The physician may not only be subject to additional litigation by being joined in a suit or sued after a final determination of vicarious liability on the part of the HMO, but may also find himself/herself without the protection of insurance.
Read More »Challenging Blues medical necessity denials
Physicians who have had claims denied or recoupment demanded by Blue Shield have the right now to initiate litigation in the physician’s local county court.
Read More »Your rights after termination without cause
The exercise of "without cause" termination rights is truly a double-edged sword for managed care organizations and practitioners alike.
Read More »How to sever your practice from Allegheny
Once you decide to leave, time is your enemy. You need to be making plans now to transition your practice.
Read More »Enforcement of your non-compete agreement
In determining whether non-compete agreements are legally enforceable, physicians would do well to consider the following six basic considerations.
Read More »Do unique identifiers violate patient privacy?
Maintaining the confidentiality of health information should not impede progress towards the development of a system within which health information may be effectively exchanged.
Read More »Third party messenger antitrust problems
Some forms of physician collaboration are permissible under antitrust law when negotiating with payers, but must be adhered to in practice and not just on paper.
Read More »Limitations of PSOs in Medicare risk contracts
Through a properly structured PSO, providers can now directly undertake Medicare risk contracts. In reality, it seems likely that few if any PSOs will be capable of exploiting this opportunity
Read More »Legalities of a telephone nurse triage system
According to the definition of a diagnosis, when nurses use a computer checklist to determine the nature and extent of a medical problem, they are identifying an illness and giving medical advice
Read More »Using physician assistants properly
Lack of appropriate supervision not only results in potential tort liability of the practice, but also affects reimbursement for services provided by the physician assistant.
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