Blog – Physician Law

Todd maintains the Physician Law blog -- a resource for current legal issues and news affecting physicians and other non-institutional health care providers. His blog provides updates on new legislation and legal issues relating to practice management, billing and coding, ancillary services, malpractice insurance, fraud and abuse developments and other important legal issues affecting physicians in their personal and professional lives.

Recent Blog Posts

  • Does Your Practice Have a Leadership Succession Plan? Many medical groups have difficulty developing a succession plan for practice leadership. Some practices do not even have a formal governance structure in place (though they should), but even those that do may find it challenging to identify and train new leaders to assume responsibility when senior physician leaders step down. Having a leadership succession plan in place is critical for a number of reasons. In practices where leadership is handled by one physician or concentrated in a small... More
  • Understanding Medicare Overpayments Under the federal Affordable Care Act, physicians and other providers have only 60 days to refund overpayments to the Medicare program before they face potential liability under the False Claims Act.  In addition, if CMS or the Medicare Area Contractor (MAC) identifies an overpayment, physicians have a limited period of time to respond or reply to the overpayment demand before CMS begins to recoup the overpayment.  A useful tool for understanding this process is this recently revised Medicare Learning on Medicare Overpayments.... More
  • OIG Issues Favorable Advisory Opinion on Patient Assistance Charitable Foundation This week the Office of Inspector General (OIG) published Advisory Opinion 15-16 addressing a 501(c)(3) charitable foundation (the “Requestor”) that would seek donations from third parties (including drug manufacturers) and provide financial assistance with out-of-pocket patient expenses for outpatient prescription drugs. Under the proposed arrangement, the Requestor would maintain two disease funds, one of which would provide assistance to patients with various types of cancer, and the other of which would provide assistance to patients with chronic kidney disease or iron deficiency anemia.... More
  • New Medicare Dashboard Highlights Drug Spending Earlier this month, the Centers for Medicare and Medicaid Services released a new tool designed to give providers and consumers insight into Medicare drug spending.  The Medicare Drug Spending Dashboard, which at present only includes 2014 data, summarizes information on 80 drugs, 40 of which are covered under Medicare Part B and 40 of which are covered under Medicare Part D.  Data on the dashboard (which is sortable) includes total drug spending, number of beneficiaries utilizing each drug, drug spending per... More
  • OIG Issues Advisory Opinion Regarding Radiology Transcription Feeds This week, the Office of Inspector General (OIG) issued OIG Advisory Opinion No. 15-15 regarding a proposed arrangement in which a hospital would bill a radiology group for transcription of the radiology group’s reports for patients who are not hospital patients, but rather patients of a third-party clinic that provides radiology studies and refers to the radiology group. Under the proposed arrangement, the clinic would perform the technical component of radiology studies and transmit the results of the studies to... More
  • Feds Extend Reporting Deadline of Employer Health Insurance Information The federal Affordable Care Act requires certain employers to provide employees with forms reporting offers of health coverage and coverage provided by the employer in 2015 by no later than February 1, 2016.  Employers then had to report that information to the IRS by February 29 (by paper) and March 31 (electronically).  According to a joint press release, the Treasury Department and the IRS have now extended these 2016 reporting deadlines.  Specifically, the February 1 is extended by two months and the February... More
  • CMS Publishes Draft Plan for Quality Measurement in Support of Payment Reform The Centers for Medicare & Medicaid Services (CMS) has stated its intention to move at least 50% of Medicare payments from fee for service to alternative payment systems based on quality and/or value by 2018.  In furtherance of this goal, the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) passed earlier this year included a requirement that the Department of Health and Human Services publish a draft plan for developing quality measures to support these... More
  • An Effective Compliance Program is as Important as Ever After many years counseling physicians regarding Medicare fraud and abuse compliance, I’m still perplexed at the general lack of understanding in the physician community regarding the need to comply with complex healthcare fraud and abuse laws and the serious risks of noncompliance.  Unfortunately, it seems that many physicians still mistakenly believe that they are “below the radar” when it comes to compliance. As evidence that even individual physicians can be held to account for improper conduct, Modern Healthcare reports this week... More
  • Centers for Medicare and Medicaid Services Published New FAQs on EHR Incentive Programs and Final Rule on Stage 3 Participation This past month, CMS published several new Frequently Asked Questions  (FAQs) on its website addressing questions about the EHR incentive programs, and in particular how to attest to certain measures for health information exchange, patient electronic access, and other objectives that require patient action.  Those FAQs can be found here on the CMS website. CMS also published the final regulations with a comment period for participation in Stage 3 of the EHR incentive program.  The public may submit comments on the regulations... More
  • Are the Days of Private Medical Practice Over? According to a recent study published by Accenture, only 1 in 3 physicians will be in independent private medical practice by 2016.  What’s killing the private medical office?  No surprise there —  according to the study, physicians cite reimbursement pressure and practice overhead as key factors driving them to hospital employment.  Access the Accenture Report here.... More