The Office of Inspector General (OIG) issued Advisory Opinion 06-22, which is another in a series of similar approving gainsharing arrangements, i.e., 01-01 and 05-01 through 05-06. Under the current proposed arrangement, a hospital would pay a cardiac surgery group 50 percent of the hospital’s first year cost savings directly attributable to specific changes in the…

In accordance with § 626 of the Medicare Modernization Act of 2003, which commissioned a study by the GAO to evaluate a payment system using groups of covered services under the outpatient prospective payment system, the Centers for Medicare and Medicaid Services (CMS) proposed a new reimbursement system for Ambulatory Surgery Centers (ASC) on August 23…

The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the 2007 Physician Schedule on November 1, 2006, which will soon be published in the Federal Register.

§      The final rule provides a 5% reduction in the 2007 Fee Schedule, which is just a slight change from the proposed 5.1% reduction…

On October 27, 2006, Pennsylvania Governor Edward Rendell signed Senate Bill 972, extending the MCARE malpractice subsidy through 2007. Physicians who are eligible for 100% abatement of their assessments are surgeons, neurosurgeons, orthopedic surgeons, obstetricians, emergency physicians, rural doctors who routinely deliver babies, certified nurse-midwives, and nursing homes. All other physicians and podiatrists are eligible for an…

“The U. S. District Court for the Middle District of Pennsylvania ruled that Lewistown Hospital was not entitled to recover the legal costs incurred fighting the allegations of Dr. Alan D. Gordon under the Sherman Act because the hospital could not show the claims brought by the ophthalmologist were frivolous or unreasonable, or brought in…

Restrictive covenants are often the most complicated clauses in a physician employment contract.  Medical practices and their lawyers are constantly striving to make these non-competition agreements more protective, more comprehensive and more enforceable.  Sometimes this "more is better" approach backfires!
Continue Reading Should You Have A Liquidated Damages Provision as Part of Your Restrictive Covenant?

Cowett v. TCH Pediatrics Inc. seems to endorse bad faith peer review, but a closer examination of the opinion should reveal a significant distinction between bad faith peer review and peer review involving legitimate peer review concerns in situations which also include bad faith motivations among the peer review entities.

After following the fair hearing…

A federal district court in Texas has ruled that Dr. Poliner can either accept a reduced damages award of $22 million or face a new trial. The U.S. District Court for the Northern District of Texas granted a motion by Presbyterian Hospital Dallas (Texas Health Systems) and Dr. James Knochel to reduce the damage award for…

The release of the August 2006 inflation figures has allowed calculation of the 2007 financial limits for health savings accounts (HSAs), according to a press release from HSA Clearing Corporation.

§      The maximum HSA contribution (excluding catch-up contributions) will be $2,850 for individual coverage and $5,650 for family coverage.

§      The minimum deductible…

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