Physicians

News & Analysis as of

Recent Changes to Stark Law's Whole Hospital Exception

The federal physician self-referral law, or Stark Law, provides a number of exceptions to the law's prohibition of physician referrals of designated health services to an entity in which the physician has an ownership or...more

Two Months After Indictment, Medicare Fraud Mastermind and Doctor Plead Guilty

Mark Morad, the man who cooked up a $56 million Medicare fraud scheme, and his accomplice doctor pled guilty yesterday in federal court in Louisiana to various health care fraud charges....more

How to Prepare Your Hospital or Medical Practice for a Meaningful Use Audit

For the past several years, the Centers for Medicare and Medicaid Services (“CMS”) has incentivized hospitals and eligible professionals to adopt and make “meaningful use” of certified electronic health records (“EHR”)...more

CMS Releases Final Rule That Increases Difficulty of Medicare Enrollment

In early December, CMS released a final rule that implements certain provider (i.e., Hospitals, SNFs, physicians, etc.) and supplier (i.e., DME companies, etc.) enrollment requirements (“Rule”). The goal of CMS’...more

OIG Releases Proposed Gainsharing Regulation

In early October, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released a proposed rule that included, among other provisions, a proposed gainsharing regulation (“Proposed Rule”),...more

Sunshine Act Update: CMS Streamlines Reporting for CME-Related Payments in 2016

CMS issues a Final Rule that removes the exclusion for reporting of continuing education payments to certain accredited organizations, while also clarifying previously existing parameters that may preclude reporting of these...more

Illinois Supreme Court to Consider Discovery Privileges Applicable in Medical Malpractice

In the closing days of its November term, the Illinois Supreme Court agreed to decide an issue of potential importance to the medical malpractice bar: what kinds of documents are privileged from disclosure in a negligent...more

Medical Marijuana Roundtable: Top Ten Takeaways

Minnesota recently became the latest state to permit the limited use of medical marijuana for treating certain health conditions. In early October, the Department of Health issued proposed regulations to implement the new...more

How Do I Get Out of this Practice?

For years the goal of many young doctors was to gain ownership in their medical practice entity. For many, when the time came for them to “make partner,” they signed on the dotted line without fully understanding the legal...more

Governor’s Council recommending mandatory use of SCRIPTS program

Prescription drug abuse is epidemic across the nation, and South Carolina has not been immune. According to a 2013 report from the State’s Inspector General, South Carolina ranked 23rd per in per capita opioid painkiller...more

Connecticut Law Establishes New Reporting and Governance Requirements for Health Care Entities: Part 1: Requirements Applicable to...

A new Connecticut law, Public Act Number 14-168, entitled “An Act Concerning Notice of Acquisition, Joint Ventures, Affiliations of Group Medical Practices and Hospital Admissions, Medical Foundations and Certificates of...more

Retained Surgical Sponges: A serious medical error

Occasionally, doctors make mistakes while treating their patients. Some of the errors that occur are so egregious that the medical profession has come to know them as “never events” because they should never, under any...more

Supreme Court Rejects Whistleblower’s Double-Dip Attempt

On Monday the United States Supreme Court declined to hear Danny Smart’s appeal of the Fifth Circuit’s rejection of his attempt to share in the proceeds of a $5 million settlement of a False Claims Act suit brought by another...more

Three Key Components to Physician Buy-In for Telemedicine

It appears some people believe physicians are slow adopters to new avenues of health care delivery. Our recent survey of senior-level health care executives identified securing physician support as their second largest...more

Illinois Legislature Passes Anti-Markup Law Applicable to Pathology Services

Last Thursdday both chambers of the Illinois legislature voted to override the Governor’s amendatory veto and passed Public Act 098-1127, which prohibits a physician from charging a markup on anatomic pathology services if...more

View From McDermott: A New Type of ERISA-Based Hold-Up—The Rise of Out-of-Network Provider Suits Against Self-Funded Health Care...

Over the past decade, there has been a significant increase in the number of physicians who have dropped out of Preferred Provider Organization (‘‘PPO’’) and Health Maintenance Organization (‘‘HMO’’) networks and attempted to...more

New Jersey Court Supports Peer Review Immunity for Hospital

On November 24, 2014, the New Jersey Appellate Division affirmed a lower court’s decision to dismiss a physician’s lawsuit against a hospital based on federal and state statutory immunity provisions that shield hospitals and...more

Case Comments: Interpretation of Standards of Practice and Standard of Review

Hunter v College of Physicians & Surgeons of Alberta, 2014 ABCA 262 (Alta CA), upholding the decision of the Council for the College and dismissing the appeal. A physician who married his former patient challenged his...more

Global Surgery and 2015 Medicare Physician Fee Schedule

On July 21, 2014, I posted the proposed Medicare Physician Fee Schedule, and described the intent by CMS to eliminate global surgery. On November 13, 2014, CMS issued the final 2015 Medicare Physician Fee Schedule, and...more

Fundamentals of Hospital/Medical Staff Issues: Minimizing Risk and Maximizing Collaboration

In this presentation: - Health System Structure and Governance - Medical Staff Structure and Governance - Committee Structure - Medical Staff Categories - Medical Staff Governance...more

Impact of Health Care Reform on Provider Liability

In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more

CMS Publishes Additional (but Limited) Guidance on the Coverage with Evidence Development Process

On November 20, 2014, the Centers for Medicare and Medicaid Services (“CMS”) published its latest round of guidance on its Coverage with Evidence Development (“CED”) policy for selected items and services under the Medicare...more

Final CMS CoPs: Navigating Revised Medical Staff Standards and New Requirements

In this presentation: - Hospital Governing Board - Hospital Medical Staff – Membership - Hospital Medical Staff – Separate or Unified? - Ordering Hospital Outpatient Services - Excerpt from...more

Does Telemedicine Matter? Yes!

Technology pervades every sector of our economy, and certainly has impacted the health care industry. One example is telemedicine. Telemedicine has the potential to exponentially expand a provider’s geographic footprint,...more

High Court Restricts Common Law Duty Of Care Where Hospitals/ Doctors Have Statutory Obligation To Discharge From Involuntary...

HUNTER AND NEW ENGLAND LOCAL HEALTH DISTRICT V MCKENNA [2014] HCA 44 - On 12 November 2014, the High Court of Australia unanimously held that a hospital and a doctor did not owe a duty of care to the relatives of a man...more

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