Little Health Law Blog

Fraud and Abuse Update: Prison As a Result of Kickback Scheme

March 30, 2018 | Little Health Law

1066058_patrol_hat_too1 The United States Department of Justice issued a press release on March 28, 2018 regarding the sentencing of Sandra Parkman, age 63, for Medicare fraud. Our business and health care law firm follows developments in the fraud and abuse legal arena. The DOJ, as well as numerous other Federal and state law enforcement agencies, are continuing with their push to crack down on offenses they determine to constitute “fraud and abuse” under applicable statutes and rules.

United States District Judge Kurt D. Engelhardt of the Eastern District of Louisiana sentenced Ms. Parkman to 32 months in prison. Additionally, she was ordered to pay $277,197 in restitution. Ms. Parkman elected to go to trial in her case. There was a three-day jury trial. At trial, the government presented evidence that Ms. Parkman engaged in a scheme to provide durable medical equipment (DME) that was not medically necessary to federal program beneficiaries in the New Orleans area. The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. Parkman to provide information of eligible Medicare beneficiaries and to obtain physician signatures on order forms for the DME in question. Brown was convicted in a separate trial and sentenced to 80 months in prison.

March 20, 2018, Following a multi-day trial on the merits in the District Court of Denver, Colorado, Kevin Little of our firm, and his co-counsel Shannon Bell, obtained permanent injunctive relief against the Obesity Medicine Association (OMA) for our firm’s physician client

March 20, 2018 | Little Health Law

Following a multi-day trial on the merits in the District Court of Denver, Colorado, Kevin Little of our firm, and his co-counsel Shannon Bell, obtained permanent injunctive relief against the Obesity Medicine Association (OMA) for our firm’s physician client, Dr. Krishna Doniparthi.

Fraud and Abuse Update: DOJ Announces $1.7 Million Fraud and Abuse Settlement Reached with Detroit Physician

January 31, 2018 | Little Health Law

gavel-952313-m Our Georgia and South Carolina healthcare law firm has learned that the United States Department of Justice issued a press release announcing a resolution by settlement of fraud and abuse allegations levied against a Detroit physician, Gerald Daneshvar M.D. Due to our focus on healthcare law, our law firm follows legal developments in the healthcare industry.

Dr. Daneshvar was criminally charged and, following a two-week jury trial, convicted of one count of conspiracy to commit health care fraud. His alleged co-conspirators and co-defendants were Stephen Mason, M.D. and Leonard Van Gelder, M.D. Mason and Gelder plead guilty to conspiracy to commit health care fraud. These doctors were alleged to have worked for Lake MI Mobile Doctors, which provided physician home visits to homebound patients who were Medicare beneficiaries. However, according to the Government’s evidence at trial, Dr. Daneshvar billed Medicare for patient visits where the patient was not really sick or homebound and, along with his codefendants, conspired to bill Medicare at the highest rates even though the patient visits were short or unnecessary. For doing so, these physicians received greater compensation from Mobile Doctors.

DOXIMITY STUDY SHOWS UPTICK IN PHYSICIAN DEMAND AND COMP IN 2017

December 29, 2017 | Little Health Law

medical-doctor-1314903-m1 Earlier this month, Doximity released a new study that provides a national review of physician compensation information and job trends, as the strong trend of physician employment by hospital systems continues. Doximity, formed in 2011, is “the largest community of healthcare professionals in the country,” according to its website. More than 70% of physicians in the United States are verified Doximity members. Doximity is a network of physicians and other healthcare practitioners. Doximity’s membership also includes many nurse practitioners, physician assistants and pharmacists. More about Doximity can be learned from its website, www.doximity.com.

The study analyzes thousands of job advertisements posted in 20 of the nation’s largest cities and involving 15 common medical specialties. Compensation growth was calculated using self-reporting from compensation surveys of tens of thousands of full time U.S. physicians. Physician compensation grew 5.1 percent in 2017, according to the study.

The Exit: Terminating Physician Employment Agreements

November 28, 2017 | Little Health Law

to-sign-a-contract-2-1221951-m All good things must end. Every employment relationship will end sooner or later, one way or the other. While it is obviously important that parties to an agreement convey on the front end of the relationship positive feelings, the exit strategy should never be disregarded in one’s planning or evaluation of contractual terms. Life happens. Things can change one’s desire or ability to be in a deal, a contract, or an employment relationship. Therefore, while perhaps it may feel counterintuitive to dwell on how to end a relationship just as you are forming it, the termination provisions are very important and, sometimes, critical.

Georgia Medical Practice Lawyers

Most physician employment agreements will articulate a specific term, typically one to five years. Often a physician employment agreement will contain an auto-renewal provision so that, following expiration of the initial term, the relationship is continued from year to year automatically absent timely advance notice of non-renewal by employer or employee. From the medical practice’s standpoint, the right objective is usually to incent longevity and continuity of the relationship with the physician, while preserving a way out of the relationship if needed. Physicians, on the other hand, usually desire stability and sometimes a feeling that employment is “guaranteed” absent real cause to terminate the relationship. In the typical written physician employment agreement, how the agreement will end is determined by term and termination provisions.

PHYSICIAN NON-COMPETE AGREEMENTS

October 24, 2017 | Little Health Law

1221952_to_sign_a_contract_3 Virtually every week, our business and healthcare law firm is engaged to provide advice and assistance concerning a physician employment agreement, either as counsel to the physician or for an employer/hospital or medical practice. “Restrictive covenants,” including non-competition agreements, are desired by the majority of employers and therefore included in their proposed form of employment agreement. Physicians most often prefer, however, if they had their druthers, not to be restricted in their ability to work following the expiration or termination of a job. Hence this section of the proposed employment agreement, particularly those with more broad and onerous non-compete provisions, can be the source of tension on the front end of the employment relationship. Restrictive covenants also show up in a variety of other contractual arrangements, including medical practice ownership agreements (e.g., shareholder agreements, operating agreements), joint venture contracts, and medical director agreements.

Expansion of Bi-Partisan 39-State Attorney General Investigation of Opioid Manufacturers and Distributors

September 29, 2017 | Little Health Law

1238683_untitled By press release on September 19, 2017, Massachusetts Attorney General Maura Healey announced the expansion of a pending review of an opioid related scheme to include additional manufacturers and distributors of opioids. The investigation has been undertaken by a 39-member bipartisan group of state attorneys general, which was first announced earlier this past summer. Our business and health care law firm follows developments in the pharmaceutical industry and our Country’s opioid addiction and overdose crisis that has led to many thousands of deaths and, in particular, related issues in Georgia and South Carolina.

Pharmaceutical companies will be required to provide additional opioid training for prescribers

September 5, 2017 | Little Health Law

medical-doctor-1314902-m The FDA has announced that it will begin requiring opioid manufacturers to provide more training for healthcare providers. At present, manufacturers must provide training about long-acting, extended release opioids to prescribers. In the future, the manufacturers of short-term and immediate release opioids will also be required to provide the same type of training. The training will be available to physicians, nurses, and pharmacists.

This change was brought about by the continuing high rate of drug overdose incidents by prescription drug abusers, particularly those abusing opioid painkillers. The training was previously only required by makers of long-acting opioids. However, the FDA stated statistics show that today the vast majority, 90% to be exact, of opioid pain medication prescriptions are for the short-acting variety. It has been found that abusers of opioids are misusing the short-acting, immediate release versions as well as the long-acting types. After becoming addicted to the commonly prescribed short-acting versions of the medication, most abusers graduate to higher doses of the prescription drugs or move to illegal drugs, which present a lower cost alternative.

FDA Addresses Digital Health Advances

August 25, 2017 | Little Health Law

doctor In late 2016, the 21^st Century Cures Act was passed to assist the FDA in keeping pace with the rapid changes in health care technology. Our business and healthcare law firm, follows developments in the healthcare industry.

Among other things, this Act amended the definition of a “device” in the Food, Drug, and Cosmetic Act to remove some medical software functions. The immediate result is that the FDA must draft new guidance for its oversight of software for medical devices.

Healthcare Technology Lawyers

Included in the concept of “Digital Health” are health information technology, wearable devices, personalized medicine, mobile health and telemedicine. The FDA has recognized that these technologies are used to reduce cost and inefficiencies, improve care and access, and better tailor medicine to the individual patient. Furthermore, patients can use the technology on their own to track and manage their own health activities. The FDA acknowledged that new technology allows unprecedented opportunities for people to obtain and potentially share information that can result in significant improvements in health care.

Cybersecurity: Is your patient information susceptible to a cyberattack?

July 28, 2017 | Little Health Law

data-storage-1-1155466-m If you are like most of the healthcare industry, the answer is “yes” according to a recent study by the United States Department of Health and Human Services. The department’s Health Care Industry Cybersecurity Task Force report, a result of the work of 21 cybersecurity experts, was issued in late spring and found that this most private of information is at significant risk of being compromised by malware or cyber hacking. “HHS task force says healthcare cybersecurity in ‘critical condition’,” according to Jessica Davis from Healthcare IT News.

The task force reported that the health care industry was breached by cyberattacks more often than any other industry in 2015. Combined with the increase in ransomware attacks the following year, the report found that sensitive patient information is at high risk of attack. The report listed several contributing factors. These include the idea among smaller entities that they are relatively safe from these attacks, because attackers target larger health care providers. This has proven false. Because the health care industry is so interconnected and interdependent, the industry’s cyber safety is only as “secure as the weakest link.” Id. Basically, if the would-be attacker can gain access to anyone within the system, it can probably access all who do business within that system. Furthermore, the report found that due to staffing shortages, three-fourths of hospitals do not have anyone dedicated to these security issues.