News & Analysis as of

An Analysis Of Physician Compare Website

The rise of consumer-driven health care passed a milestone on Feb. 21, when, for the first time, the Centers for Medicare and Medicaid Services, or CMS, posted on its Physician Compare website performance scores on quality...more

Health Law Wire: Physician Medicare Revalidation Notice

On January 29, 2014, the National Government Services, Inc. announced that it would begin mailing out revalidation notices (“Notice”) to physicians enrolled in the Medicare program sometime in the next (12) months. Physicians...more

CMS Advised to Follow Private Sector Practices to Improve Physician Feedback Reports

On March 26, 2014, the Government Accountability Office (GAO) released its report regarding the private sector’s physician feedback reporting practices and how implementation of such practices could improve CMS’s own reports...more

The use of medical reports at trial – Campbell v. Roberts

The use of a physician’s medical reports at trial has been a recurring topic in the Courts recently. One of the issues that has been the focus of recent judicial commentary concerns the use that can be made of medical...more

Health Care E-Note - March 26, 2014

In This Issue: - Hospital CEO Turnover Rate Reached Record 20 Percent in 2013 - States Take on Authority of Doctors vs. Advanced Practice Nurses - HHS Urges Hospitals to be More Prepared for Emergencies -...more

The 2014 OIG Work Plan: Select Provisions Applicable to Physician Practices

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued its 2014 Work Plan outlining its intended review activities of HHS Programs for 2014. This article summarizes certain...more

Physician Obtains Injunction Preserving Clinical Privileges Despite Attempted Exclusive Contract

Despite the many cases acknowledging the right of hospitals to enter into exclusive contracts, there is always the issue of what happens with the existing clinical privileges and medical staff memberships of the physicians...more

When It Comes to Medicare Payment, Physicians Have Choices

Health care providers can choose to enroll in, participate in, or opt out of Medicare, but… - Not everyone can choose equally and their choices will net direct outcomes in their practice income. Medicare jargon can be...more

Starting A Medical Practice: What Entity Works Best For You?

Starting a medical practice is an exciting new opportunity, but, like with many new opportunities, you will face a number of important decisions before you can open your doors to patients. One of the early decisions you will...more

Halifax Reportedly Settles Landmark Stark Case

According to minutes filed in the U.S. District Court for the Middle District of Florida, Halifax Hospital Medical Center (Halifax) and the U.S. Department of Justice (DOJ) have reached a settlement in the pending False...more

California Decision Allows Physician to Challenge Sham Peer Review as Whistleblower Retaliation

In Fahlen v. Sutter Central Valley Hospitals, the California Supreme Court found: A physician is not required to first exhaust his administrative remedies through the medical staff appeals process in order to...more

Halifax Settles Stark Damages for $85 Million

Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively, “Halifax”) have agreed to pay $85 million to settle allegations that Halifax compensated a group of physicians in a manner not permitted by the Stark...more

CMS authorizes contractors to deny ‘related’ claims of physicians who are not undergoing review

The Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services recently issued Transmittal 505 modifying Section 3.2.3 of the Medicare Program Integrity Manual. CMS employs a variety of...more

TREAT THEM RIGHT: The joys and pitfalls of treating doctors

Something came up for opposing counsel at the last minute. He didn’t show. That left us – the court reporter, videographer, and me – sitting in the conference room with the treating doctor deponent. The one who had been too...more

The Fahlen Floodgates: Straight Talk about Two-Track Peer Review

The California Supreme Court unanimously ruled on February 20, 2014, that a physician claiming that her/his privileges were terminated in retaliation for whistleblowing to safeguard patient care and safety does not have to...more

The Physician Payment Sunshine Act – The Top Five Steps for Physicians: The law defines “payment” to include almost any imaginable...

The Physician Payment Sunshine Act is a minor part of the Affordable Care Act, but it could result in major headaches for physicians. The chief purpose of the Sunshine Act is to make any payments made by medical manufacturers...more

Draft Framework for Interstate Medical Licensure Compact Released

A significant barrier to the interstate practice of telehealth is closer to being broken down. The Federation of State Medical Boards ("FSMB") recently completed and distributed a draft Interstate Medical Licensure Compact...more

Argument Report: Illinois Supreme Court Debates the Scope of the Good Samaritan Act

Our reports on the oral arguments of the recent term of the Illinois Supreme Court continue with Home Star Bank & Financial Services v. Emergency Care & Health Organization, Ltd. Home Star poses the question of whether...more

A New Tool for Ohio Physicians: OARRS Practice Insight Report - A New Feature Enhances Ability to Monitor Prescribing Practices...

Ohio physicians now have another reason to be familiar with and utilize the Ohio Automated Rx Reporting System (“OARRS”) as a component of their practices. While OARRS checks have been mandatory under certain circumstances...more

Court Orders Divestiture of Consummated Physician Practice Acquisition

In a challenge brought both by private plaintiffs and the government, a court has ruled that a health system’s acquisition of a competing physician group practice violated the antitrust laws where the transaction resulted in...more

Court Dismisses POD Lawsuit Against OIG

On February 5, 2014, a federal court dismissed a challenge to the U.S. Department of Health and Human Services’ Office of Inspector General’s (“OIG”) March 26, 2013 Special Fraud Alert (“2013 SFA”) on physician-owned...more

Better vs. Cheaper? – Court Says Cost Trumps Quality in Health Care – Orders Undoing of Physician Group Tie-up

The health care industry is in the midst of a revolution caused by demographic changes, advancements in medical understanding and, of course, Obamacare. As health care providers scramble to adjust to this brave new world, the...more

Congress Announces Agreement on Physician Payment Overhaul Legislation

On February 6, 2014, lawmakers reached an agreement to overhaul the Medicare physician payment system. The current sustainable growth rate (SGR) formula requires an annual cut in physician payments, which Congress typically...more

Joint SGR Repeal Bill Agreed Upon, Moving to Full Congress

New joint legislation to repeal Medicare’s failed SGR formula is advancing to both chambers of Congress following an agreement announced Thursday by the three committees that put forth repeal bills earlier this...more

Funding Offsets Proposed for Physician Payment Overhaul

Congressional lawmakers are currently reviewing 65 potential funding offsets for legislation that would overhaul the Medicare physician payment system. In its present form, Medicare’s sustainable growth rate (SGR) formula...more

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