In response to the development of alternative payment systems, provider networks are forming at a frenetic pace. If you are like most of my physician clients, you have been or will shortly be presented with network participation agreements for review (or in many cases, signature with very little opportunity to review) and consideration. In evaluating… Continue Reading
One of the most challenging problems I encounter in representing physician practice is disruptive physician behavior. This type of behavior usually manifests in a host of unpleasant ways such as outbursts in the office or hospital, inapropriate language with office staff or patients or, perhaps most insidious, passive aggressive undermining of other physicians in the practice. It can occur… Continue Reading
As a health care attorney, I am called upon quite frequently to draft and/or review . One of the recurring discussions I have with physicians about such arrangements revolves around the issue of contract termination. Many physicians, understandably, are hopeful of securing an “iron-clad” employment agreement that cannot be terminated without some distinct finding of… Continue Reading
The topic of telemedicine is becoming increasingly more common in the medical community. For certain, telemedicine can be a cost effective way of communicating with and monitoring patients, but it is not without its risks. For one thing, physicians need to be mindful of the potential for increased malpractice exposure which could come from not… Continue Reading
An article on Businessweek.com today suggests that healthcare companies rank worse than financial institutions, utility companies and even retailers when it comes to cybersecurity. This is particularly frightening news given the intense focus on healthcare data security under HIPAA for a number of years now. By now, healthcare companies and providers should be well aware of… Continue Reading
None of us knows what the future holds for physicians and the practice of medicine. Of course, many physicians are, by entering into various contractual arrangements with hospitals, ACOs and other networks, placing their bets on the practice model they think is most likely to prevail under the Affordable Care Act. I caution my physician… Continue Reading
This past Friday, the Office of the National Coordinator for Health Information Technology, in collaboration with the HHS Office for Civil Rights and HHS Office of the General Counsel, developed a HIPAA “Security Risk Assessment Tool.” The Security Risk Assessment Tool is a downloadable program that was developed to assist providers in performing HIPAA security… Continue Reading
Mergers and acquisitions are exceedingly common in most industries as business leaders have seen the obvious value in consolidation. Even in healthcare, major players such as hospitals and insurance companies are moving to consolidate and grow. Medical practices, however, have been much slower to consolidate — much to the detriment of many physicians who are… Continue Reading
There was an interesting article published on nytimes.com over the weekend (see ”New Law’s Demands on Doctors Have Many Seeking a Network“) comparing and contrastng the practice of two primary care physicians, one employed by a hospital and another still in private practice but perhaps concerned about her ability to remain there. The hospital-employed physician touts the… Continue Reading
The recent federal antitrust case of Federal Trade Commission and State of Idaho, Plaintiffs, v. St. Luke’s Health System, Ltd, and Saltzer Medical Group, P.A. highlights an important legal consideration for hospitals looking to acquire medical practices and physicians looking to sell to them. Notwithstanding arguments of cost savings and increased quality and convenience through… Continue Reading
Is bigger better when it comes to private medical practices? This is a question I get quite frequently from physicians who are considering whether to merge with other practices. In my experience, the answer is almost always “yes”, but usually for different reasons from those the inquiring physician has in mind. Quite often physicians believe… Continue Reading
Many physicians still haven’t come to grips with the fact that . More and more frequently the public turns to the internet first when making purchasing choices — even when purchasing health care services and selecting physicians. According to a research paper published this month in the Journal of the American Medical Association, 59% of… Continue Reading
Many physicians pay very little attention to their managed care participation agreements. In fact, some simply sign these agreements without ever reading them. I think this apathy stems from the fact that managed care plans generally refuse, at least for smaller practices, to “negotiate” their fee schedules. But, even if a payor won’t negotiate fees,… Continue Reading
Hospital-physician acquisition of medical practices continues at a furious pace. Unfortunately, no one knows for certain whether physician employment by hospitals is the key to better or more cost-effective care. Moreover, the hospital or the physician in such a transaction may for any number of reasons decide later on that the relationship is less than desirable. Because… Continue Reading
In representing healthcare providers, we are frequently called upon to assist with labor and employment legal matters. Unfortunately we are typically called in to assist after would could have been a minor issue has become a major problem — what I like to call the “clean up” phase. Not surprisingly, however, it is often much… Continue Reading
Hiring a new physician into a practice can be an expensive and risky proposition but for most practices it is a necessary endeavor. Aside from the actual costs of recruiting and negotiating a contract with the new physician, there are associated increases in overhead, and perhaps most importantly, the risk of damaging valuable practice goodwill in the… Continue Reading
Curious what the future of medicine will look like? According to this recent article on CNBC.com, it appears that for many physicians it will involve a boss, a timeclock and a steady paycheck. Not surprisingly, as the legal and administrative burdens of running a private practice continue to increase, more and more seasoned physicians are… Continue Reading
As the implementation of the federal Affordable Care Act (ACA) continues in fits and starts, healthcare providers are scrambling to best position themselves to accommodate anticipated and developing payment models. Unfortunately no one really knows what these new payment models will look like or how they will ultimately work. It is apparent, however, that most… Continue Reading
The article Pediatricians v Retail Clinics: Is It Time to Think Beyond the Office Visit? published today at time.com, highlights an important shift occurring in the delivery of physician services. Patients are foregoing their regular physician office visits in favor of “as-needed” treatment from retail clinics, urgent care centers and walk-in clinics springing up around… Continue Reading
Earlier this year, the Department of Health and Human Services (HHS) published the “HIPAA Omnibus Rule,” implementing various provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act as the related to the HIPAA Privacy, Security, and Enforcement Rules. If you are a “covered entity” or “bsuiness associate” under HIPAA, these new… Continue Reading
Hospitals interested in being in the physician business for any meaningful length of time should seek to develop an organizational structure that fosters an ownership mentality and a commitment to achieving collaborative organizational goals.
State’s “more stringent” Stark law restrictions upheld by court.
OIG has announced its priorities for 2013 and some are of special interest to physicians.
Finding it increasingly difficult to remain profitable in private practice, many physicians are turning to hospital employment to avoid the economic realities of running a small business. However, as a recent article in the New York Times illustrates (see "A Hospital War Reflects a Bind for Doctors"), physicians should bear in mind that even under hospital… Continue Reading