Med Law Blog : Pennsylvania Health Care Lawyers & Attorneys : Tucker Arensberg Law Firm : Employee Benefits, HIPAA & HIT in Pittsburgh, PA

In Bocobo v. Radiology Consultants of South Jersey, et al, a federal district court granted summary judgment to the radiology group and hospital defendants on eleven counts including the denial of a medical staff hearing. The radiologist was employed by the radiology group and the exclusive contract between the hospital and the group provided that medical staff membership and clinical privileges were coterminous, and that the physician was not entiltled to a medical staff fair hearing if the termination resulted from termination of employment by the mecial group. 2005 U.S. Dist.LEXIS 29321.

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Both houses of Pennsylvania have extended the MCare abatement program for 2006. The bill now goes to Governor Rendell for signature.

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In Naples Community Hospital v.Desmond Hussy,M.D., a Florida state court held that the Medical Staff By-Laws, and the Hospital policies enacted by the Board pursuant to those By-Laws, constitute a contract between the Hospital and the individual members of the Medical Staff. However, this did not entitle a physician to a due process hearing following the denial of his application for Medical Staff membership and clinical privileges. This physician's privileges had expired. During the term of the physician's prior privileges, the Hospital had entered into an exclusive contract, granting a different physician the exclusive right to practice those privileges at the Hospital. Although the Hospital allowed the physician with the existing privileges to continue to practice those privileges until the natural expiration thereof, his application for renewal was denied. The court held that the physician was not entitled to a due process hearing because the By-Laws provided for a due process hearing only if the privileges were terminated for professional cause, but not if they were not renewed as a business decision of the Hospital.

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For those who doubt the possibility of OIG enforcement regarding fraud and abuse violations, the OIG Semi-Annual Report lists the following enforcement results:

$2.8 billion on audit and investigative receivables;

3,806 individual and entity; receivables;

537 criminal actions; and

262 civil actions

The report is accessible on the OIG Web site.

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Electronic Health Records (EHR) are touted by proponents within the healthcare industry as a means to both improve quality and reduce cost through a combination of reduced errors and improved communication. The drive to standardize the process for the utilization of electronic healthcare records gained its greatest impetus from the electronic transaction standards of HIPAA, first enacted a decade ago with the Health Insurance Portability and Accountability Act of 1996. Since that time, healthcare reform advocate from both industry and government have pushed for the transition to HER. More recently, a provision of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) required the federal government to develop Stark exceptions and Safe Harbors to facilitate the implementation of EHR systems.

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