Physicians

News & Analysis as of

Medicare RAC Program Improvements Delayed Until 2016 - Shorts on Long Term Care February 2015

The Centers for Medicare and Medicaid Services (CMS) had planned to award new contracts to companies that act as Medicare’s recovery audit contractors (now referred to as recovery auditors) (RAs) for operation of the Medicare...more

In it Together -- Emerging Joint Venture Structures for Hospitals and Insurers

Locke Lord lawyers Jon Biasetti, Baird Allis and Benjamin Sykes provide a detailed look at recent efforts by hospitals, physician practice groups and health insurance and managed care companies to lower health care delivery...more

These Doctors Work Hard – Over 24 Hours a Day

Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more

Telehealth Bill Moving Forward in Florida-But Medicaid Coverage Sacrificed

Last week, the Florida Senate Health Policy Committee removed language from proposed telehealth legislation that would require Medicaid reimbursement for telemedicine services at the same rates as face-to-face examinations....more

Medicare and Medicaid Appeal Deadlines and Procedures: Laws that EVERY Health Care Provider Should Know

If you are a physician, most likely, you are not a lawyer. And vice versa. While there are exceptions, generally, the professions of physicians and attorneys are mutually exclusive. Personally, one reason I went to law...more

Health Law Alert: Ninth Circuit Affirms Acquisition of Idaho Medical Group by St. Luke's Hospital Violates Antitrust Laws

On Feb. 12, the Ninth Circuit Court of Appeals affirmed a trial victory for the Federal Trade Commission (FTC) and Saint Alphonsus Medical Center (Saint Alphonsus) in their challenge to the acquisition by the St. Luke’s...more

Health Care E-Note - February 2015

In This Issue: - HIPAA Privacy During Emergency Situations - Probationary Medicaid RCOs – How Do Physicians Respond Without Subjecting Themselves to Potential Criminal And Civil Liability? - Big Data...more

Will an Illinois doctor tell you when they make a mistake?

A study found in the Journal of Patient Safety estimates that 400,000 people die each year in hospitals due to preventable medical mistakes....more

In Highly-Anticipated Decision, Ninth Circuit Affirms That Hospital-Physician Group Merger in St. Luke’s Violated Section 7 And...

On February 10, 2015, the Ninth Circuit issued its highly-anticipated decision at the intersection of health care and antitrust, affirming the lower court’s finding that a hospital-physician group merger completed nearly...more

“PhysTexting” Is Not Enough to Form a Patient-Physician Relationship

The Texas Medical Board is proposing to modify its disciplinary rules to more specifically define the requisites for a physician-patient relationship required for prescribing. Under the proposed revision to 22 T.A.C. § 190.8,...more

Healthcare Legal News: Volume 5, Number 1

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014....more

IRS Ruling Permits Inclusion of “Friendly PCs” in Consolidated Federal Income Tax Returns

On December 19, 2014, the Internal Revenue Service (“IRS”) issued a private letter ruling (the “Ruling”) allowing corporations that manage physician practices through a so-called “friendly physician” arrangement to treat the...more

Classic Antitrust Principles Apply to Health Care Mergers Even Post-ACA

The Ninth Circuit last week held that St. Luke’s Health System’s purchase of a physician practice group violated federal antitrust laws. In doing so, it upheld a district court’s order that the merger be dissolved. ...more

FDA Simplifying Physician Application Process for Compassionate Use of Unapproved Drugs

On February 4, 2015, FDA released draft guidance around its “Expanded Access” program, also known as “compassionate use.” The guidance proposes a greatly streamlined application form that physicians may use on behalf of...more

Takeaways from the Ninth Circuit’s Opinion Affirming the FTC’s Victory Against the St. Luke's/Saltzer Merger

On February 10, 2015, the United States Court of Appeals for the Ninth Circuit affirmed a district court’s ruling that St. Luke’s Health System’s acquisition of the independent physician group Saltzer Medical Group violated...more

GAO Highlights Medicare Program Risks and Recommends Program Integrity Actions

The Government Accountability Office (GAO) has released its latest update to its “High-Risk Series” reports, which again lists Medicare as a high-risk program, in part because of the program’s substantial size and scope, and...more

“Oh help me, please doctor, I’m damaged”*—What does the Future Hold for Hospital-Physician Acquisitions?

With the ink still drying on the Ninth Circuit’s opinion affirming the Idaho federal district court’s order requiring St. Luke’s Health System to unwind its acquisition of Saltzer Medical Group—a for-profit, physician-owned,...more

7th Circuit Court of Appeals Creates Expansive Definition of “Referral” Under the Anti-Kickback Statute

On February 10, 2015, in United States v. Patel (Case No. 14-2607), the Seventh Circuit Court of Appeals ruled that a physician makes a “referral” within the meaning of the federal health care programs Anti-Kickback Statute...more

Ninth Circuit Affirms FTC’s Challenge to Hospital-Physician Group Merger, While Rejecting Efficiencies and Health Care Quality...

In a much anticipated appellate health care antitrust decision, the United States Court of Appeals for the Ninth Circuit upheld a district court’s finding that a consummated hospital-physician group merger violated Section 7...more

New Venture Seeks to Support Independent Physicians in Texas

The Texas Medical Association (TMA) and Blue Cross Blue Shield of Texas are launching a new services company, TMA PracticeEdge, to facilitate bringing the benefits of value-based reimbursements to the state’s independent...more

FTC Successful Challenge to Hospital Acquisition of Physician Group

In March 2013, the Federal Trade Commission, together with the Idaho Attorney General, filed a complaint seeking to block St. Luke’s Health System’s planned acquisition of Saltzer Medical Group P.A., a multi-specialty...more

Quality Over Quantity: The Shift from Fee-for-Service to Value-Based Payment Systems

The United States Department for Health and Human Services (“HHS”) recently announced its intention to tie thirty percent of fee-for-service Medicare payments to alternative and value-based payment models by 2016. HHS hopes...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

Medicare Moves Strongly to Value Based Payment...A Tipping Point?

Over the last several years, doctors and other health-care professionals have worked to transform accountable care organizations (ACOs) from an academic idea into a meaningful presence in the health-care marketplace. Last...more

Rip Van Winkle Fails in Effort to Enjoin Peer Review Process

Okay, it wasn’t really Rip Van Winkle. Rip slept for only twenty years. It was Dr. Legrand Belnap who sued a Salt Lake City hospital and its medical executive committee members. ...more

567 Results
|
View per page
Page: of 23