Legal and practical healthcare information.
The government is continuing to take a close look at laboratory testing in the wake of the COVID-19 pandemic. On February 21, 2024, a federal grand jury in New Jersey issued a superseding indictment against a New York physician. The indictment claims the physician committed healthcare fraud and conspired to defraud the United States by …
Continue reading “NY Doctor Indicted for Medicare Fraud Related to Genetic Testing and Equipment”
Originally published in Healthcare Michigan, Volume 40, No. 2 Non-compete provisions are common in healthcare employment agreements. These provisions are designed to prohibit an employed or contracted provider from competing against the contracting entity by working for or starting a competing business within a certain geographic area for a set period of time. As the Michigan …
Continue reading “Proposed Rules Could Mean The End Of Non-Compete Agreements”
The United States Court of Appeals for the Ninth Circuit recently released an unpublished memorandum decision in the landmark mental parity case of Wit v. United Behavioral Health. In this decision, the Ninth Circuit reversed the district court’s order requiring UBH to reprocess more than 60,000 claims that had initially been denied for not meeting …
Continue reading “Updates to Wit v. United Behavioral Health”
Last month, we published an article summarizing new surprise billing laws that prohibit nonparticipating providers from balance billing patients when the patient’s insurance company pays less than the provider’s usual and customary charge. The Michigan law, known as the Surprise Medical Billing Law, has been in effect since last year. The Federal law, known as …
Continue reading “Court Strikes Down Portions of Federal Regulations Concerning No Surprises Act”
What are non-compete agreements? In the broadest sense, non-compete agreements prohibit an employee from accepting employment by a competitor of an employer for a certain time. They are treated differently than non-solicitation agreements and confidentiality agreements. While non-compete agreements may not solely prevent competition – the agreement cannot prohibit an employee from using general knowledge …
Continue reading “Physician Non-Compete Agreements: What You Should Know”
Since last year, certain providers (e.g., anesthesiologists, radiologists, surgeons, etc.) in Michigan have had to navigate Michigan’s Surprise Medical Billing Law (“Michigan Act”). Starting January 1, 2022, those same providers have also had to comply with the Federal No Surprises Act (“Federal Act”). Generally, both statutes prevent nonparticipating providers from balance billing patients when the …
Continue reading “SURPRISE! NEW LAWS IMPACT PATIENT BILLING”
Some areas of the law are black and white. In those cases, contractual provisions can often be easily labeled as permissible or impermissible, allowed or not allowed, reasonable or unreasonable. The enforceability of a provision prohibiting an employer from working in a competing business following their employment (a noncompetition provision) is not one of those …
Continue reading “Enforceability of Physician Noncompetition Agreements in Michigan”
On June 19, 2020, the Department of Health and Human Services (“HHS”) released its final rule[i] (the “Final Rule”) revising its enforcement of Section 1557 of the Patient Protection and Affordable Care Act (“ACA”).[ii] In this rule, HHS reversed many of the requirements of the prior rule issued in 2016 (the “2016 Rule”).[iii] For example, the Final Rule …
Continue reading “Summary of Key Changes to Rules Implementing ACA Nondiscrimination Provisions”