Physicians

News & Analysis as of

Research Doesn’t Pay—At Least Not in Graduate Medical Education

Indirect graduate medical costs, or IGME, are what Medicare allows teaching hospitals in increased Medicare rates. IGME represents the indirect costs to a teaching hospital of hosting residents and interns—costs above and...more

Veterans Access, Choice, and Accountability Act of 2014 Increases Graduate Medical Education Residency Positions

On August 7, President Barack Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (Act). While much press has been given to the Act’s increasing of access to private health care providers,...more

Is the California Medical Board Too Slow in Disciplining Doctors?

The case of former San Diego Chargers team physician Dr. David Chao has raised questions about how much the California Medical Board is doing to discipline doctors involved in malpractice claims. Chao has been investigated...more

Antitrust Considerations Surrounding Health Care Consolidation Among Hospitals and Physicians

The Affordable Care Act (“ACA”) has resuscitated the demand for hospital and health care provider mergers. The law explicitly encourages collaborative care—through, for example, financial incentives surrounding the creation...more

Here Comes the Sunshine Act

The Centers for Medicare and Medicaid Services (CMS) released a guide for physicians to prepare for the Dispute Resolution period of the Physician Payments Sunshine Act. The CMS guide is available on the CMS Open Payments...more

OIG Issues “Special Fraud Alert” on Lab Payments for Specimen Processing and Data Registry

On June 25, 2014, the OIG issued a Special Fraud Alert addressing compensation paid by laboratories to referring physicians. This Special Fraud Alert supplements prior OIG guidance which emphasizes that providing free or...more

IOM Study Recommends Major Changes in Graduate Medical Education Funding

An Institute of Medicine committee issued its long-awaited study on Graduate Medical Education (GME) funding on July 29, 2014. The committee, headed by two former Centers on Medicare & Medicaid Services administrators, Gail...more

CMS Care Coordination Payments – A Boon to Doctors and Patients but Patient Participation Will be Essential

As the Affordable Care Act continues to mature, we are seeing new efforts by the Obama administration to incentivize care coordination across a spectrum of services provided to Medicare Fee-for-Service (FFS) patients. A New...more

New Jersey DCA Extends Deadline for Prescription Blanks

On February 18, 2014, the New Jersey Division of Consumer Affairs (the “DCA”) adopted new regulations which incorporate print-based security features into all New Jersey Prescription Blanks (NJPBs). The DCA has recently...more

Laboratory Payments to Physicians for Specimen Processing Present Substantial Risk of Fraud and Abuse

The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring...more

Proskauer Obtains Dismissal of High-Stakes False Claims Act Suit

On August 7, 2014, Judge Castel of the Southern District of New York dismissed a False Claims Act (“FCA”) complaint that was based primarily on allegations that the defendant Hospital improperly focused on referral revenue in...more

Mailing of FMLA Notices Not Sufficient to Overcome Denial of Receipt by Employee

On August 5, 2014, the Third Circuit Court of Appeals ruled that an employer’s claim that it mailed to its employee a notice of rights under the Family and Medical Leave Act (FMLA or Act) is not enough to rebut the employee’s...more

Academic Medical Centers: Clinical Care, Research and Teaching (or Maybe Not?)—Graduate Medical Education and the Future

In the world of healthcare policy and law, we usually discuss issues impacting providers, but don’t often report about the training and infrastructure behind what allows our healthcare system to treat patients in our...more

Navigating the Connected Health Landscape: AMA Issues Guiding Principles for Conducting Telemedicine

In late June, the American Medical Association (AMA) adopted a set of guiding principles for physicians who provide care via telemedicine. The AMA’s guiding principles come on the heels of policies recently published by the...more

Dark Clouds Over Sunshine Act

Once again the Obama administration has been tripped up in launching a healthcare-related online system. This time the problem concerns the Physician Payments Sunshine Act—the act that is supposed to enable the public to see...more

Minnesota Department of Health Introduces New Conrad 30 J-1 Waiver Review Process and Program Guidelines

On August 8, 2014, the Minnesota Department of Health unveiled significant changes to its Conrad J-1 waiver program for international medical graduates. The program changes will be implemented during the 2015 waiver program,...more

The Sliding Scale of Health Coverage: Finding the Intersection of Cost, Access and Quality

While not a new concept, the use of narrow networks has become a lightning rod for the controversy surrounding qualified health plans (QHPs) offered on the insurance exchanges created under the Affordable Care Act (ACA) and...more

Florida Board of Medicine Opts for Less Regulation of Office Surgical Procedures

The Florida Board of Medicine recently amended its office surgery rules to exclude numerous facilities, and providers who inadvertently may have been in violation of the previous rule requirements by not having registered...more

Impact on Medicare Payments of Shift in Site of Care for Chemotherapy Administration

Two independent trends, acting in combination, are currently resulting in increased Medicare fee-for-service (FFS) chemotherapy payments. The first trend is a shift in the site of care for cancer patients from physicians’...more

FDA Set to Regulate LDTs - Citing Safety Concerns and Advanced Technologies

Advances in medical technology have increased the use of diagnostic tests to guide therapeutic decisions for many diseases and conditions, especially in the context of personalized medicine. Citing the need to ensure that...more

Treating Physician Testimony May Establish Reasonable Value of Medical Bills

Joaquin Ochoa, et al. v. Jesus Felipe Dorado, et al. - Court of Appeal, Second Appellate District, Division Three (Shasta) (July 22, 2014) - Joaquin Ochoa and Imelda Moreno (“Plaintiffs”) were traveling in a...more

What’s an MDDS? And Why Should I Care?

Last month the Food & Drug Administration (FDA) announced still further relaxation of its oversight over anything qualifying as a “medical device data system,” or MDDS. The announcement should come as welcome news to a great...more

New Clarifications Affect Physician and Hospital Medicare Part B Billing for Services Provided by Nursing and Other Staff...

CMS recently released rules changing the requirements for Medicare coverage of services furnished incident to a physician’s, NP’s, or PA’s services. Howard Sollins, Donna Senft and Susan Turner explain the effect of the...more

Ohio Physician Assistants and Advance Practice Nurses Now Permitted to Admit Patients to Hospitals

As the prevalence of physician extenders continues to grow to meet patient demand, so does their scope of practice. Effective May 20, 2014, Ohio law now permits physician assistants, certified nurse practitioners,...more

Health Alert (Australia) - July 28, 2014

In This Issue: Judgments; Legislation; and Reports. Excerpt from Judgments: New South Wales (NSW) - 22 July 2014 - Lane v Northern NSW Local Health District (No 3) [2014] NSWCA 233 - This...more

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