Showing 23 posts by Richard C. Kraus.
For the past decade, health care has remained one of the most tumultuous and dynamic industries; uncertainty, along with opportunity, are likely to continue in 2017. This three-part series will discuss some of the most important health care trends. This section will focus on some of the largest factors affecting costs and reimbursement in health care: 1) MACRA Implementation; 2) Medicaid Reimbursement; 3) Shifting Payment Models; and 4) Drug Pricing. Read More ›
Significant changes to practice by physician assistants in Michigan will take effect on March 22, 2017. Any physicians (medical, osteopathic and podiatric), health facilities, and health agencies that work with PAs should take the steps needed to ensure compliance with the requirement by the effective date. Read More ›
Michigan’s tax on paid health care claims is not preempted by ERISA, according to a decision by the United States Court of Appeals for the Sixth Circuit. On remand from the United States Supreme Court, the federal appellate court held that the Health Insurance Claims Assessment Act does not impermissibly interfere with the uniform administration of group health plans or impose additional burdens on self-insured plans and third-party administrators. Read More ›
The Michigan Health Insurance Claims Assessment Act is back for reconsideration before the United States Court of Appeals for the Sixth Circuit. The act imposes a tax on paid health care claims that is used to fund the state share of Michigan’s Medicaid program. The act had been upheld by the federal appeals court in 2014 against an ERISA preemption challenge brought by an organization representing self-insured group health plans and third-party administrators.
The Supreme Court recently remanded the case to the federal court of appeals for reconsideration in light of a decision holding that a Vermont all-payers claim database statute interfered with the uniform administration of ERISA plans and was therefore preempted. Read More ›
The DHHS Health Resources and Services Administration (“HRSA”) has finally published the new National Practitioner Data Bank (“NPDB”) Guidebook. The original Guidebook had not been updated since September 2001.
The updated April 2015 NPDB Guidebook is available here.
The new Guidebook extensively covers the changes resulting from the 2013 merger of the NPDB and the Healthcare Integrity and Protection Data Bank (“HIPDB”). The HIPDB was a separate data bank that received and disclosed reports of final adverse actions by federal and state agencies and health plans against practitioners, entities, providers, and suppliers. After the merger, there were significant changes in the entities eligible to query and report, as well as the individuals and entities subject to reports. Read More ›
The Michigan Supreme Court has issued an important decision on the scope of peer review protection. In Krusac v Covenant Med Ctr, Inc, the court held that “objective facts gathered contemporaneously with an event” are protected when “contained in an otherwise privileged incident report.” Krusac overruled a Court of Appeals opinion, Harrison v Munson Healthcare, which ruled that peer review protection only applied to the evaluative content in an incident report. Krusac reinforces the broad protections for “records, data and knowledge” that is collected by or for peer review committees.
While Krusac clarifies the scope of the statutory protection, it also highlights the need for hospitals and health facilities to carefully structure and properly document their peer review processes. It will be especially important in litigation to establish that a committee or individual has been assigned a peer review function and that information is being collected for the purpose of reducing morbidity and mortality and improving patient care.
Richard Kraus of Foster Swift filed an amicus curiae brief on behalf of the University of Michigan Health System in Krusac.
The February issue of the American Health Lawyers Association’s AHLA Connections features a list of the top ten issues that will impact healthcare law in 2015. We summarized the first five topics in a previous blog. (Miss our summary of the first five? Please click here.)
Here are the remaining trends to think about: Read More ›
The February issue of the American Health Lawyers Association’s AHLA Connections features a top-ten list of the issues that will impact healthcare law in 2015. This two-part series discusses these important trends.
Here are the first five: Read More ›
The United States Court of Appeals for the Sixth Circuit has upheld Michigan’s tax on paid health care claims in an opinion published on August 4. The decision has very significant implications for the State of Michigan, which uses the revenues to partially fund the Medicaid program, and for employers, group health plans, and third-party administrators, which are subject to the tax. Read More ›
Health Facilities and Agencies Face Liability for Terminating or Dismissing Employees Who Report Malpractice
A recent decision by the Michigan Court of Appeals holds that a health facility or agency can be sued for taking or threatening disciplinary action against an employee for reporting or intending to report malpractice by a health professional. Employers should carefully review existing policies and practices, or if necessary, adopt appropriate policies, to protect against potential wrongful termination lawsuits. Read More ›
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