Health Care Law Blog
On August 17, 2012, the Department of Justice (“DOJ”) and the Federal Trade Commission (“FTC”) announced that they will hold a joint public workshop addressing insurers’ use of most-favored-nation clauses (“MFNs”). The all-day workshop will be held on September 10, 2012 in Washington DC and will be in-person, free and open to the public. At the workshop, the agencies intend “to explore the use of MFN clauses and the implications for antitrust enforcement and policy.” The workshop will also include a series of panel discussions examining the legal treatment of MFNs, the economic theories concerning MFNs, and their impact upon the health care industry.
For health care managers, there are a number of available options and strategies to consider when planning for retirement. In addition to traditional employer plans, an exempt health care provider may also offer supplemental plan options to its managers and highly compensated employees. Taking advantage of such benefits may prove to be a wise investment decision for health care managers.
Recently in the case of Mayo Collaborative Services v Prometheus Laboratories, Inc., the Supreme Court of the United States found two patents invalid because they claimed subject matter that was not patentable. The patents in this case covered processes that help doctors who use thiopurine drugs to treat patients with autoimmune diseases determine whether a given dosage was too high or too low.
It is now widely accepted that planning for retirement is vitally important. However, many business owners, including physicians, fail to properly plan for the transition of their businesses upon the owner’s or primary physician's retirement. In fact, lack of succession planning is one of the most common reasons small medical practices fail. In order to avoid such a result in your practice, please consider the following succession planning tips:
In what appears to be a strong response to the most favored nation ("MFN")-related lawsuits filed against Blue Cross Blue Shield of Michigan by the U.S. Department of Justice and Aetna, the Commissioner of the Michigan Office of Financial and Insurance Regulation (“OFIR”) issued an Order dated July 18, 2012. The Order prohibits insurers, HMOs, and Blue Cross Blue Shield of Michigan from either using or enforcing MFN clauses in their provider contracts unless the MFN clause has been filed with and approved by the OFIR Commissioner. This prohibition takes effect February 1, 2013.
The Health Information Technology for Economic and Clinical Health Act ("HITECH Act"), passed in 2009, imposed new requirements on health care providers (among others) related to the privacy and security of Protected Health Information ("PHI"). Included in the HITECH Act's requirements was a mandate that the Department of Health and Human Services’ ("HHS") Office for Civil Rights ("OCR") conduct audits to analyze the processes, controls and policies of certain covered entities. The pilot program for such audits began in 2011 and will conclude in December, 2012.
Foster Swift health care law attorney, Johanna Novak, was recently interviewed on Michigan Business Network radio concerning the United States Supreme Court's long-anticipated decision on the Patient Protection and Affordable Care Act (the "Act"). The interview aired on July 6, 2012, and was separated into two parts. Podcasts for both parts of Johanna's interview can be accessed here.
Today, the United States Supreme Court released its highly anticipated opinion regarding the constitutional challenges to the Patient Protection and Affordable Care Act (the "Act"). The Court ultimately concluded that the Act was constitutional, but it did not grant a complete victory to the government. The Court also held that the federal government may not withhold all Medicaid funds from States that fail to comply with the expansion of Medicaid provisions of the Act. Instead, the federal government may only withhold new Medicaid funds from States that do not comply.
In response to growing concerns about prescription drug abuse, there has been a significant increase in investigative and enforcement activities by state licensing authorities as well as local, state and federal law enforcement. We have been contacted by physicians who want to care for patients with chronic or intractable pain but are concerned about the consequences to their licenses and practices that might result if investigators question their decision to prescribe controlled substances. Given the current environment, it is a good idea for physicians to refresh themselves on the legal requirements for effective pain management.
Health care reform law requires that providers who enrolled in Medicare prior to March 25, 2011, submit enrollment revalidation information upon request by the Centers for Medicare and Medicaid Services ("CMS") or its contractors. Any provider that fails to submit the requested revalidation information within 60 days of receiving such a request risks interruption or deactivation of Medicare billing privileges. Revalidation for all providers who enrolled in Medicare prior to the above date will occur between now and March of 2015 on a steady basis. Providers can check the lists provided at CMS's website to determine if they were already sent a revalidation notice that was perhaps overlooked in the mail.
