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

MEDICARE PUBLISHES PART B SPECIALTY GUIDES

Highmark Medicare Services has developed specialty guides to explain and provide hot links to source material for the following specialties or issues:

·        Ambulance

·        Ambulatory surgery centers

·        Anesthesia

·        Clinical laboratories

·        Podiatry

·        Physical therapy

The link below lead you to the Medicare Part B Specialty Guides website at Highmark Medicare Services:

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PHYSICIAN DISABILITY CLAIMS

Physicians are facing increasing opposition from disability insurance carriers regarding claims for “own occupation” disability policies. This scrutiny and opposition is a predictable reaction to the expensive claims, which typically have long payouts including COLA and life-time riders, and the fact that the degree of disability or physical impairment necessary to substantially impede a physician from practicing is fairly limited in some circumstances.

These are multi-million dollar claims from the insurance carriers’ perspective and life-changing events from the physician’s perspective. You should not simply submit your claim and see what happens. 

Physicians are frequently reluctant to pursue these disability claims. Many physicians, just like lawyers and other professionals, define themselves and their identity by their profession. They struggle to return to practice because that is who they are. Unfortunately, some physicians struggle through just long enough to prove that they are not disabled. When they can no longer take the pain or accept the medical malpractice risk produced by their impairment, whether physical or behavioral, they may no longer qualify for the disability payments they and their family will now need to support them for the rest of their lives.

I have represented many physicians in these situations. When any event impairs your ability of practice occurs, you should do the following:

1.         Get a complete copy of your policy and all the riders from your insurance agent or advisor;

2.         Consult an experienced lawyer; and

3.         Get independent medical opinions regarding your disability prior to submitting your claim and submit that claim with all the opinions and medical records prepared in the same manner that your lawyer would prepare your brief and malpractice defense in the professional liability case.

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California courts have been active concerning peer review issues, ruling on three major decisions in the month of August. The Court of Appeals of California and the Federal District Court for the Northern District of California issued opinions further clarifying peer review processes in the state. These decisions not only affect practitioners within California, but also will influence courts across the country faced with the similar issues.

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As published in the September 2007 edition of Bulletin, a publication created by the AlleghenyCounty Medical Society.

While medical practice acquisitions continue, some physicians and practices are returning to private practice. These returns are sometimes driven by regional strategies, specialty strategies, or just individual decisions made on a physician-to-physician basis, some voluntary and some involuntary. Although returning to private practice presents many of the same issues as starting a new practice, we will focus on those issues as they are presented in a return to private practice environment. The return to private practice is actually more similar to a separation from an existing practice because, rather than starting a new practice, you are actually transitioning a practice from a third party.

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PITTSBURGH, PA - The law firm Tucker Arensberg, PC is proud to announce that Michael A. Cassidy has been named to the list of Pennsylvania Super Lawyers for 2007 by Philadelphia Magazine and Pennsylvania Super Lawyers Magazine. Selection for the honor is determined through the independent research of Law & Politics magazine. Over 36,000 Pennsylvania attorneys were contacted as part of a peer selection process. According to Law & Politics, the organization which publishes Pennsylvania Super Lawyers magazine, only five percent of Pennsylvania attorneys are included in the "Super Lawyers" directory.

"We believe that our clients would give us high marks for our service and expertise, said Gary P. Hunt, the Firm's Managing Shareholder. "For Mike to earn the respect and recognition of other professionals is very gratifying."

Mike was named a Super Lawyer in the Health Care Category. Mike is a shareholder and Chair of the firm's Health Care Practice Group. Mike's practice focuses on the area of health care. He has extensive experience in third party reimbursement, managed care and physician contracts, fraud and abuse, medical staff and credentialing issues, regulatory compliance and tax-exempt organization issues. Mike received his undergraduate degree from Brown University and his law degree from the University of Pittsburgh School of Law.

Tucker Arensberg is a 60-attorney law firm headquartered in Pittsburgh with an office in Harrisburg. The firm concentrates in general business law practice, banking, insolvency and creditors' rights, estates and trusts, health care, litigation, technology and intellectual property, environmental, labor and employment, real estate, workers' compensation and school and municipal law. For more information on the firm, please visit www.tuckerlaw.com.