Policies Rural Health Care Providers Stark Law

CMS Announces One Year Partial ICD-10 Relief for Physicians

By now, everyone knows ICD-10 coding starts October 1, 2015. Starting October 1, 2015, Medicare claims with dates of service after October 1, 2015 will only be accepted if they contain a valid ICD-10 code. The Medicare...more

8/4/2015 - CMS Healthcare ICD-10 Medicare

Telehealth News

Iowa Supreme Court Rejects Ban on Telemedicine Abortions - An Iowa Board of Medicine rule requires the presence of a physician when abortion inducing drugs are provided....more

7/14/2015 - Abortion Discrimination Healthcare Medicare Physician Fee Schedule Physicians Planned Parenthood Prescription Drugs State Medical Board Telehealth

TelaDoc Wins Injunction Against Texas Medical Board re: Telehealth Restrictions

The Federal District Court of the Western District of Texas has ruled against the Texas Medical Board and granted TelaDoc’s Motion for a Preliminary Injunction prohibiting the Texas Medical Board from enforcing new rules...more

6/22/2015 - Healthcare In-Person Exam Physicians Preliminary Injunctions Prescription Drugs Standard of Care State Medical Board Telehealth

Colorado Approves Direct Medicare Payment to CRNA’s

Medicare Regulations allows CRNA’s to administer anesthesia without physician supervision if the state governor opts out of the regular physician supervision requirement. Governor Ritter of Colorado opted out in 2010,...more

6/22/2015 - Healthcare Medicare Nurses

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