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Heads, the Hospital Wins...Tails, the Physician Loses

A recent decision by Maryland's intermediate appellate court sheds some light on a physician's hearing rights when a hospital terminates the doctor's medical staff privileges as the result of a "bu

Recent Physician Billing Developments

Recent Medicare developments in the area of physician billing include:

Supreme Court Leaves Hospitals Exposed for Medical Training Costs

The U.S. Supreme Court has ruled in favor of federal regulators with respect to graduate medical expenses. The Court's 6-3 decision in Regions Hospital v.

Did You Know? - Winter 1998

Home Health Compliance. Did you know that the Office of Inspector General of the Department of Health and Human Services has issued a model voluntary compliance plan directed at ho

How Specific Should a Health Plan's Appeals Policies Be?

A recent federal appeals court case, Killian v.

Husband's IRA Defeats Wife's Medicaid Eligibility for Nursing Home

The New Jersey Supreme Court has recently held, contrary to popular belief, that a husband's individual retirement account (IRA) must be included as a resource for purposes of determining his wife'

Maryland Attorney General Ventures into the Muddy Waters of Fraud and Abuse

At the request of a member of Maryland's General Assembly, the Maryland Attorney General recently ventured into the various State and federal laws that comprise the murky waters of health care frau

OIG Releases Guidance Regarding Voluntary Fraud Disclosure

The Department of Health and Human Services' Office of the Inspector General (OIG) issued guidelines on October 21, 1998, relating to the voluntary disclosure of "health care fraud." These guidelin

Physicians Selling Vitamins

Many physicians around the country are selling or considering selling vitamins to their patients.

The Duties of Corporate Directors

Everyday, another hospital merger is announced, but what are the duties of hospital directors in approving such a merger?

A Securities Law Primer

Doctors are increasingly finding themselves owners of interests in various health care companies. For example, some doctors are trading their practices for stock in practice management companies.

Did You Know? - Fall 1998

Health Planning Authority.

Is It Too Late To Bill?

Health care providers understand that they should send their bills out within a certain time period from the date services are rendered, but what is that time period?

JCAHO Sentinel Event Policy Stirs Controversy

The Joint Commission on Accreditation of Healthcare Organization (JCAHO), a private organization that accredits the nations' health care institutions, has adopted a new policy that encourages all a

Maryland Regulatory News - Fall 1998

1. In July, the Health Services Cost Review Commission (HSCRC) denied Union Memorial Hospital's request for a 3.89% rate increase as generated by the HSCRC's Inflation Adjustment System.

Monetary Penalties For the Violation of Agreements Not to Compete

When physicians enter into employment agreements they often are asked to agree to covenants not to compete.

Practice Management Agreements Draw Fire

The Office of the Inspector General of the Department of Health and Human Services (OIG) has recently issued an advisory opinion raising serious questions concerning the legality of many agreements

1998 Maryland Legislative Session

The Maryland General Assembly appears to have adopted a "do no harm" strategy in 1998. Although many health care measures were proposed, few were enacted.

Did You Know? - Summer 1998

Disclosure of Insurance Payments to Providers. Did you know that pursuant to Maryland legislation passed in 1997, the Insurance Commissioner and the Health Care Access and Cost Commission

Maryland Regulatory News - Summer 1998

1. In March, the Health Care Access and Cost Commission released its Annual Report on Expenditures and Utilization based on 1996 health care costs.

Proposed Stark II Regulations

The Health Care Financing Administration (HCFA), of the Department of Health and Human Services, has recently published its long-awaited proposed Stark II regulations.

SEC Breaks New Ground for Medical Group

Securities law problems and expenses not only arise when new companies are formed, but also arise later in a company's life.

Taxpayer Relief Act of 1997 Impacts Tax-Exempts

The federal Taxpayer Relief Act of 1997 (the Act) contains several provisions of importance to tax-exempt health care organizations.