Category: Legal Watch
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Liquid Gold or Reimbursement Trap? Payor Reimbursement Policies for Urine Drug Testing
Last summer, we wrote about physician roles and responsibilities to implement best practices in pain management programs and other treatments involving the prescription of opioids.1 Here we discuss issues related to getting paid to implement one of these best practices — appropriate urine drug testing. The urine drug testing field has been described as a…
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MACRA: Rolled Out and Still Rolling
Most physicians have, by this point, gained some familiarity with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The name of this law has appeared frequently in commentary over the past several years, and the changes it imposes are well on their way. However, many of the details concerning MACRA’s implementation—how it affects…
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The New Department of Justice Initiative: Aggressively Investigating and Prosecuting Opioid-Related Cases
Before joining Burr & Forman, LLP, I was a federal prosecutor for a little over a decade specializing in health care fraud and general white collar matters. In that role, I was the member of a prosecution team that secured guilty verdicts earlier this year against two pain management doctors in Mobile, Ala., following a…
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Before You Lock the Door and Turn Out the Lights . . .
Necessary Steps When Closing a Physician Practice The Gilberto Sanchez Story [1] Shortly after a group of DEA agents and other law enforcement personnel sporting tactical gear arrived in the parking lot with search and arrest warrants on a Tuesday early in August, Dr. Gilberto Sanchez was hauled away from his medical practice in the…
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Physicians Maintain High Standards
By the time this article goes to print, a lot could change, so there’s no apparent use in guessing what will come of the next Repeal and Replace efforts or what’s happening at Main Justice. Nobody knows. The only certainties from Washington are that there will be change in the payment and insurance models, and…
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Have You Properly Obtained Informed Consent?
In June, the Pennsylvania Supreme Court issued a controversial opinion holding that a physician had to have face-to-face interaction with the patient to effectively obtain informed consent. This has raised heightened awareness of a physician’s obligations to obtain informed consent from their patients and caused many to evaluate their own practice of obtaining informed consent.…
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Emergency Physicians: Georgia BCBS Policy Violates Federal Law
WASHINGTON, DC – The American College of Emergency Physicians and its Georgia Chapter recently announced a policy that Blue Cross/Blue Shield of Georgia plans to implement in July, making subscribers pay for any emergency department visit that turns out not to be an emergency, violates the “prudent layperson” standard, which is codified in federal law,…
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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…
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Texting and Emailing in the World of HIPAA
If you experience anxiety every time you consider texting and/or emailing in your health care setting, you are not alone. On one hand, the world that we live in necessitates that information is communicated in a quick and easy manner. The ability to text or email staff and patients has become a high priority for…
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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…