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December 15, 2013

Forgiving Patient Copays Can Lead to Unforgiving Consequences

At one time in America, there was no such thing as "health insurance." Patients negotiated directly with hospitals and doctors, and paid what they could, often on a sliding scale, according to ability. Eventually, health insurance entered the market, easing the burden... More >

December 8, 2013

Why the New Compounding Pharmacy Law Matters to Physicians

On November 28, President Obama signed into law the Drug Quality and Security Act (formerly HR 3204) which strengthens the provisions of the Food, Drug, and Cosmetic Act relating to the safety of compounding pharmacies. The new law is important to physicians... More >

November 24, 2013

Why UnitedHealthcare Sent Termination Letters to Doctors in 10 States

An “elevator speech” describes your business in the time it takes to ride down an elevator. Everyone in business needs one. As a health lawyer, my elevator speech used to involve “medical ethics,” and perhaps a mention of “Stark Law,” and “denial... More >

November 17, 2013

Medical Practices: Think Twice Before Waiving Copays

Historically, family practices and many other physicians groups have routinely waived insurance copays as a gesture of goodwill to patients in a tight economy. After all, who wants to hound sick patients for their portion of the charges? There was... More >

November 10, 2013

J&J $2.2 Billion Settlement: Necessary in a Third-party Payer System

Johnson & Johnson has agreed to pay over $2.2 billion to resolve criminal and civil allegations that the company promoted powerful psychiatric drugs for unapproved uses in children, seniors, and disabled patients, the Department of Justice announced recently. According to The... More >

November 3, 2013

AAPS Announces Court Challenge to Obamacare

This week, Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS) offers Physicians Practice readers insight into the group’s latest challenge to the Affordable Care Act (ACA) announced Oct. 28, 2013. Martin Merritt: What is... More >

October 27, 2013

Ethics on Ending the Patient-Physician Relationship

Once you accept a patient into your practice, you are under an ethical and legal obligation to provide services to the patient as long as the patient needs them. There may be times, however, when you may no longer be able... More >

October 20, 2013

The Evolution of Government Intrusion on the Medical Profession

This week found me sitting alone in our law firm library, preparing to defend a physician before the Texas Medical Board. In an era of electronic research, both legal and medical, it is rare to find anyone, (other than me), in the... More >

October 13, 2013

The Basics of Physician Asset Protection

The American civil justice system unquestionably disfavors those with accumulated assets. This idea can be summarized in two words: "deep pockets." Whether through malpractice lawsuits, Stark Law administrative penalties, or "whistleblower" Anti-Kickback Statute lawsuits, physicians today face an unprecedented risk of... More >

October 6, 2013

Time to Cut Physician Reimbursement Red Tape

This week’s headlines trumpeted, "Computer glitches, overloads hit health care exchanges." Meanwhile, other headlines note that little else is working in the federal government because of a government shutdown. This is not the first time in history the federal government has shut... More >

September 29, 2013

Selling Your Medical Practice from a Wealth Management Perspective

We all know the threat of civil monetary penalties, audits, and the ever-increasing expense and headache of regulatory compliance has led many physicians to pack up and head for the security and predictability offered by larger group employment or hospital employment. Perhaps... More >

September 22, 2013

The Age of 'Regulopathy'

I must give credit to the September edition of the American of American Physicians and Surgeons (AAPS) Newsletter, for directing me toward my new favorite "neologism," which is in turn borrowed from an article in General Surgery News entitled, "Petting the Tiger:... More >

September 8, 2013

Ore. Doctors Fined for Failing to Disclose Payments from Implant Firm

What is the point of medical malpractice tort reform, if the government is simply going to replace the danger of financial ruin with newerand more creative ways to fine doctors for conduct having nothing to do with patient outcomes? If you... More >

August 25, 2013

Health Insurance Exchanges: Good News, Bad News for Physicians

USA Today recently reported that people have been signing up for health insurance exchanges for in excess of expected levels. Staff writer Kelly Kennedy reports that a survey of each of the 50 states yielded 19 states reporting estimates for how... More >

August 18, 2013

The Sunshine Act and Continuing Medical Education

Beginning August 1, 2013, applicable manufacturers and group purchasing organizations (GPOs) will be required to report all payments and transfers of value to physicians and teaching hospitals to CMS. An excellent article on the rules, can be found at the Policy and... More >

August 11, 2013

OIG Opinion on Federal 'Carve Out' May Implicate ACOs

A year ago, I wrote in this column an article discussing Stark Law/Anti-Kickback Statute (AKS) and AMA Ethics Implications that may not be obvious in forming ACOs. I warned, "The question under Stark Law and the Anti-Kickback Statute isn’t the referral or... More >

August 4, 2013

Employer Mandate Delay: The Path to a Single-Payer Healthcare

This week, preventive and climacteric medical specialist, author, and healthcare speaker Elizabeth Lee Vliet offers Physicians Practice readers insight into the real reason behind the delay of the employer health insurance mandate in the Affordable Care Act, which she will share in... More >

July 28, 2013

Physicians Should Take a Closer Look at Group Purchasing Organizations

If you have been approached by someone seeking your investment or participation in a group purchasing organization (GPO), be careful. Just because there is a "GPO Safe Harbor," doesn’t mean all GPOs are safe. Before you make any decisions, consider the... More >

July 21, 2013

The Paradox of ACO Waivers of Medical Fraud and Abuse Laws

The Medicare Shared Savings program, Section 1899 of the Social Security Act, is designed to achieve three goals: Better health for populations, better care for individuals, and lower growth in expenditures. Effective November 11, 2011, the agencies responsible for administering the... More >

July 14, 2013

Healthcare Reform Mandate Delay: History Repeating Itself

The Obama administration announced July 3, 2013, that it is giving large employers another year before it will try to enforce an Affordable Care Act (ACA) provision requiring large employers to offer medical coverage to their workers or pay a fine. ... More >

June 30, 2013

How ERISA Affects Medical Practices

The Employee Retirement Income Security Act of 1974 (ERISA) is one of the most unusual and fascinating of all federal laws. Originally intended to protect employee benefits and pensions, ERISA was supposed to be helpful to employees. In a twist of... More >

June 23, 2013

ABMS: Maintenance of Certification 'Means Something' to Patients

A few weeks ago, I interviewed Jane Orient from the Association of American Physicians and Surgeons (AAPS) regarding a lawsuit the group filed against the American Board of Medical Specialties (ABMS) over the latter's maintenance of certification (MOC) process. I wanted... More >

June 16, 2013

Stark, Anti-Kickback Laws Could Get Murkier Under Affordable Care Act

As the planned rollout of Obamacare continues, with CMS administering federal Health Insurance Exchanges, (or marketplaces) expected to begin accepting individual applications later this year, many important questions remain unanswered. According to CMS' website, "these state-based, competitive marketplaces, which launch in... More >

June 9, 2013

Stark Law: Understanding the Rule

This morning, I awoke to find that my cat "Peppy" had become ill on top of the papers in a notebook I keep at home covering Stark Law. Although I have left work papers open many times over the years, Stark Law... More >

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Jason was recently elected to the position of Texas State Bar 6th District Grievance Committee Chairman. Janelle and Larry Friedman Co-Chair The "Celebrating Gloria" Luncheon Benefiting TRAC Forgiving Patient Copays Can Lead to Unforgiving Consequences Why the New Compounding Pharmacy Law Matters to Physicians Why UnitedHealthcare Sent Termination Letters to Doctors in 10 States Medical Practices: Think Twice Before Waiving Copays J&J $2.2 Billion Settlement: Necessary in a Third-party Payer System 17-year-old son of Detroit Tiger Torii Hunter files $10 million lawsuit after he was no-billed in sex assault case