By James M. Burns On January 6, two Michigan Congressmen – Representative John Conyers (D-Mich.) and Representative Dan Benishek (R-Mich.) – introduced the “Quality Health Care Coalition Act of 2015.” The bill (H.R. 105) would permit independent healthcare professionals to engage in joint negotiations with health insurers over fees and other contract terms. Currently, such …
Care Recipients’ Limited Right to Discriminate Based on Protected Characteristics of Care Provider
By David J. Houston Healthcare provider institutions including hospitals, clinics, medical practices, nursing homes and home health care providers (here, “Institutions”) are occasionally called upon to balance the preferences of Consumers against the interests or possible rights of their employee Care Providers. This may occur when Consumer complaints target assigned direct Care Providers – nurses, …
Will the ACO Proposed Rule Save the Shared Savings Program?
By Jessica L. Russell In 2011, CMS implemented the Accountable Care Organization (“ACO”) Shared Savings Program, which aims to promote increased savings for the Medicare program, improve health care quality, and create a more efficient and effective health care delivery system. While many deemed the ACO to be the future of health care models, the …
Continue reading “Will the ACO Proposed Rule Save the Shared Savings Program?”
PHIPA offers “no shelter” to Ontario Hospital from class proceedings for breach of privacy
By Wendy Hulton Back in 2012, the Ontario Court of Appeal recognized the tort of invasion of privacy – fast forward to the recent string of privacy breaches of personal information held by health care facilities in Ontario. Along comes Hopkins v Kay, 2014 ONSC 321 (CanLII), where patients from the Peterborough Regional Health Centre …
Tennessee Supreme Court Holds That Healthcare Providers Can Only collect What Insurance Companies are willing to Pay
By Keith C. Dennen A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The hospital submits its claim and the health insurance company pays $25,000.00 …
Before Your Nonprofit Health System Considers a Merger – Three Important Board Preps
By Jay Hughes The Governing Board of every nonprofit health system considering a merger, change in control, sale or significant affiliation has a key role in the process and needs to be engaged throughout the planning, research, evaluation, negotiation, finalization and implementation of any transaction. Good planning at the beginning of this process will better …
HHS Aggressive Goals for Value Based Payments
By Rose Willis In a brief article published last week in the New England Journal of Medicine, Sylvia Burwell, the U.S. Secretary of Health and Human Services (HHS), summarily set forth HHS’s efforts for improving the U.S. health care system. According to Ms. Burwell, these efforts will be focused on three methods: (1) using incentives …
Continue reading “HHS Aggressive Goals for Value Based Payments”
Attorney James Burns Speaks to Bloomberg BNA About Key Pharmaceutical Antitrust Topics for 2015
Dickinson Wright Member James Burns recently spoke to Bloomberg BNA’s Pharmaceutical Law & Industry Report for the article, “Biosimilars Policy, Accelerating Medical Breakthroughs Among Year’s Key Topics” (1/16/2015). In the article, Mr. Burns discusses some of the key antitrust issues for the upcoming year in the pharmaceutical industry. Mr. Burns noted that one significant issue …
Arrangements between Laboratories and Referring Physicians Involving “Registries”
By Rose Willis The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring physicians: Specimen Processing Arrangements and Registry Payments. Specimen processing arrangements were the subject of an earlier blog post, “Laboratory Payments to …
Continue reading “Arrangements between Laboratories and Referring Physicians Involving “Registries””
Connecticut Law Imposes New Merger Regulations on Physician Combinations
By James M. Burns and Jessica Russell On October 1, a first-of-its-kind law became effective in Connecticut that requires group medical practices and hospitals in that state to provide the Attorney General with 30 days’ notice prior to consummating any merger or affiliation-type transaction. The new law (P.A. 14-168) is noteworthy because the threshold for …
Continue reading “Connecticut Law Imposes New Merger Regulations on Physician Combinations”