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Business interruption insurance is especially important for small businesses and companies that rely on physical locations to carry out day-to-day activities associated with their organizations.  Our business and healthcare law firm represents medical practices and other businesses with regard to insurance coverage disputes.  Filing a business interruption claim can be the best way to recover income loss and damages that occur as a result of a reduction or cessation of business operations. As the COVID-19 pandemic, continues to create disruption and financial uncertainty for business owners, insurance companies’ reluctance to cover interruption claims has initiated state responses to protect businesses from losses stemming from closures, seizure of ordinary business operations, and supply chain interruption.

Georgia-based Insurance Coverage and Business Litigation Attorneys

A March 6 article in the Wall Street Journal reported that U.S. insurance companies already have rejected claims submitted for coverage of business interruption related to the Coronavirus.

dzqzy3qjSfnax53La6eDlRo2g7UAsYjdm_L0J6lb7vPPAK3pA4rMqaOcyx8OdzUcX8UIBYdQ3211KJxM1BFbD6Fw74BjciPgCtbHbWWeplYZH3t1OI8S-v8b1qbgKGUaGavSJ15sT-3JA0kq_Kr1qG0caH5RCAs0-d-e1-ft-1We salute all of our clients and friends who are healthcare providers on the front lines of COVID-19 pandemic for their commitment and steady hand during these perilous days of uncertainty. All of us are better and safer because of you.  Above all, we wish good health and safety for all healthcare providers. We appreciate the trust and confidence that our clients place in us. As we all work through this difficult time together, we reiterate our commitment to helping all healthcare providers.

The Coronavirus pandemic has created a fluid situation that may trigger unpredictable legal issues and risks for all medical practices, hospitals, other healthcare delivery businesses, and healthcare professionals, including:

  • Business interruption insurance coverage disputes where a medical practice’s lost revenue potentially triggers coverage.

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In a landmark federal False Claims Act case closely watched for many years by hospice administrators, other healthcare providers and legal experts, last week the Department of Justice (DOJ) entered a joint dismissal in settlement of the case against AseraCare Inc., a national hospice provider company.  The settlement marks an effective win for the defendants, in that the government agreed to accept repayment of $1 million, reduced from its initial demand of more than $200 million. https://www.businesswire.com/news/home/20200227005767/en/

Georgia-based Healthcare Reimbursement and Compliance Attorneys

Allegations in the case were brought initially between 2008 – 2010 by several former employees of AseraCare and the Department of Justice, alleging that AseraCare had submitted false claims to Medicare for patients who were arguably not terminally ill, and thus ineligible for hospice benefits, placing pressure on employees to enroll more patients using questionable recruitment practices – including targeting near-death patients so that length of stay numbers were kept low.

1221952_to_sign_a_contract_3As a business and healthcare litigation firm focused exclusively on advising and representing health care providers, we work virtually every day with contracts that involve non-compete agreements and other forms of restrictive covenants.  Almost all physician employment, for example, will involve a physician employment agreement that contains a restrictive covenant.  Typically, a restrictive covenant will apply to prohibit certain competitive activities both during the employment and for some agreed period following employment, often one to three years.  The details of such agreements can vary dramatically and, contrary to the impressions of many medical practice owners and employed physicians, there are not “standard” provisions for duration, geographic scope, etc.  Further, Georgia and South Carolina case law and relevant statutory provisions are subject to interpretation, about which reasonable minds can often differ.

As a healthcare law firm, we are exposed to agreements on the transactional end, when the parties get married (i.e., when they sign the contract), and when they divorce (i.e., when the employment ends).  If a non-compete issue is raised at the end of the relationship, the implications for employer and employee can be severe and, in unfortunate cases, devolve into litigation.  For a highly compensated physician, whose ability to ply his/her trade following many years of education and training is suddenly impaired by the signed contract, whether to proceed with certain employment opportunities (that might violate a non-compete agreement) can make for a highly stressful decision-making process.  Some factors that physicians may consider follow.

Should you determine if the non-compete agreement is enforceable?

861958_hidoc-on-whiteBecause our healthcare law firm often handles employment-related disputes and litigation (for employers and employees alike), we follow developing trends in employment litigation. Employment discrimination lawsuits continue to make headlines in the healthcare industry. Between 2018 and 2019, numerous allegations regarding doctors, nurses, and administrative staff have resulted in litigation challenging existing employment practices of large network hospitals and small practices. For managers and owners of physician practices or small businesses, employment concerns should be regularly discussed with legal counsel.

Georgia Healthcare Business Litigation Attorneys

Over the last two years, a variety of claims have been brought forward by employees against their employers. The stories range from allegations of discrimination on the basis of sex, age, or race. For example, on April 26, 2019, employees of Mount Sinai Health System (Mount Sinai Health) filed a lawsuit in federal court alleging age and sex discrimination against female senior leaders of the health system. The lawsuit discussed practices that occurred under Dr. Prabhjot Singh’s management. Before the lawsuit, Dr. Singh served as the chair of the Department of Health System Design and Global Health. According to the lawsuit, numerous female employees were fired or forced to resign before being replaced by younger male employees. Furthermore, the lawsuit cites instances of Dr. Singh’s “screaming” and other aggressive behavior towards women on staff at Mount Sinai Health. On July 3, 2019, it was reported that Dr. Singh resigned from his position of leadership.

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medical-doctor-1314902-mAs technology improves the ability for providers to communicate, existing healthcare laws will continue to be put to the test. Now, a new call for care coordination is driving quality improvement initiatives for physicians and hospitals. In 2018, U.S. Department of Health and Human Services (HHS) launched its initiative “Regulatory Sprint to Coordinated Care,” to facilitate value-based healthcare and promote effective communication strategies between physicians. The Regulatory Sprint seeks to increase a patient’s ability to understand their treatment plan, promote coordination between providers, establish incentives for providers to coordinate efficient care, and encourage information-sharing between providers and facilities.

Healthcare Fraud and Abuse Lawyers

The initiative highlights the importance of removing the barriers created by four federal healthcare laws: the Physician Self-Referral Law; the Federal Anti-Kickback Statute; the Health Insurance Portability and Accountability Act (HIPAA); and substance-disorder treatment rules stemming from 42 CFR Part 2. Previously, critics have claimed that the monetary penalty provisions within the statutes prevent providers from being able to adequately coordinate care. In response, HHS has proposed Stark Law and Anti-Kickback reforms.

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waiting-room-1486946-300x239Providing access to high quality services to patients in rural areas is an ongoing challenge in the U.S.  Throughout our country, a large percentage of citizens living in rural areas are less healthy than their peers in urban areas, as rural citizens lack access to healthcare providers in their small communities as well as personal financial resources and transportation options that would allow them to travel to larger cities where top-quality or specialty medical services are offered.

Georgia-based Healthcare Lawyers

According to Georgia’s State Office of Rural Health, citizens in rural Georgia are less healthy than those living in urban areas, are more likely to be uninsured or underinsured, and are more likely than Georgians in urban areas to suffer from heart disease, obesity, diabetes and cancer.

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Earlier this month, Lee Little was honored to facilitate a discussion of recommendations in contract negotiation at the 2019 Annual Meeting of the American College of Rheumatology in Atlanta, the largest rheumatology meeting in the world and the premier educational event for physicians, healthcare professionals, and scientists who treat or research rheumatic and musculoskeletal diseases. The meeting is attended by more than 15,000 rheumatology professionals from over 100 countries.

pills-2-300x225More than 2,000 opioid lawsuits are pending nationwide. A large portion of these lawsuits target drug manufacturing companies for their contributions to the opioid epidemic that is plaguing the country.

Georgia and South Carolina Pain Management Medical Practice Law Firm

For example, in one case earlier this summer in Oklahoma, a judge ordered Johnson & Johnson to pay $572 million for the company’s contribution to the opioid crisis. Furthermore, over the next few months, other courts will continue to handle cases as state governments work diligently to mitigate the impacts that the opioid epidemic has had within their jurisdictions. Although Big-Pharma companies are being targeted in litigation, however, retail pharmacies, large and small, are gatekeepers for opioid prescriptions. Given the role of pharmacies, they might be used effectively to combat the opioid epidemic. The role of retail pharmacies in the battle against opioid addiction is crucial, but not necessarily recognized by city governments. A new databank from the DEA tracks opioids at a local level, and makes it possible for pharmacies to band together in understanding unique trends within their own communities.

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On September 18, 2019, Kevin Little, a partner in Hamil Little, spoke to physician members of the national American Osteopathic Association.  The title of Mr. Little’s presentation to the physicians was Setting up a Concierge Medical Practice: Pointers and Pitfalls.  Our business and healthcare law firm has advised and represented physicians, medical practices and other healthcare professionals who have established “concierge” or “direct primary care” medical practice models, as well as other unique models and arrangements.