March 2010

NAMSS announces the following:

TJC Board of Commissioners Approves MS.01.01.01

Posted: 15 Mar 2010 11:40 AM PDT

Chuck Mowll, Executive Vice President of Business Development and Government and External Relations, has announced that The Joint Commissioner’s (TJC) Board of Commissioners has approved the Task Force revision of MS.01.01.01 (formerly MS.1.20) for implementation.

MS.01.01.01 will be

 Contributed by Paul Welk

pwelk@tuckerlaw.com, 412.594.5536

Orthopedic Institute of Pennsylvania ("OIP") and the Department of Health and Human Services Office for Civil Rights recently settled a Complaint filed by a prospective patient who is deaf. The Complaint was filed after OIP declined the patient’s request for a sign language interpreter when he called to schedule

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The American Medical Association has created a resource for physicians to understand the HIPAA Privacy and Security Rules and their changes as a result of the 2009 economic stimulus package. 

This resource outlines new requirements:

  1. Protection of patient information;
  2. How to comply with patients’ requests to access

 President Obama has signed H.R. 4691, "The Temporary Extension Act of 2010", into law. H.R. 4691 re-instates the therapy cap exceptions process until March 31, 2010. Outpatient therapy service providers may now submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2010 through March 31

Special Medicare payment update: President signs extension of physician payment freeze

Late last night, the president signed H.R. 4691, the Temporary Extension Act of 2010 into law. This legislation includes a provision that freezes Medicare physician payments at their current level until March 31, 2010. The legislation also extends the therapy cap exception process

In Patterson v. Methodist Health Care-Memphis Hospitals, the Tennessee Court of Appeals affirmed an order of summary judgment, allowing a Tennessee hospital to terminate the medical staff membership and clinical privileges of two physicians for a breach of contract. The contract was established by the medical staff bylaws, which required a certain level of continuous

There have been many articles written about the negotiation and enforceability of physician restrictive covenants, but there are just a few fundamental concepts crucial to understanding and successfully navigating these issues.

1.         The Myth of Unenforceability. Many physicians either completely ignore or dismiss the significance of restrictive covenants because of the mistaken belief that restrictive covenants are unenforceable. Except in those states which statutorily ban restrictive covenants, such as California and Kentucky, this is simply not true.

2.         Suspect Enforceability. It is true the courts in many states look with disfavor upon restrictive covenants; courts often search for exceptions and methods to invalidate restrictive covenants, because of the significant impact upon the individuals involved. However, this attitude does not make restrictive covenants unenforceable. It simply means that courts respond favorably to the arguments of making sure that the restrictive covenants are reasonable both in time and scope. However, that is certainly no reason for any individual to believe that a court will find a way to minimize the potential harm or impact of a restrictive covenant. 

3.         Injunctions and Liquidated Damages. Restrictive covenants are often enforced through injunctions, which are court orders specifically prohibiting a physician from violating the terms of a restrictive covenant, i.e. preventing practice within the time and area described by the contract. Injunctions in these matters are issued routinely. Some contracts include liquidated damages provisions, which gives the practice the option of seeking money damages instead of an injunction. If the liquidated damages are fairly low, that might actually be a benefit to the physician, who can argue that the parties have already agreed upon the damages so that an injunction is not necessary. Although the presence of a liquidated damages clause in a restrictive covenant might benefit the physician, it would be a gamble to rely upon that argument.

4.         Unenforceability and Breach. The restrictive covenant is part of a contract between the practice and the physician. If the practice breaches its agreement, it is logical and reasonable for the physician to believe that he would not be bound by a contract and a restrictive covenant that have been breached by the practice. That is a legitimate and a reasonable outcome, but it necessarily depends on proving the antecedent breach.

5.         Negotiation of Options. The harm and impact of the restrictive covenant is twofold, not only does it prohibit certain practice activities, but it provides the practice overwhelming leverage in future negotiations. Your initial negotiation strategy should always include an attempt to limit the scope of the restrictive covenant so that the physician will later have some reasonable practice alternatives that limit the leverage in this situation. Continue Reading Physician Restrictive Covenants