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By Eric A. Shore, J.D. and Pia Horton

Everyday your patients trust you to care for their health. Many of your patients find themselves unemployed and therefore, uninsured. While some will find work eventually, those with physical and/or mental limitations may not. This is especially true for those approaching retirement age (50-65 years). You can help.

Patients who are unable to sustain work due to their health may be eligible for Social Security disability benefits, therefore making them eligible for Medicare or Medicaid. Although treating your patients …

By Deborah B. Miller, Esq.
From a personal perspective, prenuptial agreements are not very appealing, but from a common sense and legal point of view, they can be essential.

Getting married is the biggest financial decision in most people’s lives, but many do not consider the financial entanglements that marriage creates.  Just ask anyone who has lost a house or retirement plan in a divorce.

Despite reading articles about the importance of using a prenuptial agreement as a tool for planning, plenty of people feel uncomfortable with prenuptial agreements.  Luckily, there are secondary …

By Lynn Lucas-Fehm, MD, JD
When the AMA was formed in 1847, the founders could not have imagined how health care delivery would change in the ensuing 150 years. The goals of the 19th century medical profession were ambitious but clear – to assure that the highest standards of excellence became the foundation for the practice of medicine.

At the first meeting of the AMA, the delegates developed policies by introducing, debating, amending and ultimately passing resolutions.  One example was the policy establishing the requirement for “gentlemen” entering the profession:

Resolved, that this …

By Lucia Francesca Bruno, JD, LLM, MBA

The proverbial statement, “You only get one bite at the apple” couldn’t be truer than when negotiating a Physician Employment Agreement.  Whether you’re the head of a medical practice inviting an experienced physician to join the group, or a resident contemplating a Letter of Intent, fair and effective negotiations are paramount to establishing a long-term working relationship.

Forethought, preparation, and the ability to listen are essential to success.  Regrettably, by the time most physicians realize that the terms of their Agreement are less than propitious …

By Daniel M. Bernick, Esq., M.B.A

When I first started as a health care attorney and consultant, 20 years ago, my mentor remarked that compensation planning for physician groups was probably the most challenging type of consulting assignment that our firm handled.  In the years since, after performing many such assignments, I agree.

On its face, choosing a compensation formula may appear to be a simple task.  It is not a highly technical problem.  There a number of standard formulas (see addendum to this article) and virtually all groups use one of …

By Martha Swartz, M.S.S., J.D.

 

With economic pressures on physicians mounting and regulatory incentives to affiliate with larger entities expanding, an increasing number of physicians are becoming employees of larger medical groups or health care systems. Restrictive covenants are becoming a mainstay of physician employment agreements. While the American Medical Association Council of Ethical and Judicial Affairs has found them to “disrupt continuity of care, and potentially deprive the public of medical services”, it has found them “unethical” only if they are “excessive in geographic scope or duration … or if …

By Martha Swartz, M.S.S., J.D.

What is a PPO? As a health care institution or individual provider, it is difficult to provide services in Pennsylvania and New Jersey without participating in at least one preferred provider network (PPO).  PPOs are a form of managed care in which: an intermediary (PPO) forms a network of health care providers and connects the health care providers to third party payers such as insurance companies, employers, and third party administrators (Payers). The providers offer their services to the PPO at a discounted rate because they …

By Joseph M. Gorrell

 

The New Jersey State Board of Medical Examiners, often considered by New Jersey physicians as difficult and unreasonable, has adopted a more aggressive approach than ever before in disciplining physicians.

This new hard line attitude of the Board can be traced to public statements claiming that the Board had disregarded its mission to protect the public, that it was too soft on physicians.  At a regularly scheduled Board meeting of September 10, 2008, Dr. Joseph Gluck, its former Medical Director, came before the Board complaining that it was …

By Mark F. Seltzer, Esq.

You are a physician who has been suffering from a medical condition, for which you have asked your Disability Insurance Company to pay you benefits, under your Disability Insurance Policy.

You have contacted your Company, you have provided it with all the pertinent information that it requested in a timely fashion; you have done “everything by the book”.  You may have met with its Field Representative, or even been evaluated by one or more of your Company’s chosen Independent Medical Examination doctors.  But, notwithstanding your compliance, the …

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Although the Patient Protection and Affordable Care Act of 2010 (PPACA), also referred to as the health care reform act, is currently being challenged on constitutional grounds, and threatened with non-funding and piecemeal repeal; the fact remains that many portions of the Act are already effective and may be enforced.  Several sections of PPACA contain requirements that affect physicians under existing broad federal regulations relating to fraud and abuse.  In addition, provisions of the Act are being incorporated into regulations.  Three of these requirements …