Industry Recognition of Akerman’s Lawyers and Practices
Chambers USA, The Legal 500, and several other publications have again ranked Akerman as a leading law firm in numerous practice areas, including healthcare.
Chambers USA has ranked 14 of the firm’s practices in Florida. On a national scale, The Legal 500 has ranked Akerman as one of the best firms in the United States for Corporate M&A, Real Estate, Land Use, Construction, and Immigration.
A record number of Akerman lawyers were also recognized this year with Chambers listing 48 Akerman lawyers; Super Lawyers listing 76 in Florida; Florida Trend Legal Elite listing 35; and The Legal 500 listing 19.
This is in addition to numerous local publications that continue to recognize the caliber of the Akerman team.
The recognition of Akerman and its many exceptional lawyers is a direct reflection of our commitment to our clients.
Here are the links to the various publications:
Complete list of firm recognition
ACOs are not for Sissies
This is the title of a presentation I gave to the Tampa Bay MGMA on July 12.
Many have touted ACOs as one of the most critical reforms in the Affordable Care Actbecause of its focus on realigning healthcare provider financial incentives to patient-centered and preventive care and away from procedure/volume based care. I agree with that assessment. Unfortunately, the proposed regulations (which have been justifiably bashed by many in the healthcare industry) have done much to derail ACOs.
The final regulations will hopefully incorporate many of the criticisms so that the movement toward ACOs can continue. According to two industry leaders, ACOs must be successful:
“The Accountable Care Organization: Whatever Its Growing Pains, The Concept Is Too Vitally Important To Fail” — Health Affairs, 30, no. 7 (2011):1250-1255
HIT, Small Physician Practices, and IPAs
In its June 2011 Research Brief, the National Institute for Health Care Reform reports that “lessons from independent practice associations (IPAs) — net-works of small medical practices — can offer guidance about overcoming barriers to HIT adoption and use” in small physician practices. The study found that IPAs, as local networks of independent physician practices, promoted the development of HIT-knowledgeable physician leaders who were able to gain the trust of their less HIT experienced colleagues in coordinating efforts to deal with risk-based managed care contracts.
The study concludes that “IPA experiences with HIT adoption can offer insights for other entities charged with helping physicians in small practices overcome barriers to HIT adoption and use.”
(The study may also provide critical insights to, and hope in, dealing effectively with the even greater hurdles that physician groups are facing in their coming together to form accountable care organizations, where HIT will be critical to success.)
Compliance Oversight for Healthcare Leaders and Compliance Plans
In a new seven minute video presentation, OIG Inspector General Daniel Levinson and Chief Counsel Lewis Morris discuss the role of compliance and its importance to the health care industry.
By now, I think we all know that compliance with healthcare laws and regulations is good, and that noncompliance can be very bad. There is nothing much to learn in seven minutes. However, there is an important reminder in the video that the OIG wants providers to have effective compliance plans in place.
Nursing homes are required by the healthcare reform law to have such plans, and the law gives the OIG the power to require other healthcare industry groups to have compliance plans.
It is only a matter of time before this requirement is imposed on physicians. The OIG published guidance for physician compliance plans over 10 years ago. That guidance is worth reading again. Similar compliance guidance can be found at the OIG website for other kinds of healthcare providers.
This is something that healthcare providers should not put off any longer.
CMS Issues Stark Advisory Opinion 2011-01
In CMS Advisory Opinion AO-2011-01, the Centers for Medicare & Medicaid Services issued an advisory opinion permitting a group to include a covenant not to compete in its employment agreement with a physician whose recruitment to the group was funded by a local hospital.
In its advisory opinion, CMS stated that the the physician recruitment exception to the Stark law “requires that the physician practice not impose additional practice restrictions on the recruited physician other than the conditions related to quality of care.” However, CMS acknowledged that, in its commentary to the Phase III Stark rulemaking, it had concluded “that non-competition provisions should not be categorically prohibited from recruitment arrangements.”
In determining that this particular noncompetition covenant did not impose practice restrictions that “unreasonably restrict the [p]hysician’s ability to practice medicine in the geographic area served by the [h]ospital,” CMS looked at the following factors:
- The time period restriction of one year was reasonable.
- The distance requirement of 25 miles was reasonable based on the geographic area served by the hospital.
- Even with the time period and distance restrictions, the physician would still be permitted to practice at certain hospitals both within and outside of the recruiting hospital’s geographic service area within the one year time period.
- The hospital had certified that the noncompetition covenat complied with applicable state and local laws.
As with all such advisory opinions, it is issued only to the requesting party and cannot be relied upon by any other individual or entity.
Nevertheless, this advisory opinion provides guidance for the first time on how CMS will analyze the language of the statute, the regualtions, and its own commentary in specific physician recruitment fact situations.
Medicare Fraud — Physical Therapy Clinic Employees
The Department of Justice announced yesterday another Medicare fraud scheme. This announcement dealt with employees of the Solstice Wellness Center in the Brooklyn-area.
The employees pleaded guilty to paying kickbacks to Medicare beneficiaries to induce them to visit Solstice where they were to receive physicians’ services, physical therapy, and diagnostic tests that were neither actually performed nor medically necessary. Solstice billed Medicare over $3.4 million.
CMS Podcasts for 2011 ICD-10 Implementation
On January 12, 2011, CMS held a national provider call on “Preparing for ICD-10 Implementation in 2011.” From the audio of that event, CMS has created the following four podcasts:
- Welcome and ICD-10 Overview – Pat Brooks, CMS
- Implementation Strategies for 2011 – Sue Bowman, AHIMA
- Question and Answer Session, part 1
- Question and Answer Session, part 2
These podcasts are now available here in the downloads section.
NEW TECHNOLOGY TO HELP FIGHT MEDICARE FRAUD
Predictive modeling once was used to help pick stocks on the rise and now is going to be used to identify Medicare cheats.
CMS announced in a press release on June 17, 2011 that it will be using new technology to track down healthcare fraud. CMS states in its press release that this technology is similar to tools used by credit card companies. This is part of the White House’s continuing campaign to cut waste in the Medicare program.
You can learn more about this technology at this CMS Factsheet.
Better Care and the Bottom Line
According to a survey of health leaders published in a HealthLeaders Media Intelligence Report, “Better Care and the Bottom Line” (June 2011), best practices for chronic care and evidence-based medicine are needed to overcome drivers of waste such as overutilized services and a lack of integration.
- 52% of the survey respondents put overutilization of services in their top 3 drivers of waste in the healthcare system
- 67% say a realistic goal for readmission rates is 1% to 3%, but only 40% have achieved that goal
- The top three tools cited to address medical cost escalation are chronic care management, evidence-based medicine, and medical liability reform.
Healthcare providers are being presented with numerous avenues for achieving better quality and more cost effective medical care — ACOs, consolidation of practices, and affiliation with hospitals, to name just a few.
If you would like to get a copy of the Report, click here.
Whistleblowers Have Rights, Too
I just picked up this story from Outpatient Surgery.
Apparently, a sheriff in Winkler County, Texas decided to punish two nurses who complained about his physician friend. The nurses had filed an anonymous complaint about a variety of questionable practices by the physician. When the shreiff discovered who had filed the complaint, he charged the nurses with “misuse of medical information.”
The sheriff now faces jail time and a $6,000 fine.
Joseph Rugg's Health Law Blog 