David M. Glaser, JD

A device company wants you to give speeches explaining how you use their product or asks you to offer suggestions for improving it in exchange for royalties. Can you do it? Should you do it?

It is relatively common to face medical necessity denials. A recent case offers lessons about challenging a Medicare contractor when it asserts your care is not medically necessary.

Whenever you enter a financial relationship with a hospital, the hospital is likely to rely on survey data to verify that the relationship is at fair market value. While the desire of the hospital to use such data is completely understandable, the odds are that the survey data is imperfect. How can I feel comfortable making such a sweeping generalization? Because if you carefully examine most of these surveys, the limitations are immediately apparent.

As a physician, you have a unique ability to make the delivery of health care more efficient and save hospitals money, which ultimately has the effect of lowering health care costs. This is true whether you are in independent practice or employed by a hospital. While the Stark law, antikickback statute and other laws place some restrictions on payments from a hospital to a physician, it is crystal clear that with some relatively simple planning, a hospital can compensate physicians for their effort to save money. While the labelling of these payments may differ (sometimes these are referred to as gainsharing arrangements, though I prefer co-management or gainsharing), the basic idea is the hospital is paying the physician for his or her assistance in improving the economic efficiency of the hospital.

The recent arrest of a courageous nurse at the University of Utah as she refused to allow a police officer to draw blood from an unconscious patient without a warrant offers some important lessons about preparing for interactions with police, whether they are investigating you or one of your patients.

If your clinic has an MRI or you are a hospital-employed and production-based orthopedic surgeon, then read this.

Choosing the right lawyer can matter. At a recent speech, I mentioned that clinics can accept referrals from outside physicians to have scans performed on the MRI or other imaging equipment. Afterward, an attendee came up and said she had worked with a local lawyer who insisted it was improper to accept these outside imaging referrals.

At the start of the month, Medicare launched a new mechanism for reimbursement of lower extremity joint replacement in 67 metropolitan areas across the United States. Within the 67 areas, hospitals are required to be under this reimbursement methodology unless the hospital is an episode initiator in Model 2 or 4 of Bundled Payment for Care Improvement, or in Model 1 of that program.

If you hire a consultant to review your practice and the consultant finds a legal issue, then can the government demand a copy of the consultant’s report? The answer is almost certainly “yes.” Here are some tips for minimizing the risk when a consultant reviews your practice.

Choosing the right lawyer can make a big difference to the success of your practice. A good lawyer will not only help you do things other practices avoid because of a misunderstanding of the law, but will also keep you from doing things that “everyone is doing” when they are illegal. The best lawyers will do this without costing you an arm and a leg. Here are some thoughts about retaining counsel.