With insight and analysis from expert attorneys who represent physicians and other healthcare professionals in all phases of their practice, the Physician Law Blog is the go-to source for physicians, nurses, chiropractors, dentists, physical therapists, and other allied health professionals interested in learning more about issues impacting their practices every day.

EEOC Releases Proposed Rule on Employer Wellness Programs and the ADA

The EEOC release, to which a link is below, provides guidance on how employers can incorporate wellness programs into their group health plans. While employers may provide incentives if employees participate in wellness programs, including health questionnaires or medical examinations, the programs must be voluntary.  Furthermore, any data obtained from the employer wellness programs may…

Senate Passes “Fix” to 21% Scheduled Reduction for the Physician Fee Schedule

Please see the notice below from the CMS MLN Connects Network. The Senate has acted to avoid the impact of the Physician Fee Schedule reduction. Attention Health Professionals: Information Regarding the Medicare Access and CHIP Reauthorization Act of 2015 On April 14 , 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015;…

Update on Medicare Physician Fee Schedule

As a result of the Congressional failure to yet adopt a “physician payment fix,” the Centers for Medicare & Medicaid Services (CMS) announced the efforts it will be taking beginning on April 15th, 2015 to alleviate the impact of the 21% decrease in payments required by current law. Meanwhile, CMS will be imposing a 10…

CMS Takes Action Against Aetna Inc. for Erroneously Identifying “Retail In-Network” Pharmacies

On April 2, 2015, CMS issued notice of imposition of a $1 Million civil money penalty (CMP) against Aetna for errors reported in Aetna’s pharmacy network directory. Due to this error, many Aetna enrollees presented prescriptions to their pharmacy, only to discover that the pharmacy was not in their plan. The Medicare enrollees complained to…

Another DOJ False Claims Act Settlement – Two Cardiovascular Disease Testing Labs to Pay $48.5M to Resolve Allegations of Kickbacks and Unnecessary Testing

The OIG has made it clear that laboratory payments to referring physicians are suspect as another False Claims Act (FCA) settlement was announced. The $48.5M settlement involves Health Diagnostics Laboratory, Inc. (HDL) and Singulex Inc. and resolves allegations they violated the FCA by paying remuneration to physicians in exchange for patient referrals and billing federal…

False Claims Act Update: Ohio Hospital to Pay $10M to Settle False Claims Allegations

Hospitals and physicians need to be alert when entering management agreements to ensure that the relationships require sufficient bonafide services to justify those management agreements. In this latest case, allegations related to violations of Stark Statute and Anti-Kickback Statute led to significant penalty payments, Ten Million Dollars. Hospitals and physicians need to ensure that any…

Missouri State Senate Approves New Medical Malpractice Non-economic Damage Cap

After several years of debate, the Missouri State Senate on March 11, 2015, voted to increase the non-economic damages in medical malpractice cases. In a bipartisan compromise, State Senators agreed to statutory language to reinstate medical malpractice caps. The caps proposed by the Senate would be $400,000 in most cases. In catastrophic injury cases (defined…

Doctor Beware – Certification for Home Health Care is a Referral

On February 10, 2015, the Seventh Court of Appeals decided the matter of U.S. v. Kamal Patel, No. 14-2607, upholding the conviction of a physician for violating the anti-kickback statute.

Phase 2 HIPAA Audits Are Coming, Now Is The Time To Get Ready

In 2011-2012, the U.S. Department of Health and Human Services Office for Civil Rights conducted a pilot audit program (Phase 1) to evaluate covered entities compliance with HIPAA privacy, security and breach notification rules. The results of those audits…

Reminder Annual OCR Breach Reporting is Due March 1, 2015

Covered entities must submit annual report to the OCR by March 1, 2015 for breaches affecting fewer than 500 individuals. Breach notification obligations differ depending on whether the breach affects 500 or more individuals or fewer than 500 individuals. A covered entity must submit its annual notification to the Office for Civil Rights (OCR) if…

MISSOURI

St. Louis  |  Clayton  |   Kansas City

ILLINOIS

Alton  |  Carbondale  |  Edwardsville  |  O'Fallon

The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation.
This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. © 2014 Sandberg Phoenix & von Gontard P.C. All Rights Reserved.

Menu