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Showing 64 posts in 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

Health Care Trends

health care trendsRural hospitals across the United States struggling to stay open

According to the National Rural Health Association, approximately 50 hospitals in the rural United States have closed since 2010. The number of annual closures is growing. Congressional healthcare budget cuts and policy changes significantly affect rural hospitals because rural hospitals often have a disproportionate number of patients who are covered under Medicare, Medicaid or who are uninsured. A number of factors affect and pose challenges to rural hospitals. One challenge is the difficulty of attracting talent, which often means paying more to healthcare professionals in order to recruit them for employment at a rural hospital.  Other challenges facing rural hospitals include:

  • changing demographics;
  • advances in medical practice that the hospital may be unable to implement;
  • new federal regulations and standards that create additional compliance related pressure; and
  • lower reimbursement rates for Medicare and Medicaid.

Closures of rural hospitals may force individuals to travel long distances for medical care, which may lead to an increase in mortality rates. The closures may discourage business ventures in rural areas due to the increased costs associated with not having a healthcare facility nearby. Metropolitan hospital closings have increased recently, but the existence of medical care alternatives in metropolitan areas typically reduces the effects that closures have on patients.  Read More ›

Categories: Health Care Reform, Hospitals, Insurance, News & Events, Physicians, Tax

The Updated April 2015 National Practitioner Data Bank Guidebook has been Released

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 ›

Categories: Criminal, Hospitals, Licensing, News & Events, Physicians, Providers

Recap from the 2015 Health Law Institute

Recap from the 2015 Health Law InstituteFoster Swift health care attorneys recently attended and presented at the 21st Annual Health Law Institute on March 12 and 13, 2015. The two-day institute, which was co-sponsored by the Institute for Continuing Legal Education and the Health Care Law Section of the State Bar of Michigan, included presentations on recent statutory, regulatory, and case law developments in the health care industry.

Foster Swift Attorney Jennifer Van Regenmorter co-presented the “Michigan Health Law Update,” which provided an overview of Michigan’s most significant health law developments from the past year. This was Van Regenmorter’s third time presenting this yearly update at the Institute. Read More ›

Categories: Fraud & Abuse, HIPAA, News & Events, Physicians

"Right to Try" Becomes a Reality in Michigan

PrescriptionOn Friday, October 17, Governor Rick Snyder signed the Right to Try Act, which allows patients to try experimental drugs and other treatments before they have been approved by the Food and Drug Administration (FDA). The law gives patients with advanced illnesses access to drugs that successfully cleared Phase 1 of an FDA approval. Phase 1 testing seeks to establish a drug's safety and profile and evaluates possible side effects. It involves 20-80 volunteers and lasts approximately one year. Read More ›

Categories: Hospitals, Insurance, Physicians, Providers

How Technology is Transforming Healthcare

While the healthcare industry has historically been knocked as slow to adapt to emerging technologies, the technological modernization of the industry is now occurring at a furious pace. From the digitization of health care records, to improved means of communications between doctors and patients, technology is transforming healthcare.

Tech behemoths like IBM, as well as scrappy Silicon Valley startups, have recognized the potential and are pouring resources into healthcare IT. According to data from investment company Rock Health, venture capital funding to healthcare information technology companies for 2014 reached $2.3 billion as of mid-year 2014. That's more than 10 times the nearly $200 million that was invested in healthcare IT in 2007.

One of the healthcare industry's newest tech innovations, called Figure 1, is the brainchild of a doctor named Josh Landy. Figure 1 is an Instagram-style app that allows doctors to share photos of patient conditions with other medical professionals in order to get their opinions regarding diagnosis and treatment. Read More ›

Categories: Physicians, Privacy

OIG Issues Special Fraud Alert on Clinical Laboratory Payments to Physicians

clinical laboratory paymentsThe Office of the Inspector General for the United States Department of Health and Human Services (the “OIG”) recently issued a Special Fraud Alert regarding laboratory payments to referring physicians (the “Alert”). The Alert relates to two types of compensation arrangements - Specimen Processing Arrangements and Registry Arrangements - between clinical laboratories and physicians who order clinical laboratory tests that the OIG believes present a substantial risk of fraud and abuse under the federal anti-kickback statute. Read More ›

Categories: Compliance, Fraud & Abuse, Physicians

Upcoming changes in the investigation and discipline of licensed health care professionals

licensed health care professionalsHave you heard? Gov. Snyder signed four bills significantly changing the procedure for investigating and disciplining licensed health professionals under the Public Health Code on April 3. The four statutes take effect on July 1, 2014.

These important changes make it even more crucial for a health professional to consult with legal counsel experienced with the disciplinary process whenever he or she is contacted by the Bureau of Health Care Services (BHCS). 

Learn more about the changes. Read the article here

Categories: Licensing, Physicians, Providers

License Sanctions Against Health Professionals Can Be Used As Evidence in Unrelated Malpractice Cases

license sanctions against health professionalsAny disciplinary sanction against a health professional’s license can have serious collateral consequences, such as termination from provider networks, loss of malpractice insurance or substantially increased rates, medical staff investigations and proceedings, adverse employment actions, and reports to the National Practitioner Data Bank. A recent Michigan Court of Appeals decision highlights an added risk that many health professionals and their attorneys may not have known. A relatively minor licensing sanction was used, with devastating effect, as evidence in an unrelated malpractice action.

A dentist was sued for malpractice following a root canal procedure in Holder v Schwarcz. The jury awarded $67,500 in damages and the trial court granted $151,555 in case evaluation sanctions. The dentist had been involved in an unrelated licensing investigation relating to root canals for another patient. The licensing action was resolved through a consent order. In a consent order, a health professional does not admit any allegations in the licensing complaint, but agrees that the board’s disciplinary subcommittee may treat them as true and enter a sanction for violating the Public Health Code. The sanction imposed against the dentist in the licensing action included probation for one year, a requirement for ten hours of continuing education, and a $5,000 fine. The sanction was fairly typical for a licensing case alleging negligent care. Read More ›

Categories: Licensing, Physicians, Providers

A Rare Reversal of a Licensing Sanctions by The Michigan Court Of Appeals Offers Hope to Disciplined Health Professionals

disciplined health professionalsA recent Michigan Court of Appeals decision offers a glimmer of hope to health professionals who face the unenviable prospect of appealing adverse decisions made by licensing boards. Since 1994, the Public Health Code has required that appeals by licensed health professionals from adverse licensing decisions be filed in the Michigan Court of Appeals. Over the past two decades, there have been very few cases where the Court of Appeals held that a decision by a licensing board was legally incorrect or factually unsupported. Read More ›

Categories: Licensing, Physicians, Providers