Mid-Atlantic Health Law TOPICS

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Did You Know? - Spring 1998

Ambulance Restocking. Did you know that the Office of the Inspector General of the United States Department of Health and Human Services has revised its recent advisory opinion regarding hospital restocking of ambulance supplies? The initial opinion found restocking suspect under the anti-kickback law. The revised opinion allows restocking if "adequate repayment" is made.

Political Contributions Disclosure. Did you know that the Maryland law regarding disclosure of political contributions by entities doing business with the State has changed this year? Now, entities (including health care providers) receiving at least $100,000 in state funds (including Medicaid payments) must report state or local political contributions in excess of $100.

PPM Fee Splitting. Did you know that Florida's medical board found that payments of a percentage of income by a physician to a practice management company constituted illegal "fee splitting?" This decision was the result of a request for a ruling on a proposed agreement with PhyMatrix. The board's decision is currently being appealed in the Florida courts.

Advertising. Did you know that the U.S. Court of Appeals for the 9th Circuit upheld the Federal Trade Commission's decision that the California Dental Association's advertising policies violate antitrust law? The Association had forbidden dentists from advertising their prices as "low" or "reasonable," and from publishing volume discount prices.

Hospital Employed Doctors. Did you know that the Illinois Supreme Court has held that hospitals are not subject to the corporate practice of medicine doctrine which prohibits corporations not owned by doctors from employing doctors? The ruling arose from a case where a formerly employed physician was being held to a covenant not to compete. The court found that the corporate practice of medicine doctrine applies only to "general corporations," and not entities licensed to provide health care services.

Health Plan Medical Directors. Did you know that the District of Columbia Court of Appeals held in a recent case that a health plan's (Blue Cross Blue Shield of the National Capitol Area) medical director was not "practicing medicine?" The court did so after carefully reviewing the medical director's involvement in discussions regarding medical issues, and cautioned that a different result might follow under different facts.

Nurse Practitioner Gatekeepers. Did you know that Maryland's Insurance Commissioner has determined that HMOs may not include nurse practitioners as primary care providers, and may not use capitated arrangements for directly compensating nurse practitioners? This ruling was based on an interpretation of legislative intent that the applicable Maryland statute requires a physician to serve as an HMO enrollee's primary care provider.


March 21, 1998




Rosen, Barry F.


Health Care