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11/15/2013
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Shashank Srivastava, DPM
I am assuming the question is whether doctors are required to accept patients through the healthcare exchanges that are being set up by federal and state governments. From what I understand, medical providers are not at this time required to participate with patients in the health exchange specifically. This is a complicated question, however, meaning that many commercial insurers will be on the exchange selling individual plans. Patients will be buying from these commercial insurers.
If you are already contracted with that commercial insurer, you will be required to treat the exchange patient from that plan. If you are not contracted with the plan, you are not required to participate. If you are contracted with the plan, you will have to take the patient. There will not be a clear distinction with a Blue Cross employer-funded plan and a health exchange plan.
If you are uncertain as to how this will impact your practice, it may be a good idea to not assume any new insurance contracts until the there is further clarity.
Other messages in this thread:
09/03/2014
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: William Deutsch, DPM
The DPM who contacted his liability insurer over a possible claim that never materialized and found out later his contact was listed as a malpractice event isn't a unique occurrence. Being involved in a 'fender-bender' and notifying your auto insurance carrier of the event, even though no claim is ever filed by anyone and there is no financial loss by your insurer, may also be held against you and raise your rates. This is a case where being pro-active and honest has its own liabilities. The insurance company isn't your friend, confidant, or priest.
08/09/2014
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Vince Marino, DPM
I am not sure that I agree with the response from the editor on this subject. I thought we were not obligated to see anyone and everyone. I thought we had the ability to suggest that the patient be seen by someone or in a place more qualified to handle their particular situation/problem. Don’t we have the right to refuse treatment to someone before a doctor-patient relationship is established? I would love some of the PM News readers who have legal degrees to render an opinion. Could we charge the patient for the interpreter? If not, then why not tell them that it will be a few months before you can accommodate them (with an interpreter) since your schedule is full and that they would best be better going elsewhere.
Editor's note: PM News does not provide legal advice. Under the ADA, you cannot charge for an interpreter. Patients must be seen within a reasonable period of time.
06/26/2014
RESPONSES/COMMENTS (MEDICAL/LEGAL ) - PART 1B
From: Jeffrey Kass, DPM
The "incentive dollars" that Dr. Borreggine discusses to participate in a "survey" is NOTHING MORE THAN A KICKBACK/SCAM. These compound pharmacies make lots of money to fill a tube with medicine. In many cases, more than a participating doctor gets to do a bunion. It is very easy for a company to give you back $200 when they are getting $3,000. (or whatever the numbers come out to). Dr. Borreggine's advice to consult a healthcare attorney is good advice. Better advice would be save the money on hiring the healthcare attorney and run away from the people soliciting you with these scams.
Why doesn't the compound pharmacy offer the medication to the patient for free and have them fill out the survey themselves? Because it's a scam!
02/28/2014
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Michael M. Rosenblatt, DPM
Those who believe that they can sneak by and live with lower limit coverage for professional liability insurance are playing a risky "board game" at the Las Vegas crap tables, with the exception that they don't even have a chance of winning the pot. The Editor pointed out that the DPM is personally responsible for the excess jury verdict. Successful plaintiffs hire special investigators to locate and expropriate a defendant's properties for the settlement.
Sometimes, these investigators also get a share of the recovery, depending on the agreement they have with the plaintiff. For this reason, they are "highly motivated." It is illegal to try to hide proceeds from legal recovery. Doctors who think that they may have a risk of going above their coverage limit should consider hiring their own private attorney to help monitor and control the process. You have every right to do this, no matter what your carrier says.
My sense is that for the recent situation of a coverage being exceeded by the settlement, there was no separate attorney to represent the podiatrist involved. Had there been, the result may have been quite different. The Editor's comments are on target. YOU will be responsible to cover what is not covered by your carrier limits. This is not legal advice. I am not an attorney - all the more reason why you should hire one if you think you need one.
12/02/2013
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: George Vito, DPM
At first thought, the increase in the state law to include ankle privileges is a great milestone, however, nothing is what it appears. Currently (as of Mid-February), there will be about only nine current podiatrists with an active state license who will be able to perform ankle surgery. You must have had:
1) a three-year residency.
2) be board certified in foot surgery AND be...
Editor's note: Dr. Vito's extended-length letter can be read here.
11/25/2013
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Pete Harvey, DPM
It is always a good idea to refer patients to other specialists to obtain more opinions. However, advise the patient to check with the family doctor first. Understandably, family doctors tend to get a little upset if a patient is referred away from their care without their knowledge.
10/21/2013
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Elliot Udell, DPM
When Dr. Sullivan complained about the recommended tests for peripheral neuropathy being 3,600 dollars, my initial reaction was to dismiss his concern, writing that if a patient needs the tests, we had better order them and not worry about the patient's pocketbook. My apologies for being a bit cavalier in dismissing Dr. Sullivan's concerns. In this week's New England Journal of Medicine, Dr. Cheryl Bettigole shares Dr. Sullivan's concerns. She wrote an editorial titled "The Thousand Dollar Pap Smear" where she showed how a test that used to cost 30 dollars is now being billed out by some labs for a thousand dollars.
The author expressed her concerns about the impact of rising laboratory tests on the finances of individuals as wells as on our healthcare system. Dr. Bettigole wrote, "...it is increasingly clear that physicians have an obligation to be good stewards of limited resources to understand the financial effects that the orders we write have on our patients."
10/01/2013
RESPONSES/COMMENTS (MEDICAL/LEGAL ) - PART 2
From: Michael L. Brody, DPM
Unfortunately, simply perforating the disk case with a drill bit a number of times is not sufficient. This is because it is still possible (though unlikely) that data could be retrieved from the disks. I DO NOT recommend this method for destruction of protected health information (PHI).
A few years ago, I 'tested' the sledgehammer method of destroying a hard disk. I hit the disk many times with a heavy sledgehammer. The spindle of the disk broke, and the circuit board was thoroughly fragmented. I then opened the case and found that the platters were still in good shape. I am 6'1" and in fairly good shape, and hit the drives hard.
Based upon my personal experience with testing this method, I strongly recommend that this method not be trusted to destroy PHI. Please either shred the disks or use software that meets the published standards.
01/21/2012
RESPONSES/COMMENTS (MEDICAL/LEGAL )
From: Richard A. Simmons, DPM
Dr. Tip Sullivan wrote of a situation where the family member of a deaf person acted as an interpreter, then presented a bill to the office demanding payment under some ADA guideline. The federal (ADA) guidelines do not support this. It is possible that some states or localities may have stricter requirements than the federal government. To be clear, on the website for the National Association of the Deaf is the following clarification of the rules established March 15, 2011 by the Department of Justice. Specifically, in this situation (a doctor’s office is included in the definition of “public accommodation”):
o Requires that when a public accommodation furnishes auxiliary aids to provide effective communication, it must consider the method of communication used by the individual; the nature, length, and complexity of the communication involved; as well as the context. Further that the public accommodation should consult with the individual with a disability, but the ultimate decision as to what measures will be provided rests with the public accommodation as long as effective communication is provided.
o Requires public accommodations to provide effective communication to families, friends, or associates of individuals seeking access to, or participating in, the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation.
o Prohibits public accommodations from relying on accompanying adults or children to interpret or facilitate communication except in emergencies.
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