Main Menu Back to Page
{ Banner Image }

Showing 63 posts in Physicians.

Updates to the Confidentiality of Substance Use Disorder Patient Records Regulations

Earlier this year, the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services (HHS), finalized updates to the Confidentiality of Substance Use Disorder Patient Records regulation at 42 CFR Part 2 ("Part 2"). Read More ›

Categories: Electronic Health Records, HIPAA, Hospitals, Physicians, Providers

Update on Michigan’s New Requirements for Prescribing Controlled Substances

The Legislature has delayed the effective date of a key provision in the new controlled substance prescribing laws until March 31, 2019, or until the Michigan Department of Licensing and Regulatory Affairs (LARA) promulgates rules on the subject. Read More ›

Categories: Licensing, Physicians, Providers

Michigan Health Care Providers May Now Prescribe Controlled Substances via Telemedicine

Keyboard StethoscopeGovernor Snyder recently signed into law Public Act 22 (Senate Bill 213), which revises the 2016 telehealth bill to clarify that health professionals in Michigan may prescribe controlled substances without an in-person examination. Michigan now joins a growing number of states that allow health professionals to prescribe controlled substances via telemedicine. Read More ›

Categories: Physicians, Technology

New Physician Assistant Statute Requires Practice Agreements by March 22, 2017

Under the new statute, a PA cannot engage in practice as a physician assistant unless a practice agreement is in place.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 ›

Categories: Physicians

DOJ Starts Cracking Down on Individual Health Care Executives for False Claims Act and Stark Law Violations Committed by Their Companies

Healthcare executives and physicians take note: The Department of Justice is now cracking down on individuals, and not just companies, for False Claims Act, Stark law, and anti-kickback statute violations. Read More ›

Categories: Hospitals, Medicare/Medicaid, News & Events, Physicians

CMS Issues Proposed Provider-Based Status Rules

On July 6, 2016, the Centers for Medicare & Medicaid Services ("CMS") released the 2017 Outpatient Prospective Payment System ("OPPS") Proposed Rule (the "Proposed Rule"). The Proposed Rule explains how CMS plans to implement Section 603 of the Bipartisan Budget Act of 2015 ("Section 603"), which established a new site neutral payment policy for certain off-campus hospital outpatient departments.

Section 603 provides that, as of January 1, 2017, certain items and services provided by off-campus hospital outpatient departments will no longer be reimbursed under the more favorable OPPS, and will instead be paid under another "applicable payment system." Read More ›

Categories: Billing/Payment, Medicare/Medicaid, News & Events, Physicians, Providers

Is Losing Money by Employing Physicians a Stark Violation?

losing money by employing physiciansModern Health Care has reported that hospitals often lose approximately $176,000 a year per each employed physician.

While this initially seems like a surprising statistic, it is understandable that hospitals lose money when they employ physicians. Physicians in private practice often pay their staff less than comparable hospital employees. When a hospital buys a physician’s practice, the benefit costs typically increase if the staff receives the hospital’s fringe benefit package. Moreover, hospital overhead is typically higher than a private physician practice with regard to HR costs and other support services.

Many systems claim that the only way to manage the health of a given population (which is what ACO and other similar payment structures are requiring) is to be fully integrated with employed physicians, so covering the losses incurred by employing physicians is the necessary cost of preparing for the new paradigm. The ugly, and legally problematic, truth is that most health systems look beyond the income generated by physicians for treating patients but also at income from physician ancillary referrals to justify the economic losses caused by acquiring physician practices. This raises concerns under the Stark law. Read More ›

Categories: Billing/Payment, Compliance, Hospitals, Medicare/Medicaid, Physicians

Department of Justice Enters Into Record-Breaking Stark Law Settlement

The U.S. Department of Justice (DOJ), and a handful of states, recently reached a settlement agreement with Adventist Health System (Adventist), resolving Stark Law issues, as well as allegations in two separate qui tam actions that included false claims. Generally speaking, the Stark Law limits physician referrals of designated health services or “DHS” for Medicare and Medicaid patients in instances where the physician - or an immediate family member of the physician - has a financial relationship with the DHS entity.  Read More ›

Categories: Billing/Payment, Medicare/Medicaid, News & Events, Physicians

Virginia Man Wins $500,000 After Recording Surgical Team’s Insulting Comments

healthcare lawsuitTalk about adding insult to injury. A Virginia man woke up after his colonoscopy to learn that the surgical team had mocked, belittled and insulted him throughout the procedure.

Fearful that he would not remember the doctor’s post-op instructions, the man pressed record on his smartphone before receiving anesthesia. Upon listening to the recording after the procedure, he realized that the members of the surgical team began their rant as soon as he drifted off to sleep. Read More ›

Categories: Hospitals, News & Events, Physicians

Tuomey Health Loses Appeal, Facing $237 Million in Fees and Damages

A very long legal battle may be nearing its final chapter after the U.S. Court of Appeals for the Fourth Circuit upheld a $237 million judgment against Tuomey Healthcare System in South Carolina. The judgment is an enormous sum for the regional health system and hospital, with even one of the Court of Appeals judges calling it a "death sentence." A three-judge panel heard the case at the Court of Appeals, so Tuomey could still seek reconsideration from all the judges of that Court or take the case to the U.S. Supreme Court. It may also opt to find a new partnership to keep the hospital afloat. Read More ›

Categories: Compliance, News & Events, Physicians, Providers