Exciting news for those in the PSO world! The United States Court of Appeals for the Eleventh Circuit issued an opinion (In re Baycare Medical Group, 101 F.4th 1287 (11th Cir. 2024)) on May 14, 2024 that expands the scope of information, known as “Patient Safety Work Product,” protected by the Patient Safety and Quality Improvement Act (“PSQIA”). The Court rejects the “sole purpose” test articulated by other courts and the Department of Health and Human Services (“HHS”), finding that the test and HHS’s guidance “contradicts” the PSQIA’s final regulations. The “sole purpose” test was extremely limiting in what providers could categorize as Patient Safety Work Product because the information had to be generated solely for reporting to a PSO.  Now, with the Eleventh Circuit’s rejection of the test, it allows additional types of information to qualify as Patient Safety Work Product.  Join Horty, Springer and Mattern partners Dan Mulholland and Charlie Chulack for a discussion of the PSQIA, the “sole purpose” test, the In re Baycare Medical Group case, and how the opinion will affect PSOs, and providers that contract with PSOs, during the podcast “Patient Safety Organizations – New Court Case Provides New Opportunities.”

HortySpringer attorneys Henry Casale and Hala Mouzaffar take a look at three clinics in rural Alabama to see how a physician’s disregard of warnings that her clinics were committing fraud led to the fall of the clinics, the physician, and the physician’s wife.  

Listen now to this episode of the The Kickback Chronicles to see what you can learn from the misfortune of others. 

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into the case of a seasoned professional who found himself in the middle of not one, not two, but three different fraudulent healthcare schemes. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.

It has been a longstanding practice within Hospitals across the U.S. for medical students and other practitioners-in-training to perform pelvic and other sensitive examinations on patients, most of whom are under anesthesia, without their explicit consent. Join Hala and Mary as they discuss the growing movement to better police this practice and how, as a result of mounting public scrutiny, it has caught the attention of CMS. 

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a look at how some not-so-routine drug testing landed two providers in hot water. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.

When hospitals and health systems are pursuing a merger or affiliation, there is a natural tendency to move things along quickly. While it is ok to conduct due diligence, explore potential efficiencies and plan for what might be possible if the affiliation takes place, the parties need to refrain from acting like they are already affiliated, implementing plans or sharing competitively sensitive information such as payor contracts until the deal is done. To do so could constitute unlawful “gun jumping” in violation of federal antitrust rules, possibly subject the parties to fines and other penalties or even derail the transaction. This podcast will summarize the gun jumping rules with suggestions about how to keep out of trouble.

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar turn their attention to a small town in Tennessee to look at a provider that helped exacerbate the opioid crisis in his community for fame and fortune.  

Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.

Two recent lawsuits decided by Utah courts draw attention to the importance of strong, broad release language protecting physician leaders who volunteer to participate in credentialing, peer review, and other medical staff activities. In both cases, the physicians challenging peer review activity argued that the release language set forth in the Medical Staff Bylaws should not be applied to block their claims. One aggrieved physician claimed that the release language only applied to formal review and not collegial intervention efforts. The other claimed that the release language should not apply because the leadership allegedly violated the Bylaws while conducting peer review. In the end, good release language saved both hospitals and their leaders from more protracted litigation. When it comes to release language, bigger is better. Learn more about these cases and releases on this short podcast.

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take their first look at for-profit hospitals to discuss a unique case involving a hospital, its investors, and an attempt to avoid repaying Medicare.  

Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others. 

CMS recently clarified that physicians can give orders via test in hospitals and critical access hospitals.  But the texts have to be through a secure system, and computerized physician order entry is still preferred. Join HortySpringer attorneys Dan Mulholland and Mary Paterni as they discuss this new CMS guidance and also talk about the dangers of texting in general.