For those familiar with the Shonda Rhimes juggernaut, Grey’s Anatomy, it is the story of surgical residents, fellows, and attending physicians as they work in the surgical wing of the fictional Grey Sloan Memorial Hospital. In most episodes, the situations in which the doctors find themselves in are entertaining, but not necessarily how they might …
Obligations and Expectations Surrounding Healthcare Compliance Programs
The phrase “healthcare compliance program” is commonly used to describe those processes and procedures implemented by a healthcare provider to prevent submission of erroneous claims and combat fraudulent conduct. The expectation is that providers using internal controls will more efficiently monitor adherence to legal and regulatory requirements than providers without such controls in place1. However, …
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2017 Tax Reform and Its Effects on Healthcare
Over the past decade, the Healthcare Industry has been accustom to being center stage in political debates, but while medical providers and facilities did not have a prominent role in the latest political drama, the far reaching effects of the Tax Cuts and Jobs Act of 2017 (the “Act”), will impact almost everyone delivering healthcare …
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The Patent Mirage: The New Challenge for Today’s IP Strategy
Rose Willis (Member, Saginaw and Troy) states “Innovators in the healthcare industry must protect their technology and innovation property rights. Dickinson Wright healthcare intellectual property attorney, Lance Anderson (Member, Austin), provides strategies and other valuable insight into the methods of protection in his article “The Patent Mirage: The New Challenge for Today’s IP Strategy”. Effectively …
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Is Your Physician Organization Complying with Antitrust Law?
It is not uncommon for a physician organization to act as an intermediary between its physician participants and third-party payers to facilitate the negotiation and acceptance of reimbursement rates and other payer contract terms. However, when facilitation becomes negotiation and a PO accepts contracts with third-party payers on behalf of physician participants, also known as …
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Prescription for Fraud: Government Enforcement Activities in Compounding Pharmacies
On October 18, 2017, a Mississippi physician was charged with health care fraud for writing prescriptions for medically unnecessary compounded medications. This is the latest – though certainly not the last – example of the Department of Justice’s efforts to combat fraud within the TRICARE program. From California to Florida, federal prosecutors have charged physicians, …
Blessings in Disguise: Hidden Opportunities in Health Care Bankruptcies
In 2016 alone, 21 hospitals were closed across the United States because of unsustainable financial performance1, and the trend has continued with 7 additional hospitals and 18 other hospital departments closing in just the first half of 20172. Financial challenges facing many entities in the health care industry are not limited to hospitals, or even …
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Department of Justice use of Parallel Proceedings
By: Kerry Harvey Corporations and individuals engaged in a heavily regulated industry, particularly those doing business with the federal government, stand a good chance of being called upon to provide information related to a government investigation. Healthcare providers, government contractors and financial institutions immediately come to mind. The initial contact may come in a number …
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Keeping Pace in Clinical Research: The Common Rule Picks up Speed
By: Billee Lightvoet Ward, Esq. Of Counsel, Grand Rapids Office Phone: 616.336.1008 bward@dickinsonwright.com In recent years, the world of human subjects research has expanded not only with regard to the number of clinical research trials being conducted and the array of drugs and devices being tested, but also with respect to the technology employed to …
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Recent Case Serves as Reminder to Take Care in Structuring Sales of Physician Practices
By: Ralph Levy Of Counsel, Nashville Office Phone: 615.620.1733 rlevy@dickinsonwright.com Over the past few years, hospitals, health systems and practice management companies have increased their efforts to acquire physician practices. Moreover, physician groups are increasingly interested in selling their practices to these interested purchasers. The primary reasons for this trend are varied but in general …