Header graphic for print
Physician Law Current news, updates, & useful tips relating to legal issues affecting physicians & non-institutional providers in their personal & professional lives

Tag Archives: physician

Bill Limits Physician Dispensing Under Pennsylvania Workers’ Compensation Program

Posted in Pennsylvania Legislation

Physicians in Pennsylvania who have been dispensing and billing for prescription drugs under the Pennsylvania Workers’ Compensation program will be disappointed to learn that House Bill 1846 (which already passed the House) was approved by the Pennsylvania Senate yesterday, essentially clearing the way for the bill to be signed into law.  HB 1846, among other… Continue Reading

It’s Official (at least for now): ICD-10 Implementation Date is Now October 1, 2015

Posted in Medicare

According to a final rule published by the Centers for Medicare and Medicaid Services on August 4, 2014, providers will be required to use  the International Classification of Diseases, 10th Revision for diagnosis coding starting on October 1, 2015.  Until then providers are to continue using the 9th Revision (ICD-9). Given the winding path that ICD-10 has… Continue Reading

OIG Publishes Fraud Alert on Physician Lab Arrangements

Posted in Fraud and Abuse, Medicare

Physician ancillary service joint ventures continue to proliferate and not surprisingly, federal and state regulators are on the lookout for arrangements which may violate fraud and abuse laws .  In its recent “Special Fraud Alert: Laboratory Payments to Referring Physicians”, the Office of Inspector General (OIG) has (once again) expressed concern over financial arrangement between… Continue Reading

Does Your Group Practice Income Division Formula Comply with Stark

Posted in Ancillary Services, Fraud and Abuse

Many physicians I speak with are still surprised to learn that the federal Stark statute imposes restrictions on income division within group practices.  These restrictions only apply to profits generated from any of the Stark “designated health services” and only those that are covered by Medicare and Medicaid (including managed care), but if your group provides… Continue Reading

Consider an Unwind Clause in Hospital-Physician Employment Arrangements

Posted in Health Reform, Practice Management

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

Thinking About Hiring a New Physician?

Posted in Practice Management

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

Physician-Hospital Integration Strategies

Posted in Health Reform, Medicare, Physician Compensation, Practice Management

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

Emphasize the Value of the Physician-Patient Relationship

Posted in Practice Management

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

HIPAA Changes Required by 2013 Omnibus Rule

Posted in Health Reform, Practice Management

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

Tuomey Case Puts Sharp Emphasis on Fair Market Value in Physician Transactions

Posted in Fraud and Abuse

Earlier this month the closely watched case of U.S. ex rel Drakeford v Tuomey Healthcare System Inc. (675 F.3d 394 (4th Cir. 2012) concluded with a jury finding that the compensation paid to physicians under certain part-time employment agreements by Tuomey Healthcare System resulted in violations of both the federal False Claims Act and the… Continue Reading

President Proposes Eliminating Stark In-Office Ancillary Services Exception For Therapy and Advanced Imaging

Posted in Fraud and Abuse

In what would undoubtedly be a devastating blow to many medical practices that rely on the Stark in-office ancillary services exception (which allows physicians to refer within their practices for Stark services), President Obama’s proposed FY 2014 would seek to eliminate the exception for physical therapy, radiation therapy and advanced imaging such as CT and… Continue Reading

FTC Sues to Block Hospital Acquisition of Medical Practice

Posted in Health Reform

Adding an interesting wrinkle to an already complex environment, the Federal Trade Commission filed a suit this month to block an Idaho hospital from acquiring a physician practice.  According to an article on thomsonreuters.com, the FTC and the IDAHO Attorney General have filed an antitrust complaint  seeking to block St. Luke’s Health System’s acquisition of… Continue Reading

DOJ Announces Record Fraud Settlement Against Physician

Posted in Fraud and Abuse, Medicare

Yesterday the U.S. Department of Justice announced that it has entered into a $26M False Claims settlement with a dermatologist in Florida.  According to the DOJ, this is one of the largest False Claims settlements against an individual in history.  The physician was accused of allegedly accepting kickbacks from a pathology lab and billing for medically… Continue Reading

Physician Unions – An Unintended Consequence of Health Reform?

Posted in Health Reform

I imagine that few physicians contemplated being part of organized labor when they enrolled in medical school but as more and more physicians make the leap from private practice to hospital employment, perhaps large-scale unionization of the physician workforce could become a reality.  According to an article by David J. Leffell today on WSJ.com, the notion… Continue Reading

J-1 Physician Waivers in Pennsylvania: Change in Processing Times

Posted in Pennsylvania Legislation

On October 9, the Pennsylvania Department of Health (PA DOH) announced that it has changed the Pennsylvania rules regarding the J-1 Physician Waiver Program. DOH has established three filing periods, which could result in the Conrad 30 numbers being assigned earlier in the fiscal year. Read the entire text: http://immigrationview.foxrothschild.com/j-1-waiver/j-1-physician-waivers-in-pennsylvania-change-in-processing-times/