Physicians

News & Analysis as of

New Law Aims to Ensure Updated and Accurate Physician Directories

An effort is underway to offer patients more accurate and complete provider information so that they may identify which providers are within their health plan and make educated decisions regarding treatment. On July 1, 2016,...more

Medical Non-Competes in Rhode Island: No Clean Bill of Health

The Rhode Island Superior Court recently refused to enforce a non-compete agreement against a local physician because it was against the public interest. Medicine and Long Term Care Associates, LLC v. Khurshid, PC 2015-0458,...more

Rhode Island Trial Court Decision Could Spell Trouble for Employers Seeking to Enforce Restrictive Covenants Against Healthcare...

One of an employer’s first steps in a suit against a former employee to enforce a restrictive covenant is to seek a preliminary injunction to prevent the employee from continuing to violate his or her contractual obligations....more

CMS Announces Latest Alternative Payment Model - Comprehensive Primary Care Plus

Continuing in its efforts to promote alternative payment models, on April 11, 2016, CMS announced the Comprehensive Primary Care Plus (CPC+) model. CMS hopes to implement CPC+ in up to 20 regions, accommodating up to 5,000...more

Insurer Actions Cut the Heart Out of Out-of-Network Providers

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management, LLC and its affiliates (collectively, Bay Area), for an alleged...more

Health Law Insights Newsletter - Issue 8 - April 2016

McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - New Payment Model for Part B Drugs Proposed -...more

AFFs, BPs, ONJ: Understanding Alphabet Soup of Osteoporosis Treatment

The American Society for Bone and Mineral Research recently reassessed the efficacy of bisphosphonate, long hailed as a wonder drug for patients with osteoporosis, and its risk factors. Through the course of two clinical...more

Tennessee Health Services And Facilities Report: - April 2016 Newsletter

The Tennessee Health Services and Development Agency (HSDA) is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program. A Certificate of Need (CON) is a permit for the...more

Court Dismisses Major False Claims Act Case Against Hospice Provider: Ruling Mere Difference of Medical Opinion is Insufficient...

On March 31, 2016, the United States District Court for the Northern District of Alabama in U.S. ex rel. Paradies v. AseraCare, Inc. dismissed a major False Claims Act case against a national hospice provider after ruling...more

Ninth Circuit Dismisses Interlocutory Appeal Of Order Denying Motion To Stay Under Federal Arbitration Act For Lack Of...

Western Security Bank brought an action in the United States District Court for the District of Montana against certain doctors seeking to enforce commercial loan guaranties. The doctors asserted that a non-party, Meridian...more

CMS Announces Major Multi-Payer Comprehensive Primary Care Plus (CPC+) Model

CMS has launched a new “Comprehensive Primary Care Plus” (CPC+) model to improve how primary care is delivered and reimbursed. According to CMS, the CPC+ initiative (which builds on the ongoing Comprehensive Primary Care...more

OIG Examines Hospice Medicare Billing for General Inpatient Care

According to a recent OIG report, hospices billed inappropriately almost one-third of Medicare general inpatient care (GIP) stays in 2012, resulting in $268 million in inappropriate Medicare payments. The GIP level of care...more

Senate HELP Committee Approves Mental Health Reform, Public Health Bills

The Senate Health, Education, Labor and Pensions (HELP) Committee recently approved the following health policy bills: - ..S. 2680, the Mental Health Reform Act of 2016 — to improve coordination between federal agencies...more

Virginia Telehealth Law: What You Need to Know

Virginia has made strides to expand the telehealth offerings available to its residents and the Old Dominion took another step forward advancing telemedicine when it enacted a bill amending Virginia Code § 38.2-3418.16 to...more

Differences in Medical Opinion Are Not False Claims Act Violations

In an important win for hospice and other health care providers facing claims under the False Claims Act (FCA), a federal court in Alabama gave a summary judgment victory last week to hospice provider Aseracare Inc. Key...more

CMS Call on 2016 PQRS Reporting & Avoiding 2018 Negative Payment Adjustments

On April 21, 2016, CMS is hosting a provider call on the 2016 Physician Quality Reporting System (PQRS), including how eligible professionals and group practices can satisfactorily participate and report in order to avoid the...more

Health Care/Health Care Litigation Advisory: Update on the AseraCare False Claims Act Litigation – A Win for AseraCare and Health...

In November 2015, we published a client advisory on the closely watched AseraCare litigation and its potential impact on the falsity element under the False Claims Act (FCA). AseraCare involves allegations that a hospice...more

Court Won’t Enjoin Physician Who Breached Non-Compete Covenant And Consented To Injunction

A physician signed a non-compete covenant, agreed to be enjoined if he breached, and allegedly did breach. But when his former employer asked a Providence, Rhode Island Superior Court judge to enter an injunction, he refused...more

Does racial bias by doctors hurt black patients’ ability to get adequate pain management?

The answer is “yes,” according to a new study which finds that medical students hold “fantastical” views about biological differences between blacks and whites, and this may result in blacks receiving less help in managing...more

District Court Deals Blow to DOJ in False Claims Act Case

Last week, the United States District Court for the Northern District of Alabama handed the Department of Justice (DOJ) a significant defeat by dismissing a False Claims Act (FCA) case against AseraCare, a national hospice...more

West Virginia's New Telemedicine Practice Standards & Remote Prescribing Laws

West Virginia Gov. Earl Ray Tomblin (D) signed into law, on March 24, 2016, a new bill (House Bill No. 4463) implementing a variety of telemedicine practice standards and remote prescribing rules in the Mountain State....more

Judge Sides with AseraCare, Grants Summary Judgment in $200 Million FCA Case

Much like the rest of the health care world, we have been following the AseraCare case since May of last year when the Alabama federal district court granted AseraCare’s motion to bifurcate its False Claims Act (FCA) trial...more

Four Distinct Federal and State Policies Addressing Prescription Opioid Abuse

The first quarter of 2016 has witnessed a great deal of attention in government to the problem of opioid-related overdose and death in the United States. In just the past few weeks, the Senate passed prescription drug...more

False Claims Act Trial Sets Precedent for Future Cases

The DOJ’s theory of falsity based on clinical disagreement alone fails as a matter of law. In a closely watched False Claims Act (FCA) proceeding by the healthcare industry and FCA practitioners, the US District Court...more

CMS Moving Ahead on Medicare Physician Payment Reform; Proposed MACRA Rule at OMB

The White House Office of Management and Budget (OMB) is now reviewing a highly-anticipated Centers for Medicare & Medicaid Services’ (CMS) proposed rule to implement major Medicare physician payment reform provisions...more

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