Firm News & Legal Alerts

Sunday, August 1, 2010


A primary, if not preeminent, goal of every physician in practice today is the avoidance of a lawsuit for medical malpractice. In pursuit of that goal, the hard reality of practice dictates that risk management of medical malpractice claims falls directly upon, and is ever present with, every physician throughout each moment of rendering care. Understanding where the highest risk areas lie, and taking affirmative and aggressive measures to risk manage those prioritized threats, will provide physicians with the greatest protection toward avoiding a claim and/or being prepared to defend, and defeat, a claim that arises in spite of these measures.


  • 1Creating Medical Records That Are Not “Self-Protective” The initial “triage” of a potential medical malpractice claim is normally carried out by a physician or nurse retained by the attorneys representing the patient. These attorneys, seeking a financial recovery/gain, are not desirous of investing large sums of capital, resources and time into a claim which presents with a strong, defensible set of medical records.
    Read more . . .

Sunday, August 1, 2010

How the Title of “Disruptive Physician” Can Ruin Your Career and How to Avoid It

In response to standards put forth by The Joint Commission, the American Medical Association, through its Council on Ethical and Judicial Affairs, continues to voice its ongoing support for use of the designation “Disruptive Physician” as a mechanism for potential discipline of physicians. In doing so, the AMA has created two distinct forms of “physician behaviors” upon which such actions can be based.


1. Inappropriate Conduct

Inappropriate behavior is conduct that is unwarranted and is reasonably interpreted to be demeaning or offensive. This behavior can have a detrimental effect on relationships between healthcare practitioners.
Read more . . .

Tuesday, June 1, 2010


The “RAC” program (“Recovery Audit Contractors”) was instituted by the Center for Medicare & Medicaid Services (CMS) in order to identify improper Medicare payments and fight fraud, waste and abuse in the Medicare program. Since it is inevitable that almost all physicians who bill for Medicare services will be involved with a RAC audit in the future, it is imperative that every physician understand and be prepared for these investigative, and potentially invasive, audits.

RAC Audits: What are they?

RAC audits are specialized Medicare audits implemented with the goal of recovering “improper payments” to CMS which were not detected using previously existing error detection and prevention program efforts. These “improper payments” include both overpayments collected from all health care providers, as well as underpayments that may need to be repaid to health care providers, although the majority of the “improper payments” discovered and acted upon are for overpayments.

RAC Audits: Where did they come from?

The RAC program began as demonstration/pilot program in 2003 to detect and correct improper payments in the Medicare program.
Read more . . .

Saturday, May 1, 2010

An End to Class Action Abuse?

Tired of getting a two dollar coupon as your part of a class action settlement, while the lawyers get tens of millions in legal fees? The United States Supreme Court has just issued an opinion which may put an end to many of these abuses.

Class action lawyers have made hundreds of millions of dollars because courts have been willing to calculate legal fees either as percentage of the total recovery, or as a multiple of attorneys’ hourly fees. In some cases legal fees have even been calculated as a percentage of the estimated benefit of a settlement to the class, even where members of the class receive no money.

These huge fees have been justified by lawyers’ claims that class action lawsuits are highly complex, take a long time to resolve, and involve substantial risk. The Supreme Court has now rejected most of these arguments, finding that except in “rare and exceptional circumstances” payment of a reasonable hourly fee, based upon prevailing community rates, is all that class action lawyers can receive.

Read more . . .

Thursday, April 1, 2010

Is it Time to Opt Out of Medicare?

With the new federal health reform law, and recent announcements dramatically increasing the number of audits that Medicare will be conducting, through its vigilante “auditors”, is it time to consider opting out of Medicare?

In order to answer that question you first need to know your options. Most physicians are participating providers with Medicare. That allows them to accept assignment and receive payments directly from Medicare. An alternative is to change to non-participating status. The advantage of this is that you can charge your patients additional fees, up to the Medicare limiting charge.
Read more . . .

Thursday, April 1, 2010


Public Citizen, a consumer oriented Ralph Nader offspring, recently rated State Medical Boards throughout the nation. Alaska, with only 1885 physicians, was rated as having the “best” Board, based upon the Board having taken serious disciplinary actions against 14 physicians last year, and 7.89 actions per thousand physicians over the past three years. By contrast, Minnesota, with 17,977 physicians, was rated “worst” based upon only 26 serious disciplinary actions last year and 1.07 actions per thousand physicians over the past three years.
Read more . . .

Monday, March 1, 2010

Physicians as Targets: Insights, Hard Realities and How to Risk Manage Them.

Michael J. Schoppmann, Esq. Kern Augustine Conroy & Schoppmann, P.C.

In order to survive (and God willing, even possibly succeed) in today’s medicine, every physician must come to accept certain key insights and recognize certain hard realities.
Read more . . .

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