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Jeffrey L. Cohen on BlogTalkRadio
Interview with Jeff Cohen
What are ACOs and Why Should You Care?
Articles from our Team
Florida laws that pertain to telemedicine are precious few. In fact, there is really only one regulation dead on target, and that requires face to face physician contact with a patient in order to write a prescription.
GlaxoSmithKline LLC ("GSK") has agreed to pay three billion dollars to resolve criminal and civil liability stemming from: the manner in which it marketed Paxil, Wellbutrin, Avandia and a host of other drugs to the public; GSK's failure to report safety data regarding Avandia; and from GSK's underpayment of rebates due pursuant to the Medicaid Drug Rebate Program.
Many business people involved in some aspect of the recovery business world (e.g. IOPs, PHPs, Detox) are not aware of the punishing laws that apply to their marketing arrangements.
"Healthcare Reform,"PPACA" and "ACOs" all have one certain thing in common: cost-saving change. Though debate swirls about politics, timing and the particulars of change, it seems clear that the changing demographics of our country (aging baby boomers) in our economic climate is not sustainable as is.
The Office of Civil Rights' recent assessment of a $1.5 million fine for HIPAA violations should be a shrill wakeup call to all health care organizations that use (or allow their physicians to use) portable devices containing patient identifiable information. The sanction stems from a physician's lost laptop computer containing protected health information (ePHI).
At some point, and usually more than once in a physician's career, the question arises: "Should I continue to lease my office, or would it make more sense to purchase an office instead?"
Recently I was asked to weigh in on life insurance policies in general and more specifically, their place in the retirement planning process.
There have been some long faces around our conference room table over the past few months.
Often great ideas or proven concepts fail to attract quality capital partners purely based on the message delivery or lack of preparation.
As 401(k) plans have become more popular and plan participants have become increasingly responsible for making their own investment decisions with respect to their retirement, the Department of Labor (DOL) has become concerned that participants in self-directed 401(k) plans are not made fully aware of critically important information that will ensure that they make informed investment decisions.
On November 15, 2011, First Coast Service Options, Inc. (FCSO) issued notice that they will be performing prepayment medical reviews of inpatient hospital claims related to 15 diagnosis related groups (DRGs).
Physician owned distributorships (PODs) have been the source of considerable controversy for years, but now they've caught the attention of Congress!
On November 10, 2011, the Office of the Inspector General of the Department of Health and Humans Services (the "OIG") issued their 2012 Work Plan. The annual Work Plan is designed to give Medicare providers and supplier notice and information on areas of potential abuse that the OIG to address with particular attention.
On November 15, 2011, First Coast Service Options, Inc. (FCSO) issued notice that they will be performing prepayment medical reviews of inpatient hospital claims related to 15 diagnosis related groups (DRGs).
The Office of Inspector General of the Department of Health and Human Services recently (October 11, 2011) shook its head at a proposal involving a pathology lab management services business that was to be owned by physicians.
On August 10, 2011, the Fourth District Court of Appeals support one litigant's huge discovery request on the treating physician.
CMS Delivers Final ACO RulesProposed Rule versus Final Rule for Accountable Care Organizations (ACOs) In the Medicare Shared Savings Program.
Healthcare reform aside, physicians are increasingly buried under the weight of nonstop regulatory scrutiny and compliance requirements.
Medical staffs are increasingly frustrated with the financial relationships their medical executive committee (MEC) members have with the hospitals where they work.
Conversation regarding ACOs and even healthcare reform itself is misplaced. The well established facts are (1) more people will receive health care, and (2) the cost of healthcare will come down.
EMTALA (the Emergency Medical Treatment and Active Labor Act) was passed by Congress in 1986. The purpose behind the law was to ease the burden of public or so called charity hospitals from having to treat indigent patients because other hospitals refused to treat such patients due to their inability to pay.
A recent decision out of the 11th Circuit Court of Appeals will help Florida's tort reform efforts.
Most readers know that the federal Stark Law deals primarily with matters involving physician self referral.
When done the old-fashioned way, tasks such as confirming appointments, delivering lab results, and calling in pharmacy refills, means hours of manual tracking and daily phone calls by office staff.
We have probably never seen so much enthusiasm and spending on anything in our history as we are on healthcare reform.
Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship. Though they approach healthcare issues differently, there are many instances where they share care or even work together.
A "company model" arrangement is reasonably popular in surgery centers these days. The model entails a legal entity owned by both anesthesiologists and referring surgeons, which performs anesthesia.
View the Advisory Opinion 11-03
Anti-trust laws are one of the greatest obstacles to healthcare reform. Here's why? They limit the way competing physicians, hospitals and the like can do business together.
As physicians retire and the era of healthcare reform rocks physicians, opportunities to purchase practices will likely surge, and not just for entities that employ physicians, like hospitals.
One of the most troubling issues facing physicians is the constant threat of a malpractice claim. To address this threat, as a first step in a comprehensive plan, every physician practice group and each individual physician should obtain the appropriate level of medical malpractice liability insurance coverage.
Though it is customary for many medical practices to pay its physicians as 1099 independent contractors (instead of W-2 employees), doing so can be very expensive because the IRS is expected to increase its investigations and enforcement actions in this area.
The advent of more entrepreneurial opportunities for physicians will cause them to wonder how to deal with Medicare patients when Medicare is the secondary payer. View The Department of Health and Human Services Memorandum.
"Patient centeredness," "fragmentation" and "value based purchasing" are just a few of the terms that are peppered throughout the newly proposed regulations for accountable care organizations ("ACOs").
Health Care Reform: Incentives May Reshape Medicare Corporate health attorneys like Jeff Cohen, of the Florida Health Care Law Firm in Delray Beach, said everyone in his industry is poring over the finer points of the rules. What has surprised him so far is the extent to which Medicare beneficiaries have a say in whether to stay in an Accountable Care Organization if their doctor joins one, and to decide whether their data will be used in the performance accounting.
Hospital TeamCare Announces Long-Term Fix for Healthcare Providers in America's Shifting Healthcare Market Hospitals are frightened because their compensation will be based on all sorts of things. It'd be tied to readmission rates, payment of physicians, and it could change from fee-for-service, to risk-based compensation, such as capitation, said Jeff Cohen, Owner of Florida Healthcare Law Firm, in Delray Beach.
Federal Agencies Address Legal Issues Regarding Accountable Care OrganizationsOn March 31, 2011, the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), proposed new rules under the Affordable Care Act to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).
Healthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be unconstitutional, the healthcare business community is unleashed. Change is afoot!
In January, a Florida appellate court upheld the denial of a physician's request to halt a hospital's intention to deny reappointment to the medical staff.
The OIG weighed in on a request to give a green light to a proposed venture between a sleep testing provider and a hospital.
We all know for instance ACOs are being proposed as the new healthcare delivery platform for the masses and that they are more an idea, an experiment, than they are a thing.
We all know for instance ACOs are being proposed as the new healthcare delivery platform for the masses and that they are more an idea, an experiment, than they are a thing.
Business owners, regardless of size, have reason to be concerned about their choice of entities in Florida following the decision rendered in Olmstead v. FTC in June 2010.
Physicians are scrambling in reaction to changes in the business of healthcare. Understandable!
As this year winds down, and next year begins to wind up, medical practices should give some thought towards how the next twelve to thirty-six months will look for the practice.
Medicare's Physician Quality Reporting Initiative (PQRI) can be "found money" for physicians who participate in the Initiative.
In the 90s, physicians were told "The sky is falling. You have to find a tree to stand under or you will be crushed."
The Centers for Medicare and Medicaid Services (CMS) issued its anticipated self referral disclosure protocol (SRDP) on September 23rd."
Healthcare providers who participate in Medicare are sometimes surprised when the government later decides that an overpayment was made.
Though CMS has delayed PECOS enrollment until January 3, 2011, that is no comfort to the providers who have registered whose Medicare payments will likely be disrupted due to the millions of providers who are expected not to meet the enrollment deadline.
By now everyone in the healthcare industry knows the term "HIPAA," but not everyone knows that the new healthcare reform law has toughened it up in many respects.
The long awaited "meaningful use" regulations are an important step in the process of weaving health information technology into the fabric of U.S. healthcare.
Medical staffs are increasingly frustrated with the financial relationships their medical executive committee (MEC) members have with the hospitals where they work.
How many times have you heard from an insurance company "Oh no, we can't pay your claim because it is coded incorrectly according to Medicare."
The physician incentive payments/penalty provisions that piggybacked their way onto the federal healthcare reform law has physicians concerned and scrambling.
Healthcare reform alone is enough of a Rubik's Cube, but CMS and the OIG has been especially well-staffed these days, enough so that their offices are turning out new laws and interpretations at an alarming rate.
News Release
Jeffrey L. Cohen, a board certified healthcare attorney with over 20 years of healthcare law experience, has proudly announced the opening of The Florida Healthcare Law Firm, a firm designed to empower the local healthcare and business community through a new way of providing legal and educational services.
News Placements
The second district court in Tampa is causing many hospitals and medical staffs to focus sharply on their contracts and medical staff bylaws, particularly as they relate to traditionally closed departments.
With more than 20 years of health care law experience under his belt, Jeffrey L. Cohen decided it was time for a change. He left the firm he had worked with for 13 years to start his own, Florida Healthcare Law Firm and Maverick Medical Claims.