News & Analysis as of

Peer Review Concludes with Termination of Reviewer

You read that correctly: the hospital fired the physician who did the reviewing in a medical staff peer review proceeding. Hospital executives present at the proceeding felt the reviewing physician was too harsh in...more

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

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

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

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

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

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

“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

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

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

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

New Rule on Medicare Reimbursement for Chronic Care Management Services

In November 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final regulation with changes intended to ensure Medicare’s payment system “reflect[s] changes in medical practice and the relative value of...more

Electronic records and medical errors

Many hospitals, clinics and medical offices in the Chicago area have been transitioning to a completely digital system for all of their patients’ health records....more

Teen Posing as Physician Raises Security Concerns for Healthcare Employers

On January 13, 2015, a hospital in West Palm Beach, Florida discovered that an unidentified juvenile had been walking its halls dressed as a physician, wearing a lab coat with the hospital’s logo and a stethoscope. According...more

HHS Announces First Timeline For Medicare Pay Reforms

On Monday, January 26, 2015, the Department of Health and Human Services ("HHS") announced a timeline for moving physicians and hospitals into new payment systems and tying Medicare reimbursements to quality of care....more

HHS Payment and Delivery Reform Announcement Sets Priorities for Remainder of Obama Administration

One week prior to the unveiling of the President’s first budget under a completely Republican-controlled Congress, the Department of Health and Human Services (HHS) made its most formal announcement yet on the Obama...more

To Close or Not to Close: Tennessee Attorney General Weighs in on Hospital Bonuses and What Constitutes a Strategic Plan

On January 28, 2015, the Tennessee Attorney General ("Attorney General") issued a formal opinion ("Opinion") addressing whether Tennessee law permits "the board of a public hospital to meet in closed session to discuss...more

Aggressive New Cms Pre-Payment Review Initiative Threatens Physician Practices And Hospitals

According to a recent report in the American Medical News, The Center for Medicare and Medicaid Services (“CMS”) published plans to increase the number of pre-payment reviews of hospital and physician claims from 1.2 million...more

Chinese Government Further Encourages, Regulates Multi-Site Practice by Physicians

The Opinions on Encouragement and Regulation of Multi-Sited Practices of Physicians demonstrate the Chinese government’s continued efforts to develop Chinese physicians’ ability to practise at multiple sites, and will provide...more

Healthcare Fraud: Aggressive Enforcement Strategies

This week I am focusing on the persistent problem of healthcare fraud. For healthcare providers, the challenge of compliance and avoiding enforcement risks is particularly difficult. ...more

Ensuring Data Protection In The Implementation Of The EFPIA Disclosure Code: Key Challenges And How Pharmaceutical Companies Are...

The EFPIA Disclosure Code will, from 2016, require pharmaceutical companies to disclose details of payments and transfers of value made to healthcare professionals and healthcare organisations. The Code aims to promote,...more

Minnesota Supreme Court Holds that Medical Staff Bylaws Are an Enforceable Contract

In an opinion released on December 31, 2014, the Supreme Court of Minnesota held that medical staff bylaws can be an enforceable contract and that a hospital’s medical staff (as an unincorporated association) can have the...more

216 Results
|
View per page
Page: of 9