The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), enacted on March 27, 2020, contains many beneficial provisions for healthcare providers dealing with the operational and business challenges of the COVID-19...more
To enable healthcare entities to address the unique and exigent circumstances created by the COVID-19 public health emergency, the secretary of the Department of Health and Human Services (HHS) issued waivers of sanctions...more
The FDA Reauthorization Act (H.R. 2430), recently signed into law by President Donald Trump, included the Over-the-Counter (OTC) Hearing Aid Act, which requires the Food and Drug Administration (FDA) to develop regulations...more
After many years of heated and contentious debate, and opposition by the Texas Medical Association and the executive director of the Texas Medical Board, Texas has significantly revised its telemedicine statute to permit the...more
Time spent drafting and negotiating an agreement often pays dividends in assuring that each party gets the benefits they desire through the agreement and incurs obligations no greater than they intended. Two recent cases,...more
The Emergency Medical Treatment and Active Labor Act (EMTALA), despite being enacted more than 30 years ago, has produced a case examining the applicability of malpractice damages limitations that bears watching.
In...more
A recent decision from a North Carolina federal court raises interesting lessons for providers surrounding contractual cure and damages provisions. Cone Health entered into a contract with Conifer Physician Services for the...more
Although we healthcare lawyers generally view ourselves as a pretty healthy lot, there are times when we are patients too. In a recent experience I was asked by a provider’s employee to sign several registration and privacy...more
The trend of holding physicians personally responsible for healthcare crimes has continued unabated over the past year. As noted in a previous article, physicians are particularly attractive targets for federal prosecutors...more
Most providers whose claims have been determined to be improper by the Recovery Audit Contractors (RACs) under the Medicare Recovery Audit Program have discovered that the appeals backlog “is incontrovertibly grotesque.”...more
The latest indictment confirms that fraud and abuse analysis is about more than just the federal and state healthcare anti-kickback statutes. The U.S. Attorney for the Northern District of New Jersey has just charged the 26th...more
Careful drafting of consent and information release provisions can ensure that providers and affiliated physicians and their debt collectors can contact patient cell phones using automatic telephone dialing systems or...more
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently announced its annual solicitation of proposals and recommendations for developing new, and modifying existing, safe harbor provisions...more
The Environmental Protection Agency (EPA) recently issued a pre-publication Proposed Rule (40 C.F.R. part 266, subpart P) regulating the management and disposal of drugs deemed “hazardous waste pharmaceuticals” by healthcare...more
Recent changes to policy and plan language and increased litigation by third-party payers suggests that out-of-network providers who waive co-pays and deductibles may be in for some rough sailing. Providers must be aware of...more
8/19/2015
/ Co-payments ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Kickbacks ,
Medical Reimbursement ,
Out of Network Provider ,
Patients ,
Third-Party ,
Waivers
For this edition of the Deeper Dive, we travel to Texas for a look at some interesting cases involving healthcare providers decided on appeal in 2015. Some of these decisions may be surprising – and perhaps even troubling –...more
8/4/2015
/ Anti-Competitive ,
Breach of Duty ,
Fiduciary Duty ,
Fraud ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medical Malpractice ,
Non-Compete Agreements ,
Physicians ,
Recruitment Policies ,
Tortious Interference ,
TX Supreme Court
The Texas Legislature in Senate Bill 760 removed barriers to Medicaid recipients receiving healthcare services and required improved access for services through managed care plans. Expedited Provider Credentialing - The...more
H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA), was signed into law by President Obama on April 16, 2015. A broad bipartisan compromise measure, MACRA repeals the much-maligned sustainable growth rate (SGR)...more
The enactment of the Patient Protection and Affordable Care Act (ACA), signed into law on March 23, 2010, represents a significant legislative milestone in healthcare reform and a continuing communications challenge for...more
Old and new regulations established by state professional boards that are composed of “active market participants” such as physicians, dentists and therapists, may be subject to antitrust challenge following the U.S. Supreme...more
Providers and health professionals face many challenges in the shifting sands of the Ebola response, including the extent of their duties to each other and their patients and their obligations under a myriad of laws,...more
11/3/2014
/ Americans with Disabilities Act (ADA) ,
Best Management Practices ,
Centers for Disease Control and Prevention (CDC) ,
Ebola ,
Employer Liability Issues ,
EMTALA ,
Ethics ,
Family and Medical Leave Act (FMLA) ,
Health Care Providers ,
Hospitals ,
OSHA ,
Physicians ,
Title VII
Many physicians and other health professionals maintain a robust Internet presence, including websites and portals to provide patients with information. However, I was recently reminded of how easy it is to overlook the...more
It is often said that advisory opinions are requested from the U.S. Office of Inspector General (OIG) when one wants a very safe deal blessed or when one wants to dissuade a competitor or counter-party from entering into or...more
A U.S. district judge in South Carolina approved the government's request for a civil penalty award and ordered Tuomey Healthcare System, Inc. (Tuomey) to pay more than $237 million in damages and fines in a whistleblower...more
Imagimed LLC, an MRI Center, its owners and chief radiologist, agreed to pay the government $3.57 million to settle false claims allegations for MRI services. The government alleged that Imagimed billed for MRI scans...more