Telehealth Update: Controlled Substances & E/M Claims

Prior to the COVID-19 public health emergency (“PHE”), the federal Ryan Haight Act allowed a provider to prescribe controlled substance medications to a patient only after conducting an in-person evaluation of that patient (with limited exceptions). At the beginning of the PHE, the Drug Enforcement Agency (“DEA”) granted temporary exceptions to the in-person requirement and …

6 Key Steps to Respond to a Health Care Investigation (and Related Issues)

Originally published in Healthcare Michigan, Volume 41,  No. 2 The United States Department of Justice (“DOJ”) and state law enforcement agencies have robust teams investigating and prosecuting health care fraud. Law enforcement often uses advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes. DOJ also employs nine regional strike forces located …

A State-Based Cure – Interested Government Agency J-1 Waivers for Physicians

Originally published in Healthcare Michigan, Volume 41,  No. 1 Recently, the president of the American Medical Association, Jesse M. Ehrenfeld, MD, stated in a national address that the physician shortage long-feared is here and that “It’s an urgent crisis…hitting every corner of this country—urban and rural—with the most direct impacting hitting families with high needs and limited …

Top Issues in Negotiating Physician Employment Agreements

Originally published in Healthcare Michigan, Volume 40,  No. 12 Successful negotiation of physician employment agreements requires a careful balance of the objectives of the prospective employer with those of the prospective employee while ensuring that the negotiated agreement complies with the federal and state laws that apply to agreements of this type.  The prospective employer wants …

Major Nursing Shortages? Foreign National Nursing Intervention as a Plan of Care.

Originally published in Healthcare Michigan, Volume 40,  No. 11 The nursing profession’s vital signs are unstable and require an intervention. The single largest occupation of health care workers is Registered Nurses (RN). It is also the fifth largest profession nationally.[1] Yet the nursing profession is facing extreme shortages as the need for health care workers grows. Specifically, …

Value-Based Care Ushers in a New Era for Primary Care Providers

Originally published in Healthcare Michigan, Volume 40,  No. 10 In an age of highly polarized opinions, there is a common consensus to address the rapidly rising health care costs in the United States. Research shows that the US average gross national product for health care costs is 17.1% while the rest of the world average is …

Tax Issues in Issuance or Repurchase of Equity in Physician and Other Practice Groups

Originally published in Healthcare Michigan, Volume 40,  No. 9 Adverse tax issues can arise for physicians and other professional practice groups interested in issuing equity to attract and retain junior physicians.  If equity is issued at below fair market value, the new equity owner will incur significant federal income tax consequences on issuance.  If the new …

Physician Recruitment: How Hospitals Can Comply With Stark Law While Recruiting Top Talent

Originally published in Healthcare Michigan, Volume 40,  No. 8 Hospitals play a vital role in ensuring the well-being of communities by recruiting and employing skilled physicians. However, physician recruitment in compliance with the Stark Law can be a complex task for hospital administrators, especially as hospitals and medical practices face an average 7.6% annual physician …

False Claims Act “Knowledge” Is a Subjective Standard

The Federal False Claims Act (“FCA”) allows private parties to bring lawsuits in the name of the federal government against defendants who allegedly “knowingly” present a false claim to the government for payment.  The question for courts has been what standard should be applied to evaluate a defendant’s “knowledge.”  The US Supreme Court recently clarified …

Supreme Court Issues Ruling on the Requisite Intent for False Claims Act Defendants

Originally published in Healthcare Michigan, Volume 40,  No. 7 A recent decision by the Supreme Court clarified the required intent for a defendant to be held liable under the False Claims Act.  According to the Court, the FCA’s scienter requirement refers to a defendant’s knowledge and subjective beliefs – not what an objectively reasonable person might have known …