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Health Law

Healthcare Law Blog

Healthcare law issues including Compliance counseling for HIPAA, Stark law, Anti-kickback Statute, CMP and fraud and abuse defense, healthcare criminal defense, joint ventures, anti-trust, and professional license disputes affecting Mountain West states Montana, Idaho, Wyoming, Utah, Colorado, New Mexico, and Nevada.
By Greg Piche

Post Frequency: 0.4/day

Last Entry: December 21, 2010 at 18:18:24

METHADONE CAN BE A ?REASONABLE ACCOMMODATION? FOR ADDICTED NURSE UNDER THE AMERICANS WITH DISABILITY ACT

Posted on July 15, 2010
A federal district court in the middle district of Pennsylvania denied a motion to dismiss and ADA claim by an opiate dependent nurse who was clean but participating in a methadone program to avoid relapse. The Methadone program required frequent opioid testing to insure compliance with the program...

ARE NON PROFIT HOSPITAL TAX EXEMPTIONS RELEVANT OR NEEDED?

Posted on July 07, 2010
The principal justification for the extension of billions of dollars of tax exemptions to non-profit hospitals has been their self proclaimed charitable mission. While many of these hospitals have in the past struggled mightily to provide health care services to those uninsured in extreme need without resources, others have provided...

EMPLOYER NOT LIABLE FOR SEXUAL ASSAULT BY PHYSICIAN WHERE MISCONDUCT NOT FORESEEABLE.

Posted on July 02, 2010
A hospital or medical group employing physicians are not generally liable for the wrongful acts of their employees committed outside the scope of their employment. What about sexual assault committed in the course of a medical examination? The answer is that it depends...

HOSPITAL AND PHYSICIAN CLINICAL INTEGRATION - FIRST HAVE A PLAN.

Posted on June 18, 2010
One of the lessons of recent health care reform legislation is that effective clinical integration of hospital/physician systems will be a core feature of health care delivery in the future, whether through accountable care organizations or other structural permutations...

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HOSPITAL/PHYSICIAN INTEGRATION: CAN THEY GET IT RIGHT THIS TIME?

Posted on May 23, 2010
Healthcare is one of the trendiest industries in the nation. It is always in a state of flux. During the advent of the deep push into managed care in the 90s there was a feeding frenzy of hospitals trying to gobble up physician primary care practices to control the ?gatekeepers?...

HOSPITAL/PHYSICIAN INTEGRATION: CAN THEY GET IT RIGHT THIS TIME?

PROVIDER INTEGRATION AND THE ADVENT OF ACCOUNTABLE CARE ORGANIZATIONS (?ACOs?)

Posted on May 13, 2010
Can financial incentives and physician practice structures be enlisted o enhance the quality and reduce the cost of healthcare? Health Care Reform supporters believe they can and the new Patient Protection and Affordable Care Act ("PPACA") signed into law by the President recently, provides incentives for the development of ACOs...

MONOPOLY AND THE BIG BAT THEORY IN ANTITRUST LAW

Posted on May 03, 2010
It perhaps deserves repeating that it is not illegal to be a monopoly in this country. In the 2004 case of Verizon Communs., Inc. v. Law Offices of Curtis v. Trinko, LLP, 540 U.S. 398, 407 (2004), the United States Supreme Court reasserted the rule, The mere possession of monopoly...

HEALTH CARE REFORM BILL (IV) : NEW REQUIREMENTS FOR NOT FOR PROFIT HOSPITALS TO MAINTAIN TAX EXEMPTION.

Posted on April 30, 2010
As part of the Patient Protection and Affordable Care Act (?PPACA?) not for profit hospitals must satisfy four new requirements to maintain their tax exemptions. They must: Conduct a community health needs assessment once every three years. Adopt a policy for financial assistance...

HEALTH REFORM BILL (III): SMALL BUSINESS HEALTH OPTION PROGRAMS (?SHOP EXCHANGES?).

Posted on April 14, 2010
Back in the 1980?s the State of Hawaii developed a health insurance exchange for businesses located in the islands. A core feature of the Massachusetts Health Plan (?Romneycare???) installed several years ago was the installation of the Massachusetts Health Care Connector, a state operated healthcare insurance exchange for small businesses...

HEALTH CARE REFORM BILL (II): MEDICAL DEVICE TAX - CONTROLLING COSTS OR STIFLING INNOVATION

Posted on April 13, 2010
There were not any easy choices in the Patient Protection and Affordable Care Act (?PPACA?)as amended by the Health Care and Education Affordability Reconciliation Act (?HCEAR?), except perhaps the opportunity to stick it to the perpetually tanned Rep...

INTRACTABLE CONFLICT AND THE FALL OF RESPECT

Posted on April 11, 2010
The bruising and polarizing debate over health care reform reflects a broader societal infection of contempt and distrust generally among politicians, professionals and ordinary citizens, among and between any group of people whose collective identity and self esteem is tied to one?s link to one group and related to distain...

HEALTH REFORM BILL EASES INTENT REQUIREMENT IN ANTI-KICKBACK STATUTE.

Posted on April 08, 2010
One of the relatively unheralded changes in the Patient Protection and Affordable Health Care Act (the ?Act?) passed by Congress recently is the change to the ?intent? requirement of proof by the government or plaintiffs attempting to impose liability for federal program related kickbacks under the federal anti-kickback statute (?AKS?)...

Health 2.0: Insurance Coverage and Broadband Expansion For Telemedicine Services.

Posted on April 06, 2010
Whether or not an insurance company will provide coverage for telemedicine services or not is generally controlled by the company?s interpretation of its policies. Many insurance companies do voluntarily provide telemedicine coverage. Some insurance policies require ?face to face? provision of services or specifically exclude telemedicine coverage...

NEW MEXICO BODY PARTS CAPER.

Posted on April 02, 2010
It came up ?heads? when an employee at a medical waste disposal facility called Stericycle in Kansas noticed a partially burned head and torso at disposal site. Stericycle normally disposes of dead tissue, but this was more like raisins in the oatmeal and he quickly perceived something was wrong...

DISRUPTIVE CONDUCT: DR. BADRI?S BAD BEHAVIOR

Posted on March 27, 2010
?Disruptive conduct? by a physician as a basis for suspension of medical staff privileges is a standard that is sometimes abused because of the elasticity of its application to conduct which is merely disagreeable or politically insensitive. In the case of Badri v...

MARKET DRIVEN HEALTH CARE IN 2057: The Movie

Posted on March 22, 2010
How about a popular movie on market based health care reform? There is actually one out there although it hasn?t yet penetrated the cloud over the current health care debate, and surprisingly didn?t score well in the box office count over the weekend...

Is the ?Slaughter Solution? for Health Care Reform Constitutional?

Posted on March 16, 2010
I Let the games begin! The Democrats are going to use the ?self execution? rule, also known as the ?Slaughter solution? by the Right and the ?Gingrich? rule by the left, depending on whose ox is being gored, to pass and deliver a health care reform bill to the President...

Filibuster v. ?Slaughter solution? or Obamascare v. Obamacare.

Posted on March 15, 2010
The anti-Obamacare crowd blogs are up on the ramparts today decrying and vilifying the sneaky move Democrats are proposing to use a House of Representatives rule to push through health care reform. The opponents entitle the maneuver the ?Slaughter solution? after the House Rules Committee Chairman, Louise Slaughter, ( D...

Fast track, "compassionate use," FDA approval bill for terminal patients filed.

Posted on March 11, 2010
Should the FDA provide ?fast track? approval for curing edge drugs and devices that may help terminal patients? Citing concerns that the current FDA approval processes may be too slow to help dying patients, ? Representative Diane Watson (D-CA) introduced H...

COLORADO FUROR OVER INTERNET SOFTWARE TAX BILL.

Posted on February 26, 2010
The Colorado legislature has many high technology companies and consumers up in arms over the passage of HB 10-1192, which in effect imposes a sales and use tax on downloaded software in the state of Colorado. This may have some impact on Colorado companies that sell healthcare software over the...

GERMAN HEALTH CARE COST CONTROLS: A GLOBAL COMPETITIVE ADVANTAGE.

Posted on February 23, 2010
There is an interesting article in the February, 2010 issue of the McKinsey Quarterly, the on-line journal of McKinsey & Company. The article entitled ?How Germany is reining in health care costs: An Interview with Franz Knieps? provides an interesting comparison to our own struggle to control rising health care...

HEALTH CARE DATA CHASE: THE ARRIVAL OF HEALTH CARE ALL CLAIMS DATA BASES.

Posted on February 21, 2010
The Colorado legislature is about to address a proposal to develop a state health care all claims data base as part of Governor Rittter?s health care initiative package. The pending bill, HB 1330, provides for the structure and development of a claims data base in the state with the hope...

DSM ?V: THE NEXT FRONTIER OF MENTAL ILLNESS (IF IT IS ILLNESS).

Posted on February 19, 2010
There is much anticipation over the soon to be released new edition of the Diagnostic and Statistical Manuel of Mental Disorders (DSM ?V) by the American Psychiatric Association (?APA.) It is due in 2012. There are many interests involved in the development and recognition of categories of mental disorders...

HOSPITAL PRIVACY BREACH -- DELIVERY OF MEDICAL RECORDS TO GRAND JURY.

Posted on February 13, 2010
In responding to government or grand jury subpoenas for medical records, analysis under the Health Insurance Portability and Accountability Act of 1996 (?HIPAA?), may not be the end of the road. HIPAA specifically authorizes a hospital to release a patient?s medical records in response to a grand jury subpoena...

What Point, Wellpoint? - Is Private Health Insurance Sustainable?

Posted on February 12, 2010
There were two interesting articles in the Wall Street Journal last week on Wellpoint, the huge health care insurer. The Saturday/Sunday Edition highlighted an interview with Angela Braly, the CEO of Wellpoint by Joseph Rago entitled ?A Wasted Opportunity...

?GENDER REASSIGNMENT THERAPY? CAN BE TAX DEDUCTIBLE --TAX COURT.

Posted on February 07, 2010
63 year old Rhiannon O?Donnabhain, formerly known as Robert O?Donnell, divorced father of three, former sailor, construction worker and engineer, has prevailed in tax court on her claim for the deductibility of $25,000.00 in out of pocket expenses for therapy and surgery related to converting her sex from male to...

ILLINOIS SUPREME COURT CLOBBERS (TORT REFORM) CAPS.

Posted on February 06, 2010
Bucking a trend in other states, the Illinois Supreme Court held this week that state liability caps imposed on non-economic damages in medical malpractice cases violated the Illinois constitution?s separation of powers clause. It found that the legislatively imposed caps was too bold an intrusion on the powers of the...

HEALTH INSURANCE CONTRACT PROVISIONS FUEL COST ESCALATION IN MASSACHUSETTS.

Posted on February 02, 2010
The Massachusetts Attorney General?s Preliminary Report, Investigation of Health Care Cost Trends and Cost Drivers issued on January 29, 2010 faulted the leveraged based disparities among health providers in pricing as the principal driver in health care cost increases in Massachusetts over the past five years...

COST DRIVERS IN MASSACHUSETTS HEALTH PLAN

Posted on February 01, 2010
The Massachusetts Attorney General, Martha Coakley, issued a preliminary report on January 29, 2010 on the conclusions of her Investigation of Health Care Cost Trends and Drivers, required by a Massachusetts statute. (Yes she is the infamous Democrat who lost Kennedy?s Senate seat to Scott Brown and stymied the Obama...

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