Category: Healthcare Management

Planning for Life’s Unexpected Turns
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Planning for Life’s Unexpected Turns | Rebecca Eddy

When we are young and fearless, not yet feeling our own mortality, we do very little planning ahead. However, as we grow older and take on greater responsibilities, we begin to address the future differently. We may use that new foresight to develop a retirement plan for when we leave the workforce and create wills to provide for our loved ones when we are gone.  What we often fail to prepare for are circumstances, whether due to an accident, illness, or mental decline, which interfere with our ability to make reasonable decisions and meet our daily needs.

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Subjective vs. Objective Complaints of Pain: What’s the Difference?
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Subjective vs. Objective Complaints of Pain: What’s the Difference? | Evan Schwartz

{4:45 minutes to read} Sometimes insurance companies will require that your subjective complaints of pain be supported by objective evidence. While not legal in all states, there may be a provision in your insurance policy that requires such proof. Insurance law dictates what can and can’t be in an insurance policy. In some jurisdictions, the requirement of objective proof of a subjective complaint of pain is illegal, as it is in New York.

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Long-term Care Insurance: What You Need to Know
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Long-term Care Insurance: What You Need to Know | Evan Schwartz

{4:55 minutes to read} Long-term care insurance is insurance that is available outside of government benefits. It provides the elderly and infirms with various forms of nursing care, home care, and other medical services to assist them as they age. Like many other types of insurance, there are a number of different policy types: Private Individual Private individual long-term care insurance policies are typically more expensive but provide the best benefits.

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The Pitfalls of License Discipline for Healthcare Practitioners
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The Pitfalls of License Discipline for Healthcare Practitioners | Stephanie J. Rodin, Esq.

{4:00 minutes to read} Healthcare practitioners should be careful: What happens with your professional license in one state may affect your existing or future license in another. Many healthcare practitioners have licenses in multiple states. If your license in one state is affected by an action or investigation against you, it’s important to know that there may be reciprocity with other states. While eachstate has their own licensing rules, you may be in breach or there may be implications to other state licenses as well.

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Medicaid and the Undue Hardship Exception
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Medicaid and the Undue Hardship Exception | Ronald A. Fatoullah

By Ronald A. Fatoullah, Esq. and Stacey Meshnick, Esq. {3:51 minutes to read} When an individual in a nursing home applies for Medicaid benefits, the Medicaid agency will examine the applicant’s financial statements to determine if any assets were transferred during the five years prior to application. If assets were transferred to someone other than a spouse or a disabled child for less than fair market value, the agency will impose a period of ineligibility, i.e., a penalty period. The individual will not be eligible for Medicaid benefits and will be required to pay privately until the penalty period expires.

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Long-term Disability — Care and Treatment Appropriate for Your Condition
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Long-term Disability — Care and Treatment Appropriate for Your Condition | Evan Schwartz

{4:00 minutes to read} Most long-term disability policies have provisions which specify that you must be receiving appropriate care and treatment to receive your disability benefits. Long-term disability policies establish this concept through policy language, defining “disability” in a number of ways. For example, 1. Some policies define disability as being unable to perform the material and substantial duties of your regular occupation, and being in the care of a physician.

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Proceed With Caution: What Physicians Need to Know Upon Receipt of a Subpoena
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Proceed With Caution: What Physicians Need to Know Upon Receipt of a Subpoena | Stephanie Rodin

{4:00 minutes to read} Upon receiving a subpoena, an attorney can help physicians proceed properly by providing detailed clarification and explanations while concurrently minimizing precarious errors. Before responding to a subpoena, it is important that physicians are aware of how regulations govern the release of patient information, as well as what circumstances qualify the subpoena as valid and appropriate.

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Websites, Social Media and HIPAA — Do You Know the Requirements?
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Websites, Social Media and HIPAA — Do You Know the Requirements? | Stephanie J. Rodin

{4:40 minutes to read} In this article, I will discuss the requirements for websites & social media to be HIPAA-compliant. As healthcare practitioners already know, the goal of the Health Insurance Portability & Accountability Act of 1996 (HIPAA) is to protect the privacy and security of Protected Health Information (PHI). One thing many do not realize is that HIPAA has some very specific rules about how to protect PHI on the Internet.

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My Facebook Page Can Be Used As Evidence?! I Wish Someone Had Told Me!
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My Facebook Page Can Be Used As Evidence?! I Wish Someone Had Told Me! | Stephanie J. Rodin

{3:40 minutes to read} Twitter. Instagram. Facebook. LinkedIn. Public social media sites are prolific, and their use is increasing in our society. Almost everyone has some type of profile on a social media platform. Sharing information has become as commonplace as breathing; however, unlike the latter, the former has imbedded risks. It is important to not only be cognizant, but to also be cautious, of the content that you put on the internet. Under New York law, any statements or photographs that are posted on social media websites may be discoverable and can then be utilized in trials or legal matters brought against healthcare providers or patients.  

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Eddy & Schein Celebrates 15 Years of Service!
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Eddy & Schein Celebrates 15 Years of Service! | Rebecca Eddy

{4:35 minutes to read} The first seed of Eddy & Schein, Inc. was planted in 1990 when Rebecca was hired by a friend to pay bills while she and her husband were out of the country for six months. She has been Rebecca’s client ever since. Meanwhile, Gideon was caring for his ailing mother, and subsequently her best friend, which was the impetus that led him to take on his first paying client.

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Eager for More Time to Focus on Patient Care? Leave Compliance to Me!
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Eager for More Time to Focus on Patient Care? Leave Compliance to Me! | Stephanie J. Rodin

{3:20 minutes to read} How can healthcare practitioners focus more on helping their patients? The answer: by having an attorney address the business aspect of their practice and handle compliance issues behind the scenes. My prior experience as a malpractice defense attorney afforded me the opportunity to learn and understand how healthcare practices work. It was this position that guided me to open my own practice and concentrate on the overall legal compliance for healthcare providers.

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Profits Before People: An Unacceptable Model for Healthcare
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Profits Before People: An Unacceptable Model for Healthcare  | Ron Katter

{2:25 minutes to read}  Does patient care suffer when a healthcare facility's profit motive conflict with its duty to provide the highest quality patient care? There is evidence that some facilities are cutting corners and rushing patients through the system in order to save money and increase profits.

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Steps To Take Prior To Selling Your Independent Practice
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Steps To Take Prior To Selling Your Independent Practice | Stephanie Rodin

{3:10 minutes to read} When a healthcare practitioner is thinking of their next step in life, regardless of the reason, they have to begin thinking about what to do with their practice. As a healthcare practitioner, if you have contingencies in place with an operating agreement, or if you have a partner, leaving the practice is a lot easier. However, if you are an independent owner – a true sole proprietor – there is more to plan for. You will need to start looking at your practice in terms of its value to a potential purchaser.

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Long-Term Disability and Social Security Disability Benefits: You Can’t Have It Both Ways
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Long-Term Disability and Social Security Disability Benefits: You Can’t Have It Both Ways | Evan Schwartz

{3:25 minutes to read} If you’ve worked and received earnings in the US, you’ve likely paid enough into the Social Security system to qualify for Social Security disability benefits should you become disabled in accordance with their legal definition. If you qualify for those benefits, however, they can have an impact on your long-term disability benefits. The government is becoming extremely stringent in its review of these claims, making it even more challenging to get a claim approved.

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What Is My Occupation? Good Question!
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What Is My Occupation? Good Question! | Evan Schwartz

{3:20 minutes to read} Contained in your disability insurance policy you will find an occupational definition – read it! Some policies have an “own occupation” clause only, stating the insurance company will pay you through the life of your policy if you cannot perform the duties required to do your job. Other policies pay only if you are disabled and unable to perform the duties of “any occupation.” A typical “any occupation” definition states:

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Group Disability Insurance Claim Denied? Get Your Claim File
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Group Disability Insurance Claim Denied? Get Your Claim File | Evan Schwartz

{3:45 minutes to read} Disability insurance exists to protect individuals who get sick or injured and are unable to work. It can be devastating when disability insurance is denied or suddenly discontinued. If this happens to you, it is vital to know your rights before you file an appeal. The federal law, ERISA (Employee Retirement Income Security Act), gives individuals certain rights if a disability claim is denied or terminated. ERISA governs most employer-sponsored, group disability insurance policies in which an individual

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Understanding HIPAA: Is Your Practice a Covered Entity?
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Understanding HIPAA: Is Your Practice a Covered Entity? | Stephanie Rodin

{2:45 to read} Many healthcare providers are subject to the Health Insurance Portability and Accountability Act (HIPAA); however, these laws do not apply to everyone. HIPAA relates to covered entities or business associates acting on behalf of a covered entity, and the law is very particular on what falls into these categories. A covered entity is any healthcare provider that transmitsany Protected Health Information (PHI) in an electronic form in connection with a transaction for which the U.S. Department of Health and Human Services has adopted a standard. A healthcare provider includes any doctors, psychologists, clinics, dentists, chiropractors, nursing homes or pharmacies. In today’s age of technology, there is an increased chance that a healthcare provider will be transmitting this type information electronically, especially to third party insurance carriers, and thus is covered under the act.

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Steps to Take to Avoid a Potential Lawsuit by a Patient
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Steps to Take to Avoid a Potential Lawsuit by a Patient | Stephanie Rodin

{3:15 minutes to read} When running a practice, the practitioner may be presented with the situation where a patient becomes so dissatisfied or so unhappy with their treatment that they ultimately threaten to file a lawsuit against them. Although there is always a risk of litigation, it is common practice for practitioners to become upset or even frustrated when faced with this possibility. The best way to handle this situation is to make sure the patient knows you have their best interest at heart.

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Small, Trusting Practices Need to Know: Paper Trails Are Everything
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Small, Trusting Practices Need to Know: Paper Trails Are Everything | Stephanie Rodin

{2:42 minutes to read} When a practice isn’t large enough to have a dedicated HR department, what happens when an employee starts to make waves in the workplace? I’ve been approached by physicians and dentists of different specialties who have had a dispute that arises with either a current or past employee. Example 1: An employee isn’t fulfilling the job responsibilities they were hired to complete and/or complaints are being made about an employee’s lack of professionalism in the workplace, and thereafter that employee decides to quit. Is the employee entitled to unemployment? Generally, no.

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Anti-Kickback Statutes in New York and Tenant or Subtenant Violations
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Anti-Kickback Statutes in New York and Tenant or Subtenant Violations | Ian Lifshutz

{3:30 minutes to read} This is an analysis of federal anti-kickback statutes and what a landlord/owner or tenant can do to protect themselves from tenant or subtenant violations. 42 USCA 1320a-7b(b) federal law states that no medical provider shall make a referral in exchange for remuneration of any kind, whether directly or indirectly (including non-monetary compensation). In general, most healthcare providers know:

  • They cannot directly take any kind of cash;
  • Accept a reduction in rent; or
  • In the case of a subtenant, charge more in rent,

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The National Practitioner Data Bank: What Does It Say about You?
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The National Practitioner Data Bank: What Does It Say about You? | Stephanie Rodin

What is the biggest threat to physicians, resident physicians and dentists? Not knowing who has access and what gets reported to the National Practitioner Data Bank. What is the National Practitioner Data Bank?  The National Practitioner Data Bank (NPD) is where information is stored regarding settlements, jury verdicts, and any information related to a physician’s or dentist’s licensure.

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Various Entities for Asset Protection: What is potentially the best for you?
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Various Entities for Asset Protection: What is potentially the best for you? | Ian Lifshutz

When structuring and planning any asset protection strategy, one of the more importantfactors is often how the asset protection entity or multiple entity structure is funded. While the funding of the structure itself is of paramount importance, one of the major factors is to create an asset protection structure that titles assets in a manner that takes the equity away from the person who is of primary risk, and whose assets are to be protected.

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The Importance of Minutes
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The Importance of Minutes | Ian Lifshutz

[Time to Read: 2.5 mins]  As we've just ended the year, it is always important to remember to do proper annual minutes for your various business organizations. Many corporations, limited liability companies, partnerships, and other business entities get tied up in other year-end business and ignore what is often perceived as minutia in the recording of annual minutes and year- end operational meetings. Others just forget to do them. Small businesses are particularly susceptible to ignoring this very important corporate obligation and tool.

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How Is Profiting From Non-consensual TV Coverage of a Patient’s Death Not “Outrageous” Enough?
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Tomorrow’s (1/4/15) NY Times has an article entitled “Dying in the E.R., and on TV.” It raises troubling issues concerning patient privacy and the emotional distress suffered by a family already hurt by the death of its patriarch.  In April, 2011, ABC-TV’s hospital-based reality show, “NY Med,” was filming inside NY Presbyterian/Weill Cornell Medical Center the night Mark Chanko was brought in. He had been badly hurt by a garbage truck outside of his Manhattan apartment building, and died later that night when his heart stopped. He was 83.

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Texas Doctors Send a Posse Out After Those No Good, Thievin’ Dentists!
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Would you trust a dentist to diagnose your sleep disorder?  If you said “no,” the Texas Medical Association is on your side, and is taking its concerns to court.  Why, you ask? Because diagnosing and treating sleep disorders is outside the realm and qualifications of dentists–at least it is if you are a physician and member of the Texas Medical Association.

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Will Ohio Doctors Say “It’s My Fault”?
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Words can mean a lot when patients are injured or killed by medical malpractice.  First came the phrase, “I’m sorry,” which I discussed just over one year ago in this post.  Even the medical establishment has recognized the true value of an apology, as they have come to acknowledge that medical malpractice lawsuits are not fueled by greed, but by anger at the failure to even offer these words of comfort after lives have been derailed.

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Changing The Way The Medical Industry Processes Medical Errors
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Patients who become victims of medical malpractice rarely receive an acknowledgement of the mistake, or an apology, according to a new study by Johns Hopkins University School of Medicine. Apparently, only 9% of the patients who participated in the study said that the medical provider/facility voluntarily disclosed the mistake. When harm was disclosed, it was often because the provider was forced to do so. And only 11% of patients reported ever receiving an apology.  

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Tort Reform-The Ugly Elephant In The Room
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The NY Times editorial board has called for increased accountability and transparency in products liability cases–a call prompted by the recent revelations that General Motors, maker of faulty ignition switches that killed drivers,  and Takata, maker of airbags with deadly defects, hid evidence of the defects as consumers continued be to injured and killed.  The editorial has a more expansive view about such secrecy.

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How California Works To Not Improve Patient Safety
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They say you should learn from your mistakes, and they are right. That’s how growth and development happen. But it is hard, and usually impossible, to learn from your mistakes if you don’t know what they are.  So when hospitals fail to report medical errors, or lump all of them together into the nebulous category of “adverse events,” without enough case-specific information to make the reporting useful, improvements in medical care fail to happen. Yet that is exactly what is taking place in California right now, according to this investigative report from NBC News.

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False Advertising Times Three
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Here is a brief roundup of recent news in the area of false advertising.  Two stories concern medical care, and  consumers of medical care ought to know about them.  One delves into the subject of mayonnaise, and whether a certain upstart manufacturer is selling the “real” item. First, from The Center for Public Integrity, comes the troubling news that nursing home care levels may be much lower than families think.

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