Patients

News & Analysis as of

Payment is due at the time services are rendered

Typically, physicians collect co-payments from patients when services are provided, submit claims for reimbursement to government and commercial payers, and then send bills to patients for the balance owing. The payment and...more

Little Reprieve for Prisoner Zyprexa Suit

Happy birthday, Louise Fletcher, who won an Academy Award for her portrayal of the sadistic Nurse Ratched in One Flew Over the Cuckoo’s Nest (1975). Happy birthday also to Albert Brooks, writer/director/star of Modern...more

Telehealth Roundup: Federal Bill Seeks to Expand Medicare Use of Telehealth; Delaware and Connecticut Update Telemedicine Laws

On July 7th, the House introduced much anticipated bipartisan telehealth legislation. The Medicare Telehealth Parity Act of 2015, introduced by Representative Mike Thompson (D-CA) and co-sponsored by Representatives Gregg...more

Health Plans in Connecticut Must Cover Telehealth Services

Connecticut marks the 28th state to enact a telemedicine commercial reimbursement statute. The legislation (SB-467) was sponsored by Senators Looney, Duff, Crisco and Gerratana with twenty co-sponsor senators, and was signed...more

Issues Concerning Substance Abuse Patient Confidentiality Laws

It was with the best of intentions that Congress passed the Federal Confidentiality of Alcohol and Drug Abuse Patient Records Law over forty years ago. The patient privacy regulations (“Part 2”) spawned by this law reflected...more

A Personal Injury Claim Involving a Patient’s Fall on a Wet Hospital Floor Is Not Within the Scope of MICRA’s One-Year Statute of...

Asma Pouzbaris v. Prime Healthcare Services-Anaheim, LLP - Court of Appeal, Fourth Appellate District (April 23, 2015) - On June 13, 2010, plaintiff Asma Pouzbaris (“Plaintiff”) was admitted to defendant’s...more

PATIENT PRIVACY IN AN ERA OF SOCIAL MEDIA [Video]

The rise of social media has introduced new opportunities and new legal challenges for companies in the health care industry. Attorneys Seth Northrop and Sharon Roberg-Perez discuss the legal issues faced by care providers,...more

OIG Warns Lab “Pull-Through” Arrangements May Be Illegal

In an important advisory opinion, the U.S. Department of Health and Human Services Office of Inspector General (OIG) gave a thumbs-down to a proposed clinical laboratory “pull-through” arrangement even though the patients in...more

A New Wave – Eleventh Circuit Rejects “Barbetta Rule,” Opts for Cruise Line Liability

What happens if a passenger gets sick on a cruise ship and the treating physician, employed by the cruise line, is negligent in caring for the passenger? Is the cruise line liable?...more

Second Circuit Revives Medicare Beneficiaries’ Observation Status Suit

On January 22, 2015, the U.S. Court of Appeals for the Second Circuit reversed a decision by the U.S. District Court for the District of Connecticut dismissing a lawsuit by Medicare beneficiaries alleging deprivation of due...more

Steps to Take Before Terminating a Physician-Patient Relationship

At times physicians are faced with the burden of having to remove a patient from their practice. Circumstances leading up to this unfortunate decision may include a difficult or disruptive patient who is abusive to the staff...more

What patients misunderstand about their right of informed consent [Video]

Many patients misunderstand what "informed consent" is all about. They often believe it's about signing a form ahead of surgery that acts as a waiver against any rights they may have for legal recourse if the surgery goes...more

Similarities in Diversity between a Law Firm’s Culture and a Clinical Trial [Video]

“We need a population of employees as diverse as the patient populations we seek to serve…our vendors should be lined up with the same beliefs and the same focus as we are.” – Marla Persky, GC and Corporate Secretary...more

Physician Owned Distributorship Concerns Continue to Make News

On June 17, 2014, Southern California Public Radio affiliate KPCC broadcasted a report about physician-owned distributors of implantable medical devices (“PODs”) and the legal and ethical concerns that are raised when POD...more

AB 1000 and Corporate Practice in California: More than Meets the Eye—or Less?

On the way to authorizing direct access to physical therapy, the California legislature may have broadly loosened the restrictions on numerous business arrangements imposed by California’s corporate practice ban. AB 1000,...more

Health Alert (Australia) - June 16, 2014

In This Issue: Judgments; Legislation; and Reports. - Except from Judgments: New South Wales - 12 June 2014 - Rosten v Mid North Coast Local Health District [2014] NSWIRComm 29 - This was...more

The American Board of Obstetrics and Gynecology Reverses Its Unlawful Ban on Treating Male Patients

In September of 2013, the American Board of Obstetrics and Gynecology adopted a policy of excluding obstetrician/gynecologists from eligibility for Board certification and recertification if they treated any male patients....more

Lab Worker Infects 30. One Incident Or 30?

Thirty patients sued Exeter Hospital in New Hampshire when they came down with hepatitis C. The infection was traced to a single hospital lab employee, David Kwiatkowski. (Needless to say, David is no longer with the...more

What Is “a Patient?”

Braintree Labs, Inc. v. Novel Labs, Inc. - On appeal from summary judgment, the U.S. Court of Appeals for the Federal Circuit construed “a patient” to mean “a population of patients,” overturning the district court’s...more

SAMHSA to Hold Part 2 “Listening Session”

The Substance Abuse and Mental Health Services Administration (“SAMHSA”) has scheduled a “public listening session” on Wednesday, June 11, 2014, to seek input on potential changes to the federal Confidentiality of Alcohol and...more

OIG Recommends Reduction in Hospital Outpatient Rates for Certain Procedures that Can Be Performed in ASCs

On April 16, 2014, the OIG released a report concluding that between CYs 2007 through 2011, Medicare has saved nearly $7 billion by covering surgical procedures in ASCs. In addition to the savings that would continue to...more

HIPAA Impaired Providers and the ER - What Happens When Your Employee Becomes Your Patient?

I was speaking this week at IAHIMA’s Annual Conference on the issues relating to HIPAA audits and recent updates from OCR and ONC. As part of my program we typically solicit questions prior to the presentation, most of which...more

OMB Extends Review of Rule That Would Require Labs to Release Results to Patients

The Office of Management and Budget has extended its review of a proposed rule that would require HIPAA-covered laboratories to make test results available to patients. In our previous post on this issue way back in...more

Clinically Integrated Networks Give Providers and Payers an Opportunity for Transformative Collaboration

I. Executive Summary - The health care sector is experiencing a series of market reforms that have the potential to reshape how care will be delivered and reimbursed for decades to come. Although a number of concepts...more

CMS Instructs Contractors Not to Conduct Patient Status Reviews for Claims with Dates of Admission Through December 31, 2013

On November 15, 2013, CMS issued Transmittal 1315, a One-Time Notification (CMS Transmittal), instructing Medicare Administrative Contractors (MACs), Recovery Auditors and the Supplemental Medical Review Contractor not to...more

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