Medicine & the Law

Knowing which Medicare billing errors to disclose, when, and to whom is critical. Unfortunately, there is no guarantee that any form of disclosure will be 100 percent effective in avoiding or minimizing penalties

The medical professional liability crisis, with its spiraling liability insurance costs and exorbitant jury verdicts, has sparked a renewed and vigorous effort to demand legislative action on tort reform. In Pennsylvania there have been and continue to be obstacles to the enactment of tort reform. The law in Pennsylvania presently provides little guidance and wide latitude to juries in determining damage awards.

The Stark law applies to both a physician's financial relationships with his medical practice to which he makes referrals, and to a physician's direct or indirect financial relationships with outside entities, such as hospitals, to which the physician refers.

Examples of transactions affecting physicians that may be subject to this tax are practice sales, practice divestitures, employment arrangements, medical director agreements, leases, practice plans, and independent contractor arrangements.

HCFA has attempted to broaden the in-office ancillary services exception through the liberalization of the supervision requirements, easing the criteria for qualifying as a group practice, and permitting separate cost centers within a group.

With the general principle of "scalability" in mind, physicians and physician groups can take initial steps toward compliance with the new Privacy Standards.

It is important to have full knowledge and understanding of your disability contract and of all issues in order to protect your rights and entitlements. It is equally important to know the process of a claim and receive guidance in negotiating the potential problems and issues that may occur.

The cornerstone of any response to the malpractice crisis must either be in the nature of group lobbying activities or individual decisions that may be preceded or followed by limited forms of coordinated activities. Physicians of the same specialty must be cognizant at all times of the need not to reach agreements that limit each other's individual economic actions, but they can take advantage of the opportunity to coordinate a response to individual actions that is consistent with good professional practice.

Patients know that communication matters, and it is often poor communication in the face of a bad outcome that initiates legal action by the patient turned plaintiff.

Whatever reluctance your practice may feel, the reality is that you could face real economic challenges if a physician leaves your practice only to open a competing office in your neighborhood.