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Summer’s Not Over…Hit the Road with these Safe Travel Tips from Medjet Assist!

Summer’s Not Over…Hit the Road with these Safe Travel Tips from Medjet Assist!

There’s nothing more American than packing up the car and taking a family summer road trip. Whether you’re headed down the road to grandma’s house, across state lines to the nearest beach, or all the way across the country, making sure you get your family there safely is top of mind. By following these summer road trip tips, you’ll help ensure you’ve thought of everything to keep your family safe while you’re on the road.

Tune up the car

Before leaving on your road trip, take your car for a tune-up. Make sure all oil and fluid levels are topped off and that the tires are properly inflated. Consider that your car may soon be under stress it’s not used to, like driving up and down mountain passes, so make sure your brakes are working properly as well.

If you do experience some minor glitch while driving, it helps to know simple car maintenance techniques like how to use jumper cables, how to refill your wiper fluid, how to check the air pressure in your tires and how to change a flat tire—so brush up on your maintenance skills before you leave. Clean your headlights, taillights, signal lights and the inside and outside of your windshield.

Many newer cars come with their own roadside assistance.  Familiarize yourself with the coverage and make sure the emergency numbers are handy.  If you don’t have this coverage, consider joining a roadside assistance service like American Automobile Association (AAA). As a member, AAA will come to your rescue should you lock your keys in the car, get a flat tire, or break down.

Bring a map

You may plan to use GPS to navigate to your destination, but you never know when you may lose signal, cell phone service or your GPS might fail. Good, old-fashioned maps won’t lose power and are reliable no matter what goes wrong, so be sure to bring one along.

Consider the weather

We’re all aware of the dangers of driving in inclement weather. Severe summer weather can often produce heavy downpours, tornados and flash floods. If the weather looks threatening, tune in to a local radio station for updates and keep your ears peeled for storm sirens. It’s always good advice to stay on main roads and highways if possible and try to avoid backcountry roads when you can—especially if you’re driving in unfamiliar areas that may have the threat of flash floods.

If you find yourself in storm conditions that force you to stop driving, make sure you pull all the way off of the highway and turn on your hazard lights. If you are stranded and have to run your vehicle for any reason, do so for 10 minutes every hour and make sure windows are open slightly to prevent carbon monoxide buildup. If you find you’ll be spending the night in your car, illuminating the interior lights will not use as much battery as your exterior light, but still provide a visual indicator to rescuers.

Have a travel safety kit

You should always have a safety kit in your car, but make sure your kit is well stocked before leaving for your summer road trip. Your kit should include warm blankets, water and first aid items, a small flashlight, flares, a battery-operated radio and an emergency contact card. It’s also a good idea to keep a car safety hammer near the driver’s seat. If you happen to be in an accident or your car is submerged in water, the car safety hammer can be used to break the window and create a path to safety.

If you are prescribed important medication, keep it in the car with you and not in the trunk in the event that your trunk becomes inaccessible.

Make sure car seats and boosters are properly installed

The annual family road trip time is a good time to make sure that car and booster seats are properly installed and appropriately fitted to your child. In most cities, local hospitals or fire stations provide free car seat fittings and instillations. Schedule an appointment before you hit the road and travel with peace of mind.

Leave your phone on for cell location

Should your family experience an emergency in a rural environment where communication with the outside world is not possible, remember that cell phone location technologies are extremely helpful in locating missing people. If you’re stranded in your car, keeping your cell phone on will help rescuers pinpoint your location. However, when your phone is out of power it will no longer be helpful in locating you. Keep portable phone chargers and power cords in your car so you’re not stuck with a drained battery in an emergency. Just (And) don’t forget to charge them in advance!

If you’re tired, stop driving

It seems like an obvious tip, but according to the CDC there are 72,000 crashes and nearly 6,000 fatal crashes due to drowsy driving each year. A study by AAA found that the risks of fatigued driving are comparable to drunk driving. We know it can be tempting to push through to your destination, even when you begin to feel tired, but the risks aren’t worth it. If you begin to feel fatigued, get your family to a hotel and resume your drive in the morning.

Let someone know your destination and when you plan to arrive

Communicating your travel plans with someone back home is a crucial piece of your safety plan. Designate a friend or family member to share your itinerary with. If plans change, let them know. When you’ve stopped for the night, check in and share your location as well as your travel plans for the following day. These mundane details could be crucial in locating your family should you suddenly drop off the radar.

Be prepared in a worst-case scenario

It’s hard to think about, but if your family was involved in an auto accident with injuries, what is the long-term plan for returning back home? With an air-medical transport membership like MedjetAssist, members who are hospitalized 150 miles or more from home can arrange medical transport back to their hometown hospital for free, after the cost of the annual membership (sounds expensive but it’s incredibly affordable). Medjet will arrange air medical transfer to a home hospital of choice, regardless of whether it’s deemed “medically necessary.” Your health insurance will only get you to the nearest “acceptable” medical facility (which may not be “acceptable” to you).  The cost for other family members to remain nearby for any extended period of time may also break the bank, so it’s worthwhile coverage to explore.

It can be stressful and overwhelming to think about what danger could befall your family while on the road. Hopefully, you’ll never find a need for this information, but following these safety tips will give you the confidence to handle a crisis, and a sense of comfort knowing that you are prepared for the unexpected.

 

Article contributed by MedjetAssist, an official partner with the Medical Association. With MedjetAssist, you travel prepared. The safer you feel, the more you can focus on the moment. Especially when you travel. MedjetAssist empowers our members to feel safer and more prepared for travel’s many possibilities.

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Burnout Proof – Healing the Healers with Debbie Booher Kolb, M.D.

Burnout Proof – Healing the Healers with Debbie Booher Kolb, M.D.

MADISON — According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.

As president of the Madison County Medical Society, Dr. Kolb wanted to make a difference in the lives of her colleagues. Together with a wellness committee she chairs, they began to formulate a plan to help physicians in the area who felt overwhelmed in their medical practice and achieve a better work-life balance. They had no idea the vast support they would have for the Physicians Resource Network Wellness Program.

“My father is a retired radiologist,” Dr. Kolb explained. “I remember being in school and hearing about a friend of my fathers who changed careers. I was mystified by that. I didn’t know that was even an option. I’d never heard of a physician changing careers. It’s not even on your radar once you’re in the medical profession. If you do change careers, it’s to go into pharmaceuticals, medical directorships, or to be a life coach. For physicians, it’s truly a business decision once you leave the profession. It’s sad really to think you could burn out so badly that you leave the profession you loved so much completely behind you.”

But, it’s happening more and more to physicians. With the added pressures of government regulations, such as MACRA, electronic health records, ICD-10, and Medicaid funding, the practice of medicine has become even more complicated today than it was just a decade ago. Unfortunately, these pressures have caused physicians to burnout and not only voluntarily leave the profession of medicine, lose their medical license for inappropriate behavior, or commit suicide.

Dr. Kolb’s mission is to help her colleagues prevent burnout by learning how to cope with its symptoms and find a better work-life balance. Her mission began in 2014 at the annual meeting of the American Academy of Family Physicians where she first met Dr. Dike Drummond, better known as The Happy MD, and discovered his book, Stop Physician Burnout.

“This book transcends medicine, and his website is great, too. I was so impressed with his actionable advice. What he gives you to do is really good nuts-and-bolts that made me want to bring him to Huntsville so my colleagues could hear him locally. We’ve had three physician suicides in two and a half years in Madison County alone. So it really became more and more apparent that we needed to do something. This is heartbreaking and preventable. All of this coalesced to really be something that we could all get behind.”

As Dr. Kolb and her colleagues admit, everything begins with a discussion. But, little did they know just how many lives they were about to touch when they rolled out the first component of their burnout program. The first step was an evening event with Dr. Drummond, which sold out 200 seats and had a waiting list for attendees.

“Burnout transcends specialties, and that’s why our physicians have been so appreciative of this program. After the event with Dr. Drummond, we had people commenting and sharing their stories on social media. That’s what we’re trying to do — effect a paradigm shift in the culture of medicine. We really want to let our colleagues know that this is more common than they may realize because physicians just don’t talk about it. We want to start talking about it,” Dr. Kolb said.

Learn more about Madison County’s Physician Wellness program.

*Thanks to the following physicians, committee, Madison County Medical Alliance members, as well as our sponsors whose generosity in time and funding helped make this program a reality:

Wellness committee volunteers include: Board of Trustee members Drs. Aruna Arora, Greg Bouska, James Gilbert, Dawn Mancuso, Paul Tabereaux, Sherrie Squyres and Tarak Vasavada; therapist Dr. Violet Gilbert; Madison County Medical Alliance President Christina Tabereaux; and MCMS Executive Director Laura Moss. While not a committee member, MCMS Past President Dr. Amit Arora has also been instrumental in supporting this mission.

Burnout Proof LIVE was made possible by the generous donations of Huntsville Hospital, ProAssurance, the Madison County Medical Alliance, Blue Cross Blue Shield of Alabama, ServisFirst Bank, Fyzical Therapy and Balance Centers, Crestwood Medical Center, Dr. Hayes Whiteside and the Medical Association of the State of Alabama.

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How is Tax Reform Impacting Physician Practices?

How is Tax Reform Impacting Physician Practices?

The biggest U.S. tax reform since 1986 consists of major tax law changes that will affect everyone. The most significant change for corporations is a move from the graduated corporate tax rate structure to a flat rate. Although President Trump was originally fighting for the corporate rate to be reduced to 15 percent, lawmakers settled by reducing the rate from 35 percent to 21 percent. Other aspects of the tax law are more complex, and many businesses are wondering how this new law will affect their particular industries.

Let’s dive a little deeper into how tax reform is affecting physician practices.

A significant amount of attention has been focused on the 20 percent pass-through income deduction (also known as the qualified business income “QBI” deduction). Unfortunately, physician practices are specifically excluded from QBI deduction eligibility. However, an exception is made for physicians with taxable income under $415,000 for joint filers and $207,500 for single filers. Physicians with taxable income below these thresholds may be eligible for the 20 percent QBI deduction. The QBI deduction calculation is complex and should be considered in conjunction with physician group compensation models and reasonable compensation guidelines.

Entertainment expenses need to be evaluated and minimized. Under the new law, deductions for business-related entertainment expenses are disallowed. Meal expenses incurred while traveling on business will remain 50 percent deductible. The 50 percent disallowance will now also apply to meals provided at an on-premises cafeteria or otherwise on the employer’s premises for the convenience of the employer. After 2025, the cost of meals provided through an on-premises cafeteria or otherwise on the employer’s premises will be nondeductible.

Physicians should also take into account the tax reform changes for individuals by evaluating their personal mortgage interest structure to maximize the interest deduction. This can be achieved by turning a home equity line of credit (HELOC) into a traditional mortgage, if applicable. The home mortgage interest deduction has been modified to reduce the limit on acquisition indebtedness to $750,000 for married filing jointly (MFJ), down from $1,000,000 under previous law. However, if the acquisition indebtedness occurred before Dec. 15, 2017, the limit remains $1,000,000.

Finally, tax reform limits the Federal tax deduction for state and local taxes to $10,000, beginning in 2018. Many physicians will far exceed the $10,000 state and local tax deduction cap. The limitation on state and local tax deduction encompasses both income taxes, sales tax and property taxes. Physicians can potentially minimize tax liabilities by strategically planning the payment of their individual state taxes and utilizing any state scholarship granting organizations, such as an Alabama Scholarship Granting Organization (SGO) or Georgia Student Scholarship Organization (SSO). These programs allow taxpayers to receive a state tax credit in return for an eligible contribution. This contribution qualifies as a charitable contribution on a federal return. This turns a state tax payment into a charitable deduction for federal purposes, increasing itemized deductions.

 

Article contributed by Warren Averett CPAs and AdvisorsWarren Averett CPAs and Advisors is an official Gold Partner with the Medical Association.

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Cyber Security:  Five Common Phish Attack Schemes

Cyber Security:  Five Common Phish Attack Schemes

Hackers only need you, that’s right just you. They are sneaky and know the general population is busy and doesn’t pay close attention to the emails they receive. Hackers know people are comfortable in their daily habits. They exploit this behavior by creating email scenarios designed to encourage a click. They need just one person to click just one time to infect their computer with malware that grants them access to the information they need to launch a more sinister attack.

“Phishing attacks are by far the most common cyber attack today, and these attacks continue to get more and more sophisticated.  Gone are the days of the ‘dear sir’ attack-now we have to worry if an email appearing to be directly from a co-worker is actually from them,” said Steven Hines, president of Threat Advice.

Because hackers are continually changing their tactics, clicking on a nefarious email or link leading to a cyber attack can happen to anyone. Recognizing the threat before it turns into a disaster is just one way we each can be more prepared. The following are five ways hackers are currently trying to access your business and personal information:

  1. Look but don’t click. If the email address or the attachment name seems “phishy,” it probably is. Are there spelling or grammatical mistakes? Companies with professional staff are not going to make these types of mistakes.
  2. Analyze the salutation and signature closely. Most legitimate businesses will use your name rather than a generic greeting like “Dear customer.” The business should provide ways to contact them in the signature. If that’s not provided, it could be a phishing attempt.
  3. Know your brands. Hackers will spoof your favorite brands and make their emails look enough like the actual brand to fool you. Is the logo color wrong? Are there additional words in the brand name? Did you sign up to receive emails from them? Don’t click any links before you examine the email to confirm the sender.
  4. Urgent or Threating – No one likes a bully. A common phishing technique is to use harassing or threating language in the subject line or email content or to create a sense of urgency to handle a fake problem. Most legitimate banks, utilities/municipalities and businesses will not ask you to provide your private information via email nor threaten you in an email.
  5. What grandma said…“If it’s too good to be true, it probably is!” Hackers will continue to send phishing emails promising riches and prosperity if you only send your social security and bank information. Why? Because unfortunately, people still take the bait.

Article contributed by Cobbs Allen. Cobbs Allen is an official Gold Partner with the Medical Association. For more information about cyber liability insurance and how it protects your business, contact Margaret Ann Pyburn.

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Medical Association Chooses PCIHIPAA to Help Benefit and Protect Its Members

Medical Association Chooses PCIHIPAA to Help Benefit and Protect Its Members

MONTGOMERY – The Medical Association of the State of Alabama has partnered with PCIHIPAA to help protect its members from the onslaught of ransomware attacks, HIPAA violations and data breaches impacting Alabama physicians. Under HIPAA’s Security and Privacy Rules, health care providers are required to take proactive steps to protect sensitive patient information.

“The Medical Association services more than 7,000 Alabama physicians. It’s critical that our members understand the risks surrounding HIPAA compliance and patient data privacy and security laws. We vetted many HIPAA compliance providers and believe PCIHIPAA’s OfficeSafe Compliance Program is the right solution for Alabama physicians. PCIHIPAA’s compliance program is robust and easy to implement. I’m confident our partnership will provide a necessary, value-added program for our members.” said Association President Jerry Harrison M.D.

The partnership comes on the heels of an important announcement surrounding HIPAA compliance regulation. The Director of U.S. Department of Health and Human Services’ Office for Civil Rights recently stated, “Just because you are a small medical or dental practice doesn’t mean we’re not looking and that you are safe if you are violating the law. You won’t be.” In addition, in 2017 hacking and employee errors led to data breaches at Alabama-based Surgical Dermatology Group, UAB Viral Hepatitis Clinic and The University of Alabama, supporting the importance of HIPAA compliance and patient data protection.

According to the U.S. Department of Health and Human Services, OCR has received over 150,000 HIPAA complaints following the issuance of the Privacy Rule in April 2003. A rising number of claims filed under HIPAA in recent years have led many patients to question whether or not their personal payment and health information is safe. As the government has become more aggressive in HIPAA enforcement, large settlements have become widespread and rising penalties for HIPAA non-compliance are a reality.

According to HHS.gov, the types of HIPAA violations most often identified are:

  1. Impermissible uses and disclosures of protected health information (PHI)
  2. Lack of technology safeguards of PHI
  3. Lack of adequate contingency planning in case of a data breach or ransomware attack
  4. Lack of administrative safeguards of PHI
  5. Lack of a mandatory HIPAA risk assessment
  6. Lack of executed Business Associate Agreements
  7. Lack of employee training and updated policies and procedures

“We are honored to be partnering with The Medical Association of The State of Alabama. They have a 140-year track record of helping Alabama physicians thrive. PCIHIPAA’s mission is to help physicians easily and affordably navigate HIPAA requirements and provide the solutions they need to protect their practices. We find that many practices don’t have the resources to navigate HIPAA law, and are unaware of common vulnerabilities. We encourage all association members to take a complimentary risk assessment to quickly assess their HIPAA compliance and risk levels. To get started go to Start Risk Assessment.” said Jeff Broudy, CEO of PCIHIPAA.

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About PCIHIPAA
PCIHIPAA is an industry leader in PCI and HIPAA compliance providing turnkey, convenient solutions for its clients. Delivering primary security products to mitigate the liabilities facing dentists and doctors, PCIHIPAA removes the complexities of financial and legal compliance to PCI and HIPAA regulations to ensure that health and dental practices are educated about what HIPAA laws require and how to remain in full compliance. Learn more at OfficeSafe.com and PCIHIPAA.com.

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Are You a Medicare Provider Without an EHR?

Are You a Medicare Provider Without an EHR?

You can still avoid the MIPS 4 percent penalty by participating this year!

In 2017 the TEST portion of MIPS allows a provider to submit one Quality measure (previously known as PQRS) for less than a 90 day period to potentially avoid a 4 percent MIPS penalty (to be incurred in 2019) on Medicare Part B claims. One example of this is G8427 – Current Medications Documented. Every office typically documents a patient’s Current Medications. If you submit this code on your claims, even if only for a short period of time, you will be participating in the test portion of MIPS and may avoid a 4 percent penalty on Medicare Part B in 2019.

Remember, you will need to do this for every TIN/NPI combination in your practice.

The graph below shows a broad overview of the current MIPS attestation guidelines. Each line gives a brief summary of the four different attestation paths an office can choose from for 2017. Based on your 2017 participation, the above information references the row with one star and explains the simple criteria required this year to easily avoid a 4 percent penalty which incurred in 2019.

Need help understanding these new MIPS requirements? Contact MediSYS today at 1 (334) 277-6201 or email questions to sales@medisysinc.com. Our staff has been assisting practices with various CMS incentive programs since their inception. We combine years of experience with ongoing support and detailed expertise for our clients at no additional support charges.

 

For information on MediSYS electronic health records and practice management solutions as well as outsourcing CCM services, please contact MediSYS at sales@medisysinc.com and visit the website at www.medisysinc.com. MediSYS is an official partner with the Medical Association.

 

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A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

Editor’s Note: The following is the final installment of a three-part series discussing important provisions in physician employment agreements.

When a physician leaves a medical practice, especially if the physician stays in the area to compete against his/her former employer, the situation can become stressful and acrimonious. During the final weeks of employment, the departing physician can start to focus more on his/her new practice to the detriment of the current employer, and disputes often arise regarding access to medical records, soliciting patients and employees and when to schedule procedures – before or after termination. We have seen both medical practices and departing physicians engage in questionable conduct in order to keep as many patients as possible. Lawyers are often engaged in negotiating the terms of separation or, in a worse-case scenario, filing or defending a lawsuit.

Over the years, we have counseled hundreds of physician practices on how to successfully navigate the various issues that arise when a physician departs, regardless of whether the physician is an employee or an owner. Careful planning on the front end through a comprehensive employment agreement is the most important element in an amicable and fair separation. More often than not, we have found that disputes and subsequent litigation can arise when the employment agreement is not properly drafted or does not adequately address the specific terms of separation.

This three-part series provides a summary of the key provisions (with sample language) that can be incorporated into a physician employment agreement to help mitigate problems when a physician leaves your practice. Since each medical practice is unique, please consult with your own attorney before using any of the provided sample provisions in a physician employment agreement.

Protecting the Practice’s Confidential Information. Especially if the departing physician will continue to practice in the same service area as the medical practice, it is very important that the practice protects its sensitive and confidential information, including medical records, charge masters and policies and procedures. As such, the employment agreement should address the confidentiality of such items. Failure to do so will make it more difficult for the medical practice to protect its sensitive information.

Physician agrees that all data and information which he/she receives from Employer, whether directly or indirectly, in connection with this Employment Agreement or Physician’s employment with Employer shall be considered confidential and proprietary information belonging solely to Employer (the “Confidential Information”). Without limiting the foregoing, “Confidential Information” shall mean any written or oral information of Employer, including, without limitation, all business or management studies, patient lists and records, financial information, Employer documents, forms, business or management methods, marketing data, fee schedules, employee and operating manuals, trade secrets as defined by the Alabama Trade Secret Act, as amended from time to time, accounting information, and any other information treated by Employer as being confidential or labeled “Confidential” by Employer. Physician shall hold such Confidential Information in strictest confidence and shall not make use of such Confidential Information except in the performance of his/her services for Employer. Physician shall not disclose, distribute or otherwise divulge such Confidential Information to any other third-party without the prior written consent of Employer, except in the performance of his/her services for Employer. Notwithstanding anything contained in this Section to the contrary, the obligations of Physician under this Section shall not apply to information or property which Physician can demonstrate is: (a) now in the public domain or later publicly available through no fault of Physician, (b) has been or is in the future rightfully obtained without restriction by Physician from other sources not subject to a confidentiality agreement, or (c) independently developed without use of Employer’s Confidential Information. Upon request of Employer and upon termination of this Employment Agreement, Physician shall immediately return to Employer all Confidential Information which Physician received from Employer or any Confidential Information within Physician’s possession. The terms of this Section shall survive termination of the Employment Agreement.

Protecting the Practice from Future Liabilities. When a physician leaves a medical practice it is still possible for the practice to face liability stemming from the physician’s past conduct. For example, federal payers, such as Medicare and Medicaid, as well as commercial payers, can audit medical practices for professional services rendered several years prior to the date of the audit.  Further, HIPAA violations, malpractice issues and other misconduct may not surface until after a physician leaves a medical practice. Unless the employment agreement continues to hold the departing physician responsible after termination for his/her conduct during employment the medical practice may have insufficient remedies in the event a problem arises.

Physician shall hold harmless, indemnify and defend Employer, and its members, partners, officers, directors, employees, successors, representatives and assigns, from and against any and all liabilities, costs, damages, suits, judgments, fines, losses, demands or expenses of any kind whatsoever (including, but not limited to, court costs, arbitration fees, if applicable, and attorneys’ fees and expenses actually and reasonably incurred) from or attributable to: (a) any breach by Physician of this Employment Agreement, (b) any and all negligent or intentional acts and/or omissions of Physician, and/or (c) any overpayment, refunds, offsets or recoupments related to claims for medical services provided or ordered by the Physician, but only to the extent the Physician received compensation from the claims subject to the refund, offset or recoupment.  The terms of this Section shall survive termination of the Employment Agreement.

While it may take more work on the front-end, having a well-thought out and comprehensive physician employment agreement will save significant time, effort and potentially money when a physician leaves your medical practice.

Read the full series:

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part I)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

Howard Bogard is a Partner with Burr & Forman LLP and serves as the Chair of the firm’s Health Care Industry Group. Kelli Fleming is a Partner with Burr & Forman LLP practicing in the firm’s Health Care Industry Group.

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The Lowdown on Public Wi-Fi

The Lowdown on Public Wi-Fi

I am writing this from an airplane. Often, when I hop on a plane — particularly for a long flight — I wait for the ascent to 10,000 feet and immediately jump onto public Wi-Fi, just as I do in coffee shops, the dentist’s office, and pretty much anywhere else I can grab a signal. But that was before I spent an hour chatting with Joe Gervais, director of security communications at LifeLock, and part-time hacker (though Gervais points out, he hacks “only for good”). The point of the conversation was to figure out when it’s okay to use public Wi-Fi, when it’s not, and what you can do instead. Here’s what I learned…

What is public Wi-Fi? Any Wi-Fi that’s shared with someone other than yourself and the members of your household. A guest account that’s been set up for visitors to a particular company? Hotel Wi-Fi, free or not? In-flight Wi-Fi? Public, public and public. It doesn’t matter if it’s free or you pay a fee, or if it’s password protected.

Get that? Even if the Wi-Fi network requires a password, that doesn’t mean it’s safe.

What danger does that pose for me? Whenever computers are on a shared network, all the data is flowing over shared “wires.” Every computer on the network can see all the data flowing over that network. The default behavior, Gervais explains, is to ignore data that isn’t meant for your machine. But if you’re technically savvy and so inclined, you can, essentially, flip a switch and see everything. Most of it, he says, is garbage unless you’re a “network geek, a hacker, or attacker.” Then you can learn things that could be used, for example, in targeted phishing attacks.

For example? Say you’re a veteran, and you’re researching PTSD. You go online to search the terms, “PTSD” and “treatment.” Maybe you look up a local treatment center or a Veterans Administration support group. How much information an attacker can glean depends on the kinds of website pages you visit.

If you’re on secure websites (which have “https” in the URL address) vs. insecure ones (which have only “http”), the attacker can see the site itself, but not the page you went to. Visit enough sites, though, and it still might give someone enough information to launch a relevant phishing attack against you.

Even downloading apps on public Wi-Fi is to be avoided. A sophisticated attacker could pose as that app telling you there’s an update and use that via phishing to get you to give up personal information—your financial info, for instance, if you were downloading a bank’s app.

This is getting very scary. You’re telling me. But there a few things you can do to keep yourself safer.

  1. Limit your behavior on public Wi-Fi. Don’t do anything on your browser that you wouldn’t do if a stranger was sitting next to you staring at your screen, Gervais says. That means no transacting. It also means not sending emails that contain sensitive information. You’re better off picking up the phone or, if that’s not possible, texting.
  2. Use a VPN app. VPNs are virtual private networks and they come in app form for your smartphone and tablet. This creates an encrypted channel, so your online business is protected from prying eyes. Some good ones include WiTopia and F-Secure Freedome. You will find plenty of free ones in the app store, but Gervais cautions: “If you’re not paying for the VPN, you the user, are the product.” Use your hotspot. If you don’t want to go the VPN route, use cellular data on your phone and, for your computer or tablet, connect using the personal hotspot on your phone. Now that many of the cellular carriers are going to unlimited data, you can feel better about using it freely.

Oh, and while you’re at it, make sure your home Wi-Fi network is protected with a strong password. You don’t want neighbors “borrowing” your bandwidth, slowing your internet connection, or — if they’re so inclined — seeing what you’re doing online.

Contributed by LifeLock, which is a partner with the Medical Association. Medical Association members receive a discount on LifeLock memberships. Click to learn more.

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A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

Editor’s Note: The following is the second installment of a three-part series discussing important provisions in physician employment agreements.

When a physician leaves a medical practice, especially if the physician stays in the area to compete against his/her former employer, the situation can become stressful and acrimonious. During the final weeks of employment, the departing physician can start to focus more on his/her new practice to the detriment of the current employer, and disputes often arise regarding access to medical records, soliciting patients and employees and when to schedule procedures – before or after termination. We have seen both medical practices and departing physicians engage in questionable conduct in order to keep as many patients as possible. Lawyers are often engaged to try and negotiate the terms of separation or, in a worse-case scenario, to file or defend a lawsuit.

Over the years, we have counseled hundreds of physician practices on how to successfully navigate the various issues that arise when a physician departs, regardless of whether the physician is an employee or an owner. Careful planning on the front end through a comprehensive employment agreement is the most important element in an amicable and fair separation. More often than not, we have found that disputes and subsequent litigation can arise when the employment agreement is not properly drafted or does not adequately address the specific terms of separation.

This three-part series provides a summary of the key provisions (with sample language) that can be incorporated into a physician employment agreement to help mitigate problems when a physician leaves your practice. Since each medical practice is unique, please consult with your own attorney before using any of the provided sample provisions in a physician employment agreement.

Protecting Other Practice Employees. When a physician leaves a medical practice he/she may want to encourage other practice employees (i.e., nurses, technicians, receptionists, etc.) to leave and work for the physician. These employees are a valuable asset to the medical practice and oftentimes the medical practice has invested significant time and resources in training its employees. Under Alabama Code Section 8-1-1, which was amended Jan. 1, 2016, a medical practice can protect an employee from being hired by a departing physician; provided, however, that the practice can demonstrate that the employee is “uniquely essential” to the medical practice. The term “uniquely essential” has not been specifically interpreted by the courts, but appears to require that the medical practice demonstrate that the protected employee(s) is not easily replaced due to a unique skill set or training, and the loss of the employee(s) would be detrimental to the medical practice.

Physician agrees that, during the term of this Employment Agreement and for a period of one (1) year following termination of this Employment Agreement, regardless of the cause of such termination, Physician shall not, directly or indirectly, through any individual, person or entity, without the prior written consent of Employer: (a) solicit, induce or attempt to solicit or induce away, or aid, assist, or abet any other party or person in soliciting, inducing or attempting to solicit or induce away from employment or other association with Employer, any employee of Employer, or (b) employ, hire or contract for services with any employee of Employer, or any person who was an employee of Employer during the six (6) month period prior to termination of Physician’s employment with Employer. The Employer and Physician acknowledge that the restrictions contained in this Section are reasonable and necessary to protect the protectable interests of Employer which include, without limitation, Employer’s confidential information, Employer’s commercial relationships with its patients, patient goodwill associated with its business, and the unique training of its employees, which was and is provided by Employer at considerable expense.  Physician acknowledges and agrees that the Employer’s employees hold positions uniquely essential to the management, organization and service of the Employer.

Compensation.  When a physician leaves a medical practice he/she will be compensated through the date of termination. If, however, the employment agreement provides for some form of bonus compensation based on, for example, collections or other measures of productivity, the employment agreement should address whether the physician is eligible for a bonus, pro-rated through the date of termination, or if termination before the end of the bonus measurement period results in the physician forfeiting any bonus. In addition, if the physician is paid based on production (e.g., collections less allocated expenses), then the employment agreement should address whether accounts receivable generated by the physician which are collected after termination for some designated time period will be counted toward the physician’s final paycheck, or if only collections received through the date of termination will be allocated to the physician. With either a bonus or production compensation model, some employment agreements provide that the departing physician will not be eligible for a bonus or the allocation of any post-termination collections if the physician terminates the employment agreement without cause or if the medical practice terminates the employment agreement with cause. Regardless, it is very important to clearly delineate in the employment agreement how compensation will be addressed upon termination.

Continuing Malpractice Insurance.  When a physician leaves a medical practice it is critical that medical malpractice insurance is maintained which provides continuing insurance for the physician’s professional services if a claim arises after the date of termination. Payment of a reporting endorsement (sometimes referred to as “tail insurance”) is typically an item negotiated by the parties. Regardless of how the costs are allocated, it is important that the employment agreement require either the purchase of a reporting endorsement or that the departing physician be obligated to maintain his/her then current malpractice insurance without interruption for a period of at least four years (eight years if minor patients are involved) after termination of employment. The following sample provision obligates the departing physician to pay for tail insurance, but can be modified as appropriate to provide that the medical practice will cover the costs of such insurance.

Immediately upon termination of employment with Employer, Physician shall, at Physician’s sole expense: (a) purchase or obtain a professional liability insurance reporting endorsement (e.g., tail coverage) with the same base and excess coverage limits and annual aggregate as the professional liability policy made available by the Employer for the Physician (the “Professional Liability Insurance Policy”) in order to provide continuing insurance protection for Physician and Employer against claims for malpractice or negligence occasioned by the acts of Physician while he/she was an employee of Employer (hereinafter referred to as the “Reporting Endorsement”), or (b) make arrangements for the continuation of the Professional Liability Insurance Policy with the same professional liability insurance carrier and with the same base and excess coverage limits and annual aggregate as the Professional Liability Insurance Policy, and listing Employer as an additional insured on such policy (hereinafter referred to as the “Continuation Policy”).

To evidence compliance, Physician shall provide to Employer within ten (10) days following the date of termination of this Employment Agreement either: (a) a copy of the Reporting Endorsement, or (b) a copy of the Continuation Policy, a “Certificate of Insurance Holder,” evidencing the existence of the Continuation Policy and written confirmation from the insurance carrier that Employer is listed as an additional insured on the Continuation Policy. If Physician obtains the Continuation Policy, and within ____ (____) years after termination of employment with Employer, should the Continuation Policy lapse, terminate or be modified so as not to satisfy the definition of a “Continuation Policy” in this Employment Agreement, or should Physician ever change professional liability insurance carriers, Physician agrees that he/she shall immediately purchase the Reporting Endorsement and that he/she shall provide Employer with a copy of the Reporting Endorsement at that time. If Physician fails to purchase such coverage and/or provide Employer with a certificate of same in accordance with the above‑stated requirements, Employer shall have the right, as hereby acknowledged by Physician, but not the obligation, to purchase such coverage and notify Physician in writing of the total premium costs thereof. Physician hereby expressly acknowledges and agrees that the total premium cost for such coverage purchased by Employer under this Section (plus a ten percent (10%) administrative fee) shall be immediately due and payable by Physician to Employer upon Physician’s receipt of said notice and Employer shall have the right to offset Physician’s cost of insurance against any amounts due Physician, with Physician reimbursing Employer for any deficiency. The terms of this Section shall survive termination of the Employment Agreement.

While it may take more work on the front-end, having a well-thought out and comprehensive physician employment agreement will save significant time, effort and potentially money when a physician leaves your medical practice. Stay tuned for Part III of this three-part series which will discuss protecting confidential information and protection from future liabilities.

Read the full series:

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part I)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

Howard Bogard is a Partner with Burr & Forman LLP and serves as the Chair of the firm’s Health Care Industry Group. Kelli Fleming is a Partner with Burr & Forman LLP practicing in the firm’s Health Care Industry Group. Burr & Forman, LLP, is an official Bronze Partner with the Medical Association.

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Four Types of Identity Fraud on the Upswing

Four Types of Identity Fraud on the Upswing

If you thought that the promising (albeit modest) drop in the total dollars stolen by identity thieves in 2015 was a harbinger of things to come, think again.

According to the just released 2017 Identity Fraud Study from Javelin Research, the number of victims of this crime—in all its permutations—climbed to a record high of 15.4 million last year. And, despite the fact that the average amount per fraud went down, the total cost topped $16 billion, also an all-time high. What does that say about efforts to rein in identity thieves?

“We’ve gotten pretty good at closing the door once the horse has left the barn,” says Al Pascual, Javelin senior vice president and head of fraud and security. But we need work when it comes to “barring the door” to begin with.

The research, funded by LifeLock, also made clear that even if you don’t maintain a large online presence, taking steps to protect your identity is a smart move. Offline consumers are less likely to experience fraud, Pascual explains. But when it happens it’s worse, because it takes more time to detect. On the other hand, if you’re highly connected, your risk is much higher than average. But you’re also likely to detect—and shut down—attempts at fraud more quickly. How do you protect yourself? “If you’re not digitally inclined, sign-up for a credit protection service,” Pascual says. “If you are, don’t use the same passwords even across retailers.”

The study, now in its 14th consecutive year, highlights a number of specific places identity fraud and theft are on the rise or particularly troubling. Here’s a look at what they are and how to protect yourself:

Card Not Present Fraud

What you need to know: Incidences of this type of fraud, where a thief uses your card number without having the actual card, rose 40 percent last year. Pascual expects those gains to continue. “We’ve gone digital because it’s convenient,” he says. “So have criminals.”

How to guard against it: Take advantage if your credit card offers ways to obscure your payment details, advises Dr. Stephen Coggeshall, Chief Analytics and Science Officer of ID Analytics. Some credit card issuers and fraud protection services will send you alerts if a charge is made and your card is not present. Do that as well. And pay attention to your credit card statements, watching, in particular, for charges you don’t understand.

New Account Fraud

What you need to know: This form of fraud, where a thief steals enough of your identifying information to open an account in your name, is on the upswing. Incidents nearly doubled from 2014 to 2015, and this year showed “almost the same degree of growth,” Pascual said. Importantly, the new accounts being opened are not just at traditional lenders, but also at alternative ones, including payday lenders and peer-to-peer lenders. Those are tougher to track.

How to guard against it: Monitoring your credit, by either taking a very consistent look at your own reports or having a service do it for you, is the key here. One advantage of some services, notes Pascual, is that they look beyond the item on your credit reports to checking and savings accounts and alternative lenders. Also, it sounds run of the mill, but open every piece of mail you get from a financial institution—even those you don’t patronize. Often, you’ll receive notice when an account is opened in your name, giving you a chance to shut it down and alert the credit bureaus.

Account Takeover Fraud

What you need to know: This type of fraud is distinguished by the fact that a criminal is essentially trying to usurp control for a pre-existing account that you’ve set up. Signs that it might be happening include receiving change of password or change of address notices that aren’t prompted by your actions. “These cases result in the highest average loss amount, and sometimes a consumer can be stuck for more of the bill,” says Pascual, explaining that it can be difficult to prove that you didn’t take the actions involving your account, such as removing or spending funds.

How to guard against it: Don’t reuse passwords across sites—particularly across financial ones. Criminals will take the password list from one breach and try those passwords at every major bank across the country to see if they can be used. Tell your financial institutions you want multiple notifications—by both text and email—if actions are taken on your account. “The idea is to make it harder for communication to be severed between you and the institutions,” says Pascual. And if two-factor authentication is available for entry to any of your financial sites, use it.

Sophisticated Phishing

What you need to know: The phishers have gotten better at their game. “We’re used to seeing phishing with poor misspelling, bad grammar, and poor formatting,” says Coggeshall. Criminals have moved beyond that. Today, corporate emails are being spoofed and employees are being sent letters from the CEO or finance department that look legitimate. In some cases, hackers take the time to learn things about you specifically, then target you with a specially crafted phish.

How to guard against it: If someone contacts you that you’re not used to hearing from and asks for any sort of financial or identifying information, a bell should go off in your head. Don’t click on the email. Don’t give out information by phone or text. Instead, back away and—if you believe it might be real—initiate the communication yourself to figure out if the need is legitimate.

LifeLock is a partner with the Medical Association, and physician members receive discounted rates on LifeLock memberships.

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