In early August, the Centers for Medicare & Medicaid Services (CMS) published an updated set of guidelines stating that hospitals will now be required to annually publish a list of charges online. CMS announced that the change in guidelines will “help improve access to hospital price information” and “give patients greater access to their health information.” However, hospitals are contending that the new guidelines may be problematic as they do not show prices after negotiating with insurance companies. Jeffrey Bomme, the chief legal officer at Adventist Health System, commented on the new guidelines stating the charges will not be relevant to patients because the bill may be reduced or some services may have no charge due to a hospital’s charity policy. These reported prices may also mean that patients neglect needed care because of the listed price and not the price that they may have to pay out of pocket, says Tom Nickels, executive vice president for government affairs and public policy at the American Hospital Association. Yet, the CMS feels as though the new rule will “incentivize value-based, quality care at these facilities.”
Today, the United States Department of Justice announced by press release its formation of Operation Synthetic Opioid Surge (S.O.S.). An objective of SOS is the reduction of dangerous opioids in particular areas of focus, to identify wholesale distribution networks, and to locate suppliers.
The Opioid Crisis
Opioids are medications that affect the nervous system and/or specific receptors in the brain, for the purpose of reducing pain. In the late 1990s, based on assurances from the pharmaceutical industry that patients were not likely to become addicted to pain relievers, physicians began to prescribe opioids at a higher level than in prior years. Increased prescriptions led ultimately to widespread misuse of opioids. Later, it became clearer to the medical community that opioids can be highly addictive.
Genetic testing companies, such as 23andMe, have become a craze in the United States within the last 10 to 15 years. 23andMe was formed with the purpose of informing its customers of their genetic health risks, carrier status, and ancestry information. After collecting DNA from saliva, the DNA is sent off to research labs that perform qualitative genotyping–the process of discovering variants in DNA. The genetic tests that 23andMe runs analyze the donor’s DNA, RNA, chromosomes, proteins, and metabolites to determine mutations and changes in chromosome structure. This genotyping allows the labs to discover the customer’s genetic information and background.
Many citizens remain wary of using such resources due to a fear that employers and health insurance companies will use the genetic information for discriminatory purposes. In 2008, the Genetic Information Nondiscrimination Act (GINA) was passed to combat this potential discrimination and protect those employees or insured persons. Continue reading
House Bill 1, Haleigh’s Hope Act, went into effect on April 16, 2015. HB 1 makes it lawful to possess up to 20 fluid ounces of low-THC oil, commonly known as “medical marijuana.” On May 8, 2018, Governor Deal signed House Bill 65, which expanded the conditions medical marijuana could be used to treat. As a consequence of HB 65’s expansion, it is likely that more employees will be allowed to possess and use medical marijuana.
Does this mean that you must permit your employees to possess and use medical marijuana while at work, and if you terminate their employment, you are committing disability discrimination?
Healthcare employees filed the fourth largest number of sexual harassment claims with the EEOC from 2005 to 2015, according to Jocelyn Frye, a senior fellow at the Center for American Progress. As a result of the #MeToo movement, many healthcare organizations in Georgia are rethinking their sexual harassment policies, and employees are educating themselves on their rights. This post examines Georgia employees’ rights and how Georgia employers can reduce sexual harassment in the workplace.
Georgia Discrimination Laws
Georgia’s employment discrimination laws protecting employees in the private sector are limited to age, wage, and disability discrimination. Although Georgia’s Fair Employment Practices Act covers a wider range of protected classes, it only applies to state agencies with fifteen or more employees.
The United States Department of Justice issued a press release on March 28, 2018 regarding the sentencing of Sandra Parkman, age 63, for Medicare fraud. Our business and health care law firm follows developments in the fraud and abuse legal arena. The DOJ, as well as numerous other Federal and state law enforcement agencies, are continuing with their push to crack down on offenses they determine to constitute “fraud and abuse” under applicable statutes and rules.
United States District Judge Kurt D. Engelhardt of the Eastern District of Louisiana sentenced Ms. Parkman to 32 months in prison. Additionally, she was ordered to pay $277,197 in restitution. Ms. Parkman elected to go to trial in her case. There was a three-day jury trial. At trial, the government presented evidence that Ms. Parkman engaged in a scheme to provide durable medical equipment (DME) that was not medically necessary to federal program beneficiaries in the New Orleans area. The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. Parkman to provide information of eligible Medicare beneficiaries and to obtain physician signatures on order forms for the DME in question. Brown was convicted in a separate trial and sentenced to 80 months in prison.
Our Georgia and South Carolina healthcare law firm has learned that the United States Department of Justice issued a press release announcing a resolution by settlement of fraud and abuse allegations levied against a Detroit physician, Gerald Daneshvar M.D. Due to our focus on healthcare law, our law firm follows legal developments in the healthcare industry.
Dr. Daneshvar was criminally charged and, following a two-week jury trial, convicted of one count of conspiracy to commit health care fraud. His alleged co-conspirators and co-defendants were Stephen Mason, M.D. and Leonard Van Gelder, M.D. Mason and Gelder plead guilty to conspiracy to commit health care fraud. These doctors were alleged to have worked for Lake MI Mobile Doctors, which provided physician home visits to homebound patients who were Medicare beneficiaries. However, according to the Government’s evidence at trial, Dr. Daneshvar billed Medicare for patient visits where the patient was not really sick or homebound and, along with his codefendants, conspired to bill Medicare at the highest rates even though the patient visits were short or unnecessary. For doing so, these physicians received greater compensation from Mobile Doctors.
Earlier this month, Doximity released a new study that provides a national review of physician compensation information and job trends, as the strong trend of physician employment by hospital systems continues. Doximity, formed in 2011, is “the largest community of healthcare professionals in the country,” according to its website. More than 70% of physicians in the United States are verified Doximity members. Doximity is a network of physicians and other healthcare practitioners. Doximity’s membership also includes many nurse practitioners, physician assistants and pharmacists. More about Doximity can be learned from its website, www.doximity.com.
The study analyzes thousands of job advertisements posted in 20 of the nation’s largest cities and involving 15 common medical specialties. Compensation growth was calculated using self-reporting from compensation surveys of tens of thousands of full time U.S. physicians. Physician compensation grew 5.1 percent in 2017, according to the study.
All good things must end. Every employment relationship will end sooner or later, one way or the other. While it is obviously important that parties to an agreement convey on the front end of the relationship positive feelings, the exit strategy should never be disregarded in one’s planning or evaluation of contractual terms. Life happens. Things can change one’s desire or ability to be in a deal, a contract, or an employment relationship. Therefore, while perhaps it may feel counterintuitive to dwell on how to end a relationship just as you are forming it, the termination provisions are very important and, sometimes, critical.
Georgia Medical Practice Lawyers
Most physician employment agreements will articulate a specific term, typically one to five years. Often a physician employment agreement will contain an auto-renewal provision so that, following expiration of the initial term, the relationship is continued from year to year automatically absent timely advance notice of non-renewal by employer or employee. From the medical practice’s standpoint, the right objective is usually to incent longevity and continuity of the relationship with the physician, while preserving a way out of the relationship if needed. Physicians, on the other hand, usually desire stability and sometimes a feeling that employment is “guaranteed” absent real cause to terminate the relationship. In the typical written physician employment agreement, how the agreement will end is determined by term and termination provisions.
Virtually every week, our business and healthcare law firm is engaged to provide advice and assistance concerning a physician employment agreement, either as counsel to the physician or for an employer/hospital or medical practice. “Restrictive covenants,” including non-competition agreements, are desired by the majority of employers and therefore included in their proposed form of employment agreement. Physicians most often prefer, however, if they had their druthers, not to be restricted in their ability to work following the expiration or termination of a job. Hence this section of the proposed employment agreement, particularly those with more broad and onerous non-compete provisions, can be the source of tension on the front end of the employment relationship. Restrictive covenants also show up in a variety of other contractual arrangements, including medical practice ownership agreements (e.g., shareholder agreements, operating agreements), joint venture contracts, and medical director agreements.