Firm News & Legal Alerts

Saturday, October 1, 2016

Permitted Use of Protected Health Information in Furtherance of Patient Care

A byproduct of the ever-increasing hyper-regulation of the practice of medicine is that practitioners have become more attuned to their absolute obligations towards patients' privacy. One such obligation relates to the use and disclosure of patients' identifying information and health records -- designated "Protected Health Information"-by "covered entities" including healthcare practitioners and health plans. In establishing a set of national standards, the Department of Health and Human Services issued the socalled Privacy Rule to implement the requirements of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA'').


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Saturday, October 1, 2016

Final Section 1557 Rule Nondiscrimination in Health Care Programs and Activities

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This law prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health programs or activities.
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Thursday, September 1, 2016

Medicare Access and CHIP Reauthorization Act of 2015: The Future of Medicare Reimbursement - The Merit-Based Incentive Payment System

When the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) goes into effect, most participating physicians will fall under the Merit-Based Incentive Payment System (“MIPS”).  MIPS was originally scheduled to go into effect on January 1, 2019, but its first “performance period” was to begin on January 1, 2017, as assessments in 2019 were to be based upon a two-year “look back” period; thus, payment adjustments in 2019 were to be based upon the performance factors as applied beginning in 2017.  However, on July 13, Andy Slavitt, the Acting Administrator of the CMS, testified before the Senate Finance Committee that implementation may have to be delayed, due to fears of an adverse impact upon small and rural practices, so it now appears these timelines will be modified.  There are three exceptions from participation in MIPS: 1) a physician who is participating in Medicare for the first time is exempt from MIPS for the first year of participation; 2) a physician who sees a small number of Medicare patients and falls below the volume threshold established for participation; and 3) a physician who participates in an eligible Alternative Payment Model (“APM”) and qualifies for incentive payments through that program (the APM exception will be discussed in a later article in this series).


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Thursday, September 1, 2016

Medicare Access and CHIP Reauthorization Act of 2015: The Future of Medicare Reimbursement - The Alternative Payment Models

When the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) goes into effect, some participating physicians will be eligible for the Alternative Payment Models (“APM”).  Under MACRA, a physician who participates in an eligible APM will qualify for incentive payments through that program and be exempt from the Merit-Based Incentive Payment System (“MIPS;” discussed in the last article in this series).  The intent of the APM is to implement new payment policies which move away from fee for service.  The APM program was scheduled to take effect in January, 2019.  However, on July 13, 2016, Andy Slavitt, the Acting Administrator of the CMS, testified before the Senate Finance Committee that implementation of MACRA may have to be delayed, due to fears of an adverse impact upon small and rural practices, so these timelines will likely be modified.


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Thursday, September 1, 2016

Medicare Access and CHIP Reauthorization Act of 2015: The Future of Medicare Reimbursement - An Introduction


On April 16, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) into law.  This law will radically alter the manner in which physicians will be compensated for providing treatment and services to Medicare patients.  The good news is that the statute repealed the heavily criticized Sustainable Growth Rate (“SGR”) formula for payment for physician services.  SGR would have drastically reduced payments to physicians under the Medicare program.  However, it replaced this scheme with the “Quality Payment Program,” which has two different “paths” for physician compensation under Medicare: the Merit-Based Incentive Payment System (“MIPS”) and the Alternative Payment Models (“APM”).
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Friday, August 5, 2016

Should I adopt an Employee Manual? What are the benefits?

An Employee Manual: (i) ensures that your employees are aware of their duties and responsibilities; (ii) supplements, or in some cases, acts as employment agreements; (iii) informs your employees of your business policies; and (iv) provides your business with legal protections. For a more detailed discussion on Employee Manuals, please click here to read the article entitled “Understanding General Business Employee Manuals.”

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Friday, August 5, 2016

What do I need to consider before I sign a lease for my business?


A lease is imperative to the value of a business. Important items to consider include: parties to the lease, personal guaranty, term of lease and exit strategy, build-out, rent, assignment and subletting provision, landlord responsibilities, insurance, competition in the building and right to enter. For a more detailed discussion on General Business Lease Agreements, please click here to read the article entitled “Understanding General Business Lease Agreements.
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Wednesday, August 3, 2016

Should I adopt a Physician Employee Manual? What are the benefits?

A Physician Employee Manual ensures that (i) your employees are aware of their duties and responsibilities, (ii) supplements, or in some cases, acts as employment agreements, (iii) informs your employees of your practice policies and (iv) provide your practice with legal protections. For a more detailed discussion on Employee Manuals, please click here to read the article entitled “Understanding Physician Employee Manuals.”


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Monday, August 1, 2016

What do I need to consider before I sign a lease for my medical practice?


A lease is imperative to the value of a medical practice. Important items to consider include: parties to the lease, personal guaranty, term of lease and exit strategy, build-out, rent, assignment and subletting provision, landlord responsibilities, insurance, competition in the building and right to enter. For a more detailed discussion on Physician Lease Agreements, please click here.
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Friday, July 29, 2016

I am an anesthesiologist and I currently render services on behalf of an ASC. Can the non-anesthesiologist owners of the ASC where I render services share in the revenue generated by me?


Maybe. In light of the OIG opinion rendered 5/25/12 (OIG Advisory Opinion 12-06), any arrangement between an anesthesiologist and an ambulatory surgery center (ASC) (or any other provider) must be analyzed in the context of the general prohibitions under New York and Federal law against kickbacks to ensure that such arrangements are compliant and minimize risk. For additional information please click here to read the article entitled “Understanding Financial Arrangements Between Anesthesiologists and Ambulatory Surgical Centers as Per the Recent OIG Opinion.


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Wednesday, July 27, 2016

Several of my colleagues have been treating their patients remotely using facetime and other video-chatting applications. Am I allowed to do this?


While you are technically able to treat patients remotely via telemedicine, there are many legal and regulatory issues to take into consideration. For instance, practitioners need to understand the risks associated with potential malpractice actions, licensure actions, HIPAA violations, and reimbursement issues. Failure to appropriately utilize telemedicine can have a harmful effect on a practitioner. For additional information please follow click


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