Health Law Attorney Blog

One of HLP's founding partners, Adrienne Dresevic, Esq., who specializes in Stark and fraud & abuse analysis, published a new article in the latest issue of the RBMA Bulletin, a publication of the Radiology Business Management Association. Adrienne's article, entitled "Key Regulations Impacting Marketing: Entertainment and Gifts," explains the regulatory limitations placed on health care professionals when marketing, and is a must-read for physicians and other providers trying to expand their business.

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As a service to our clients and friends in NY, we are reproducing the notice circulated by the Medical Society of the State of New York urging all interested constituents take action to prevent the proposed 21% reduction in Medicare physician reimbursement. "On February 28, the two month extender of the current Medicare > conversion factor expires. If this is allowed to happen, it will > result in a 21% cut to Medicare physician reimbursement. This could devastate senior access. Congress must act to prevent this from > happening. The American Medical Association and MSSNY continue to push for repeal of the unfair SGR formula used for determining Medicare reimbursement updates. While several proposals are under consideration in Congress which would prevent this cut, including another short-term extender to a time later in the year, no action has yet been taken. Physicians are urged to call the AMA Grassroots Hotline, 1-800-833-6354, to contact Senators Schumer and Gillibrand, as well as their respective member of the House of Representatives, to urge a long-term fix to this problem. Time is running out, so please act now."

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HLP is pleased to welcome a new addition to our growing firm, attorney Kathryn Hickner-Cruz, formerly of Hall, Render, Killian, Heath & Lyman, P.C. Kathryn specializes in health care corporate matters, including fraud and abuse, mergers and acquisitions, and private offerings, and has significant experience in federal and state health care law compliance matters. The Health Law Partners, P.C. is excited to have her on our team of lawyers who specialize in the business of health care.

The January 2010 issue of Link, the online journal of the AHRA, is now available. This issue includes a new column called Regulatory Review, the first installment of which is called "Healthcare Marketing--Navigating the Regulatory Landscape." The column, to be a regular feature in Link, is authored by The Health Law Partners' Adrienne Dresevic and Carey Kalmowitz. In the article, Dresevic and Kalmowitz provide an overview of the legal risks that radiology providers should consider when constructing their marketing programs, together with detailed guidance on mitigating those risks.

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The Health Law Partners, P.C. is growing. We recently exercised the option to expand into neighboring office space in our Southfield headquarters. We've also added staff, and are pleased to welcome attorney Adele Jorissen as a new associate. Adele has previous healthcare law experience, and will be practicing in all of HLP's specialty areas.

Health Law Partners Adrienne Dresevic and Carey F. Kalmowitz published an article in Link, the American Healthcare Radiology Administrators (AHRA) member newsletter, which discusses current application of the Federal Stark law. The article addresses the In-Office Ancillary Services Exception (IOASE), which many office-based diagnostic imaging arrangements rely upon to enable referring physicians to provide ancillary services within their practices. Without such an exception, the Stark law prohibits physicians from referring Medicare patients to entities that provide designated health services (DHS) if the physician has a financial relationship with that entity. Ms. Dresevic and Mr. Kalmowitz explain that despite attempts to restrict or eliminate the IOASE, it still continues to permit appropriately structured diagnostic imaging arrangements in the physician office setting.

To read the Link article, please click here.

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On August 3-4, 2009, Abby Pendleton, Esq. will speak at the World Research Group's Healthcare Management Conference titled "Preparing for the Next Round of Medicare RAC Reviews." Ms. Pendleton, a founding member of The Health Law Partners, P.C., will present among several experts in the field of Recovery Audit Contractors. She will discuss how to manage the RAC appeals process.

Ms. Pendleton has authored numerous publications regarding the RAC program and successfully appealing Medicare claim denials. These publications include:

"Recovery Audit Contractors And Medicare Audits: What Can Hospitals and Health Systems Expect as the RAC Program Expands Nationwide?" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., American Health Lawyers Association, Hospitals and Health Systems Practice Group Member Briefing, January 2009.

"Get Ready -- Recovery Audit Contractors Are Coming to Michigan," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 4, No. 4, Winter, 2009.

"RAC to the Future: What Can Medicare Providers and Suppliers Expect from the Recovery Audit Contractor Program?" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., The Health Lawyer, The ABA Health Law Section, Vol. 21, No. 2, December, 2008.

"The RACs Are Coming - Are You Ready?" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., The RAP Sheet, American Health Lawyers Association, Regulation, Accreditation and Payment Practice Group, December 2008.

"Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Caring, National Association of Home Care and Hospice, November 2008.

"Get ready for increased nationwide Medicare audit activity," co-authored: Abby Pendleton, Esq., and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 3, No. 3, Fall, 2007.

"Get Ready: The RACs May Be Nationwide Sooner Than Expected!" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., HCCA Compliance Today, 2007.

For more information about the World Research Group's Healthcare Management Conference, please click here.

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On May 12, 2009, Robert S. Iwrey, Esq. will present to members of the Oakland County Medical Society and Oakland County Bar Association. Mr. Iwrey, one of the founding shareholders of The Health Law Partners, P.C., will co-present with Virginia Trzaskoma, the Assistant Attorney General of the State of Michigan. They will discuss the interaction of physician licensing and discipline and criminal investigations and prosecutions.

Mr. Iwrey presently chairs the Oakland County Medical-Legal Committee.

For more information regarding the Oakland County Medical Society, please click here. For more information regarding the Oakland Country Bar Association, please click here.

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On March 31, 2009, Adrienne Dresevic, Esq., one of the founding shareholders of The Health Law Partners, P.C., presented to members of the Radiology Business Management Association ("RBMA") on the topic of "Regulations Impacting Healthcare Marketing." The presentation addressed the following healthcare legal topics:

• Federal Stark Law;
• Federal Anti-Kickback Statute;
• Civil Monetary Penalties Law;
• Independent Diagnostic Testing Facility ("IDTF") Regulations; and
• The Health Insurance Portability and Accountability Act ("HIPAA").

RBMA was founded in 1968 and is a radiology-specific business organization with over 2,200 members. According to its website, the mission of RBMA is to provide its members with information, resources, education and networking to run successful radiology businesses. Ms. Dresevic presented as part of the Building Better Radiology Marketing Programs conference. For more information regarding RBMA, please click here.

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