Pennsylvania Health Law Lawyer & Attorney : Fox Rothschild LLP : serving Philadelphia, Pittsburgh, Allentown, Erie, Upper Darby Twp

Notwithstanding the fact that 13 Philadelphia area hospitals have stopped delivering babies since 1997, Governor Ed Rendell's office has concluded from a recent study that in fact there is no obstetric physician crisis in Pennsylvania.  According to an article in the Philadelphia Inquirer (found here), the number of practicing OB-GYNs was stable from 2004 to 2006, but 18 percent of OBGyns in southeastern Pennsylvania surveyed in 2006 indicated that they planned to stop delivering babies in 12 months suggesting that a crisis may in fact be coming.  

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At least one Pennsylvania lawmaker is hoping loan forgiveness will stem the flow of physicians out of Pennsylvania.  According to a recent article in the Pittsburgh Tribune-Review, State Rep. John Shapiro of Montgomery County has introduced legislation (House Bill 1093) which would forgive medical school debt at the rate of 10% per for physicians who practice in Pennsylvania for at least 10 years.   

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According to an article today in the Greenwich Post (found here), a box full of paperwork containing patient information, including names and contact information, was found in a dumpster outside of a medical office building.  Not only that, the good citizen who found the box decided the most appropriate course of action was to turn it over to the Greenwich Post!  The HIPAA privacy rules may not be making the headlines they did a few years ago, but they are very much still in effect.  Failing to abide by the rules when it comes to the disclosure of protected health information can result in substantial fines, so don't forget to revisit you HIPAA compliance policy from time to time.

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Under what it is calling its Provencare program, Geisinger Health System is now offering patients what amounts to a ninety warranty on surgical care.  Under the program - something like capitation and use of clinical protocols - insurers are charged a flat fee for which patients receive unlimited follow up care after surgery.  Geisinger intends to control costs by developing and applying specific clinical protocols depending on the patient's condition.  So far Geisinger has only actually contracted with its own insurance unit but hopes the concept will gain in popularity. 

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The Medicare incident-to rules permit a physician to bill for the services of auxiliary personnel as if the physician performed those services himself.  You may already know that the incident-to rules require a physician to be present in the office suite and immediately available to assist while auxiliary personnel are performing incident-to services in the office.  But, did you know that you could be supervising incident-to services without even knowing it? 

In a recent federal District Court whistleblower case out of Hawaii, a court rejected a whistleblower physician's claim that he could not have been the supervising physician for incident-to services since he was not made aware by his group practice that the services would be billed to Medicare under his provider number.   Under the incident -to rules, any physician in a "physician directed clinic" may supervise incident-to services and the court agreed with the defense that a physician in a "physician directed clinic" need not have specific knowledge that he will be the supervising physician for billing purposes.  The court's opinion can be found here.

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According to a report released on May 24, 2007 by the American Association for Justice (AAJ) and the Pennsylvania Trial Lawyers, the medical malpractice insurance industry has been price-gouging doctors through excessive premiums.  The study, based based on annual reports from the top 15 medical malpractice insurers as rated by A.M. Best, suggests that premiums continue to skyrocket even though actual and projected losses dropped by 48% between 2003 and 2006.  A copy of the full report can be found here.

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