Several physicians employed by Court Street Family Practice, a division of the Sisters of Charity Health Systems Inc. (Health System) resigned to join a competing practice owned by a competing health system. The employment contracts included a “Limitation of Practice” clause which “forbade them from practicing medicine with Central Maine Health Care Corporation, its affiliates or
Uncategorized
Medicare EHR Incentive Program Deadline for Hospitals Soon Approaching
The last day for eligible hospitals and critical access hospitals to begin their 90-day reporting period for this fiscal year for the Medicare EHR incentive program is July 3, 2011. Hospitals and critical access hospitals must begin their 90-day reporting period by this date if they still want to successfully demonstrate meaningful use and…
Amendment to the Healthcare Reform Grandfathering Rules
On November 15, 2010, the Internal Revenue Service, the Department of Labor, and the Department of Health and Human Services jointly issued an amendment to the interim final rules relating to status as a grandfathered plan under the Patient Protection and Affordable Care Act. With the amendment, insured group health plans are now able to…
The Official Web Site for the Medicare and Medicaid EHR Incentive Programs
Physician Restrictive Covenants
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
Deciphering “Meaningful Use” for Electronic Health Record (“EHR”) Technology (Contributed by Lee Kim, Esquire)
The Health Information Technology for Clinical Health Act (the "HITECH" Act) provides economic incentive for the adoption and meaningful use of health information technology and qualified Electronic Health Record systems ("EHR"s). A physician, other professional, or hospital shall be deemed to be a meaningful EHR user if:
1) Certified EHR technology is used in a…
Ultimate EMR Irony: Harvard Study Says No Savings – CMS Issues 556 pages of EMR Incentive Regs
Thanks to the commenters of the linkedIn Health Innovations Group for highlighting the Harvard study concluding that hospital computing modestly improves processes, juxtaposed with CMS announcement of intent to publish EMR incentive payment and meaningful use regs in early January.
http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf
http://www.amjmed.com/webfiles/images/journals/ajm/AJM10662S200.pdf
Physician Wins Case for Payment of Claims Made Tail Insurance
In Wojnicki v. Warren Geriatric Village, Inc. a malpractice action against Dr. Manisha Gupta and Anchor Senior Medical Services, LLC., a Michigan state court ruled that the nursing facility must indemnify Dr. Gupta for failing to provide the tail portion of a claims made malpractice policy.
The issue in this case was which party is…
CBO Projects Minimal Impact of Tort Reform
One component of the ongoing health care reform debate is the cry for tort reform. While tort reform would certainly be welcome in the health care industry, the need for tort reform is more an issue of justice than controlling health care costs. The Congressional Budget Office (CBO) and the Congressional Research Service provided a report (Medical…
PA 2010 MCare Assessment = 21%
The Pennsylvania Insurance Department published a notice in the Saturday October 24, 2009 PA Bulletin announcing the 2010 MCare assessment to be 21% of the “prevailing primary premium,” which is the Joint Underwriting Association’s (JUA) occurrence rate.