Legal and practical healthcare information.
Perhaps one thing we can agree on in discussing the healthcare industry: it is in a state of distress stemming from the challenges created by an ever-increasing regulatory burden, changes in reimbursement rates, uncertainty with the Affordable Care Act, mounting tort and employment litigation. The recent rampant growth of urgent care centers and retail clinics …
Continue reading “Blessings in Disguise: Hidden Opportunities in Healthcare Bankruptcies”
Telemedicine is a relatively new concept that allows healthcare providers to treat patients via the Internet through varying technology platforms, such as FaceTime or Skype. While the practice initially started as a means for healthcare providers to treat patients in rural or remote areas who were far away from local health facilities or in areas …
Continue reading “Ohio Expands Telemedicine to Include Teledentistry”
Earlier this month, on March 5, 2019, the U.S. District Court in the Northern District of California filed a 106-page Findings of Fact and Conclusions of Law in the class action Wit v. United Behavioral Health (“UBH”). Here are the highlights: Under ERISA, Plaintiffs asserted two claims against UBH based on UBH’s Level of Care …
Continue reading “Court Rules UBH Coverage Guidelines a Monumental Fixer-Upper”
A summary of the article “A Review of Key 2018 False Claims Act Recoveries and Developments,” which first appeared in Physicians Practice. In December, the Department of Justice announced that it recovered more than $2.8 billion in False Claims Act judgments and settlements for fiscal year 2018. The largest settlements involved pharmaceutical companies: AmerisourceBergen Corporation, …
Continue reading “A Review of Key 2018 False Claims Act Recoveries and Developments”
When your resident first expresses a desire to leave against medical advice (“AMA”), take it seriously. Step 1: Verbal Prevention Your first line of defense to ensure your resident’s wellbeing (and consequently, to reduce your risk of liability) is prevention – attempt to understand, to the extent possible, the reason for the resident’s desire or …
Healthcare providers balance their time and resources between providing the best possible care to patients and keeping up with their ever-changing regulatory landscape. Providers are often at the mercy of the federal and state agencies that administer healthcare programs, which have significant discretion in interpreting statutes, promulgating rules and guidance that implement those statutes, and …
Continue reading “Want to Challenge a Government Agency Decision? Three Key Takeaways to Consider”
48,000 Americans were lost to opioid overdoses in 2017. Michigan opioid-related deaths and overdoses rank 18th-highest in the nation. Over the last year, significant attention was dedicated toward combating this widespread issue on both a Federal and State Level. Michigan Recently enacted Michigan opioid laws were executed with the intent to save lives and decrease …
Continue reading “Recent Efforts to Tame the Opioid Epidemic”
In early August, the Internal Revenue Service (IRS) issued proposed regulations that provide guidance to owners of pass-through businesses as to eligibility for a federal tax deduction of 20% of the income generated by the businesses. This deduction was part of the Tax Cuts and Jobs Act (TCJA). Although the stated purpose of the proposed …
It’s no secret that the United States is battling an opioid epidemic. As relevant for our Phoenix practice, in Arizona, Governor Ducey declared a State of Emergency on June 5, 2017 which led to the passing of emergency regulations, effective March 6, 2018, and the Opioid Epidemic Act of 2018, most of the provisions of …
Continue reading “Before you draft an opioid policy, read this”
Conflicts between a benefit plan Summary Plan Description and a plan document are an ever-present concern for plan sponsors. An aggrieved participant who relies on SPD language will often pursue a claim for benefits even though he/she is not entitled to the benefit under the plain terms of the plan document. This problem is illustrated …