April 2013

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Clients and Friends,

I’m delighted to share that the attorneys here at the firm are on top of breaking developments and trends in health law and are being published in national health law publications. In just the last week, the following have occurred.

  • Senior associate Kelly Downer’s article, “Representing DEA Registrants in Light of Recent DEA Enforcement Actions” appeared yesterday in the April 2013 Physicians Organizations newsletter of the American Health Lawyers Association. In the article, Kelly explained that from 2000-2011, the number of Final Agency Orders in which the DEA administrator revoked a certificate of registration more than tripled. She provides strategic advice for physicians and pharmacies that face investigations by the Drug Enforcement Agency. Click here for Kelly’s profile.
  • Associate Caroline Kubovy’s analysis of last week’s new Special Fraud Alert issued by the Office of Inspector General of the Department of Health and Human Services was “e-blasted” by the American Health Lawyers Association to more than 1500 healthcare attorneys across the country. Her analysis addressed the OIG’s recent published stance regarding surgeons who hold ownership interests in medical device manufacturers or distributorships.
  • I was quoted in the American Medical Association’s national monthly publication in an article entitled “Five Steps for Employed Physicians in Contract Disputes.” The journalist for the AMA article interviewed me about strategies physicians employed by hospital systems can use to solve disputes with their employers.
  • Today I’m one of the speakers on a national webinar sponsored by the American Health Lawyers Association. It’s part of the Health Care Transactions Boot Camp Series: “Impact on Physician Network Development and Medical Staffs.” Attorney Robert Homchick from Davis Wright Tremaine, LLP in Seattle and consultant Jon Spees from the Camden Group in El Segundo, California will join me in the hour and a half webinar that will provide an overview of the integration of physicians into newly formed organizations or partnerships, including combining faculty practice plans/employed multispecialty groups and clinically integrated networks in health systems; review the current climate related to physician transactions, and the deal structures that are being utilized in the industry; and review the transition of free-standing physician offices to hospital outpatient departments/provider-based facilities and the potential ramifications of implementing this strategy.

I was also asked to speak at the American Health Lawyers Association’s Annual Meeting in San Diego in July. Teresa A. Williams, J.D., Corporate Compliance & Privacy Officer and Vice President Regulatory Services at INTEGRIS Health, Inc. in Oklahoma City and I will be leading sessions entitled “Physician Post Integration Issues: After the Honeymoon Are We Friends or Foes?” It will address proactive steps pre-integration to prevent a break up, blending of culture, information and clinical systems, physician compensation and changing financial outlooks, managing hospital expectations and collaborative strategic planning.

We are able to share our knowledge based on the projects our wonderful clients ask us to assist them with. We learn so much from the health law questions presented by our clients. Here’s a summary of what “hot” and keeping us busy right now:

  • HIPAA! A 563-page regulation was issued in January. Associate Caroline Kubovy and myself are on top of it, already creating turn key solutions for clients, updating their HIPAA Privacy and Security Plans. This will keep all healthcare providers busy throughout the summer. The new final rule is now in effect. There are expansions of individual patient rights with regard to their health information and expanded “business associate” rules, particularly extending to subcontractors. All Notice of Privacy Practices, Business Associate Agreements and Policies and Procedures will have to be updated. We are planning a seminar in Jacksonville in May to bring clients up to speed on what is needed. If you want an invitation, please email legal assistant Patricia Clark at patricia@bittingerlaw.com.
  • We are doing some “corporate cleanup” work for a group whose success and growth got ahead of its documentation of its legal structure and relationships among physicians and ancillary subsidiaries. We’re making sure proper operating agreements, shareholder or buy sell agreements, employment agreements and other documents are in place.
  • We are representing a practice implementing a Management Services Organization for other physician groups.
  • We have a few administrative hearings and Board of Nursing and Medicine matters we are working on, including cases brought by AHCA against licensed facilities.
  • We are coordinating a Medicare repayment following a client’s billing self-audit that revealed a need to refund.
  • We are reviewing a number of Clinical Trial Agreements and Informed Consents for clinical research.
  • Of course, the integration trend is keeping us busy also: employment agreements, professional services agreements, management services agreements and the like. And we’re already seeing some of the early integration start to fall apart.

Thanks for your business and friendships,

Ann Bittinger