Maria Danaher and Ogletree Deakins have posted an article on a medical staff discrimination case that focuses on the contractual requiremants and the medical staff bylaws issue at http://www.employmentlawmatters.net/. Not only does it raise the issue of the 1981 requriements, but also how Georgia views medical staff bylaws.
Michael Cassidy
Therapy Cap Exceptions Process Re-instated
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…
Medicare Physician Fee Schedule SGR Reduction Postponed One Month
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…
Tennessee Appellate Court Allows Termination of Privileges for Bylaws Violation
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…
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
Medicare SGR Physician 21.5% Cut Will Happen March 1, 2010
The Senate failed to act on The House bill to postpone the Sustainable Growth Rate (SGR) Medicare Physician Fee Schedule cut. Therefore the mandatory 21.5% Medcare cut will happen on March1. Legislators have promised renewed efforts but there is no immediate relief in sight.
However, CMS is suggesting anpther 10 day hold to provide time…
Advisory FY 2011 H-1B Quota Opens April 1, 2010
Contributed by Piyush Seth
412.594.5640, pseth@tuckerlaw.com
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21.2 Percent Cut To Take Effect March 1
Courtesy of the MGMA
Barring last-minute action by Congress, the 21.2 percent cut to Medicare physician payments will take effect next Monday, March 1. Despite previous indications that the Senate was considering an amendment to an anticipated job-creation bill to avert the cut, no clear legislative pathway for relief has yet been defined. Medical Group…
CMS Mandates Advanced Imaging Accreditation by January 2012
Section 135(a) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) amended section 1834(e) of the Social Security Act and required the Secretary to designate organizations to accredit suppliers, including but not limited to physicians, non-physician practitioners and Independent Diagnostic Testing Facilities, that furnish the technical component (TC) of advanced diagnostic…
Key HITECH Act Compliance Date of February 17, 2010 Quickly Approaching
The Health Information Technology for Economic and Clinical Health Act ("HITECH") provisions of the American Recovery & Reinvestment Act of 2009 ("ARRA") contain a number of changes affecting the compliance obligations of covered entities and business associates under HIPAA. Many of the key provisions of HITECH are effective as of February 17, 2010 and it…