Firm News & Legal Alerts

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  The good news is that the statute repealed the heavily criticized Sustainable Growth Rate (“SGR”) formula for payment for physician services.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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Friday, July 1, 2016

Considering Going Out of Network in New York? Food For Thought


As insurance companies continue efforts to reduce reimbursement rates and increase administrative burdens on their participating providers, more and more physicians are considering terminating their in-network contracts with private insurance payors and going out-of-network.  If you or your practice are contemplating doing so, here are some issues you may want to consider when making that decision.

 As an out-of-network physician, you are not limited in the fees that you can charge by either in-network negotiated rates (although you continue to be subject to the Medicare fee schedule for Medicare patients should you continue to accept Medicare); you are free to charge any rate that you believe is commensurate with your expertise and the quality of services you provide, subject to the regulations of the New York State.  Generally, absent a contractual agreement, a physician should charge a reasonable and customary fee for your specialty and geographic area.  Keeping in mind, private payors are increasingly attempting to challenge the fees charged by out-of-network physicians.
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Friday, April 1, 2016

Defending the "Impossible Day" Healthcare Fraud Prosecution


Defending the "Impossible Day" Healthcare Fraud Prosecution is featured within the April 2016 issue of the New Jersey State Bar Association (NJSBA) publication, New Jersey Lawyer.

Mr. Giaquinto is a Partner with Kern Augustine, P.C., where he heads the firm’s white collar criminal law section.
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Friday, January 1, 2016

Firm Name Change: Weiss Zarett Brofman Sonnenklar & Levy, P.C.

Effective January 1, 2016, Weiss, Zarett, Brofman & Sonnenklar, P.C., a law firm concentrating in healthcare and business matters, has changed its name to Weiss Zarett Brofman Sonnenklar & Levy, P.C. as Mathew J. Levy has joined the firm as a principal and will serve as co-chair of the firm’s corporate transaction and healthcare regulatory practice.


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Tuesday, December 8, 2015

AG’s Office Begins Enforcing the Surprise Bill Law

This past Spring, the Surprise Bill Law took effect in New York State, imposing various disclosure and billing requirements on out-of-network providers and insurance companies. The aim of the law is to protect consumers from “surprise” or emergency out-of-network medical bills. Patients who receive surprise bills are to be held harmless, with the exception of their usual in-network co-pays and deductibles. Out-of-network providers and insurance companies are required to resolve any fee disputes in an arbitration-style format.


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