By:  Michael R. Burke, Esq.

In August 2009, the Office of Inspector General for the Department of Health & Human Services (“OIG”) issued a report entitled “Prevalence and Qualifications of Non-Physicians Who Performed Medicare Physician Services.”  In its report, the OIG studied services provided by certain physicians during the first quarter of 2007.  In its findings, the OIG noted that unqualified non-physicians performed 21% of the services that physicians did not perform personally.  Among other things, the OIG found these non-physicians did not possess the necessary licenses or certifications, had no …

By Daniel M. Bernick, Esq.
In our practice of assisting physicians with contracts, we are privileged to see a large volume of “deal flow.”  Recently, physician income guarantee agreements are enjoying a resurgence.  These are the agreements in which a hospital entices a physician to relocate to the hospital’s service area to set up a new private practice, or join an existing group practice.  The hospital guarantees that the new recruit will achieve a certain level of income in first and possibly second years of practice.  If he or she does …

By John W. Jones, Esq
Investigations of and settlements by pharmaceutical and medical device manufacturers with respect to their arrangements with physicians has led to increased transparency of these arrangements in the industry and heightened awareness over permissible consulting and marketing deals.
Drug and devices industry associations have updated their codes on interactions with professionals and several manufacturers are making payments to physicians publicly available.  Although these are steps in the right directions, it is most important that the written consulting agreement between the parties be properly structured.  Physicians and manufacturers should …

By Charles E. Kutner
Since the declaration of an H1N1 influenza pandemic in June 2009, virtually all countries are now reporting cases. Speaking at a press conference in Geneva Switzerland in November, Dr. Keiji Fukuda, Special Adviser to the Director of the World Health Organization (WHO) on Pandemic Influenza, told reporters “the pandemic virus has become the dominant influenza virus in all countries.” Dr. Fukuda went on to say that WHO anticipates continued or increased activity during the winter period in the northern hemisphere, and continued reports of serious cases and …

While Congress is in the process of further complicating the practice of medicine, the state of New Jersey has decided to blame the docs in an effort to restrict industry compensation.
The state’s Attorney General has issued a report of recommendations to “ensure that patient care is always guided by the unbiased, best judgments of the treating doctor.”  The inference is that the physicians are at fault for accepting gifts, however, pharmaceutical companies, etc., are excused from offering those gifts in the first place.  The Medical Society of New Jersey issued a …

By Vasilios J. Kalogredis, Esq.

Even in today’s relatively difficult healthcare environment, we are still seeing many medical and dental practices being sold.  Some of the sales are to other doctors.  Some of the transactions relate to an acquisition by a hospital or other larger organization.
Most people do think about and negotiate some of the obvious points.  These relate to things such as price and payment terms, whether and how the Seller doctors will be employed by the Purchaser, and when the Closing will take place.  This article will focus on …

Fact Sheet: Patient Safety and Medical Liability Reform Demonstration
On September 9, 2009, President Obama addressed a joint session of Congress to announce his proposals for health insurance reform. One component of such a plan includes investing in new ways to manage medical liability claims. The President stated:
Now, finally, many in this chamber — particularly on the Republican side of the aisle — have long insisted that reforming our medical malpractice laws can help bring down the cost of health care…Now, I don’t believe malpractice reform is a silver bullet, but …

By Rebecca J. Patchin, M.D.

Every day across America physicians are forced to consider the broken medical liability system when making important medical decisions. Physicians are compelled to order unnecessary tests to avoid lawsuits, yet many still wind up in court fighting a meritless case. This expensive, ineffective cycle has to stop for the sake of both physicians and patients, and the AMA is working to make that happen.
Medical liability reforms will ensure adequate access to health care, as well as reduce health-care spending. Not only are physicians forced to …

 
 
by Katherine M. Keefe
Chair, Health Law Practice
Marshall, Dennehey, Warner, Coleman & Goggin
 
 The federal stimulus bill enacted on February 17, 2009, the “American Recovery and Reinvestment Act of 2009″ (ARRA), contains many new compliance challenges for physicians and other health care entities and their vendors. In addition to creating a new federal bureaucracy for a new national electronic health records (EHR) infrastructure to set EHR standards and administer EHR stimulus money, and establishing new Medicare and Medicaid reimbursement methods to incent EHR adoption, ARRA contains many new health information privacy and security …

By Reed Tinsley, CPA
Medical practices operating in discounted fee for service managed care markets must address all of the financial and nonfinancial issues involved in a relationship with a managed care plan. These issues are spelled out in the provider contract between the managed care plan and its participating physicians.
But what if the medical practice does not like the financial and nonfinancial terms of the contract? Can the practice change them? What if the managed care plan changes the terms of the contract after it is signed? Can the practice …