News & Analysis as of

Physicians

Pill Mills, Poppy Flowers, Dead Poets and the Human Resources Department

Having been through a seven-week federal criminal “pill mill” trial, I think a lot about enforcement of the Controlled Substances Act and its effect on physicians. Aggressive enforcement effects others in healthcare as well,...more

Telehealth Opportunities Worth Watching in 2018

Continued physician shortages, reduced reimbursement from government and private insurance plans and the ever-increasing health care needs of an aging population are forcing payors and providers alike to increase the...more

House of Representatives reintroduces resident rotator legislation

by Dentons on

On December 5, members of the US House of Representatives reintroduced a bipartisan bill designed to help hospitals that accidentally established Medicare GME caps and/or per-resident amounts based on small numbers of...more

Appeals Court: No Bad Faith For An Insurer’s Legitimate Exercise Of A Contractual Right Or Its Settlement Within The Policy Limit...

In a Rule 1:28 decision applying New Hampshire law, the Appeals Court affirmed the entry of summary judgment dismissing a doctor’s suit accusing her professional liability insurer of improper settlement of a claim without her...more

2018 Reimbursement Cuts for Some Off-Campus Hospital Provider-Based Departments

by McGuireWoods LLP on

On Nov. 2, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized a rule changing reimbursement rates under the Medicare Physician Fee Schedule (MPFS) for certain non-excepted hospital off-campus provider-based...more

Texas Hospital Settles Kickback Allegations Relating to Marketing Services Payments

by King & Spalding on

On December 4, 2017, the DOJ announced a $7.5 million settlement with Pine Creek Medical Center, a Dallas-based physician-owned hospital. The settlement resolves allegations that the hospital paid physicians kickbacks in the...more

“Tap Here For A Doctor” – The Proliferation of Telemedicine In The Gig Economy

by Fisher Phillips on

Several years ago, many people were leery of the thought of ordering personal drivers through a mobile app and getting into a car of a complete stranger. However, over time, the idea of ride-sharing through Uber or Lyft has...more

Healthcare, Hospitals, and Immigration: The Need to Access the Global Medical Professional Workforce with Ease

Every healthcare organization has two essential requirements: (1) continuous access to qualified talent; and (2) continuous access to significant numbers of that talent. Hospitals clearly need a lot of employees. To meet...more

The Rollback of Immunity for Healthcare Institutions under Mahmoodian

by Steptoe & Johnson PLLC on

A recent decision by the West Virginia Supreme Court of Appeals could significantly increase the potential for litigation arising from adverse privileging decisions by healthcare institutions in the state. Under the Court’s...more

CMS Provides Advice On Electronic Laboratory Alerts

by Fox Rothschild LLP on

CMS recently issued an Advisory Opinion suggesting that physicians who refer diagnostic tests reimbursable under Medicare to a laboratory may, under certain circumstances, receive electronic pop-up notifications in the...more

Another Obstacle to Medicare and Medicaid Compliance

by McGuireWoods LLP on

When investigating whether an individual or entity is excluded from the federal healthcare programs, healthcare organizations must be on the alert for yet another method for defrauding the government: alias names. Alias names...more

OIG: Medicare Program Integrity at the Top of HHS Management Challenges

by Reed Smith on

The OIG’s latest compilation of top HHS management and performance challenges flags vulnerabilities in key HHS health and social services programs, including includes the following: 1. Ensuring Program Integrity in...more

Why Finding Your Physician’s Disciplinary History Is So Hard

by Howard Ankin on

Physicians are not required to inform their patients that they are on probation for unethical conduct or medical errors that result in disciplinary actions. Most databases that contain this important information are either...more

CMS Modifies Medicare Physician Quality Payment Program Rules for 2018

by Reed Smith on

CMS has issued a final rule with comment period making changes to the Quality Payment Program (QPP) for 2018, the second performance year for the reformed physician payment framework mandated by the Medicare Access and CHIP...more

Abrupt Closure of SynerMed Shakes Up Medical Management Industry

by Nossaman LLP on

SynerMed, a Southern California-based physician management company, will be shutting down, per an email from its CEO earlier this month. Recently, the company had come under increasing scrutiny by health plans and California...more

The risk of uncertain partnership arrangements

by Dentons on

The risks for partnerships operating without a written partnership agreement in place are well known. A recent Court of Appeal case is a useful reminder that these risks can arise in the period after new partners join a...more

Sale of Generic Drug to Physician With “Extensive Information” on the Label May Induce Infringement

In Sanofi v. Watson, No. 2016-2722, the Federal Circuit affirmed the district court’s decision, upholding induced infringement and validity of Sanofi’s patents covering compositions of, uses for, and methods for administering...more

Legislative Session Primer: Governor Holcomb's Agenda and Study Committee Recommendations

by Faegre Baker Daniels on

The legislative season will officially get underway on Tuesday, November 21 when the Indiana General Assembly convenes at the Statehouse for its annual Organization Day. Two newly elected state representatives will be sworn...more

MACRA Update: Attestation Regarding Your EHR System

by Fox Rothschild LLP on

CMS recently issued guidance on the three-part “Prevention of Information Blocking” attestation which physicians and other eligible clinicians will need to submit to CMS in order to qualify for points under the “Advancing...more

CMS Releases Final 2018 Medicare Payment Regulations

by Baker Donelson on

On November 1 and 2, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 Medicare Payment Regulations for the Physician Fee Schedule, Hospital Outpatient Prospective Payment System and Ambulatory...more

Recent Case Highlights Risks of Paying Physicians for Routine Duties - Signed writing required, informal documentation may not be...

by Stinson Leonard Street on

Payments to physicians, even for routine, necessary duties, may cause referrals to the entity making the payments to be "prohibited referrals" under the Stark Law. This means the hospital or other entity should not have...more

“Always a bridesmaid, never a bride” Might Work for Stark Liability but Not the Anti-Kickback Statute

by Nossaman LLP on

Last Thursday, a jury in federal district court in St. Louis handed down a verdict in a False Claims Act (“FCA”) case that presents a laundry list of the challenges which can arise in a FCA case. ...more

CMS Finalizes Medicare Physician Fee Schedule Update for 2018

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has published its final Medicare physician fee schedule (PFS) rule for CY 2018. In addition to updating rates for 2018, the rule includes important policy changes, including...more

Three Years Later, Foley Survey Reveals Positive Prognosis for Telemedicine

by Foley & Lardner LLP on

When we launched Foley’s inaugural Telemedicine and Digital Health Survey in 2014, it was apparent that health care executives weren’t ready to make telemedicine a significant focus of their business and patient strategies....more

Florida Supreme Court Strikes Defendants' Ex Parte Interviews with Treating Physicians

by Holland & Knight LLP on

• The Florida Supreme Court has dealt a significant blow to Florida's medical malpractice pre-suit process, ruling that statutes authorizing the conduct of informal, ex parte interviews with a medical malpractice claimant's...more

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