• Member Statistics

    • 767,796 Colleagues-to-Date [Sponsored by a generous R&D grant from iMBA, Inc.]
  • David E. Marcinko [Editor-in-Chief]

    As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

    entrepreneur

    Frontal_lobe_animation

  • ME-P Information & Content Channels

  • ME-P Archives Silo [2006 – 2019]

  • Ann Miller RN MHA [Managing Editor]

    ME-P SYNDICATIONS:
    WSJ.com,
    CNN.com,
    Forbes.com,
    WashingtonPost.com,
    BusinessWeek.com,
    USNews.com, Reuters.com,
    TimeWarnerCable.com,
    e-How.com,
    News Alloy.com,
    and Congress.org

    Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

    Product Details

    Product Details

    Product Details

  • CERTIFIED MEDICAL PLANNER® program

    New "Self-Directed" Study Option SinceJanuary 1st, 2018
  • Most Recent ME-Ps

  • PodiatryPrep.org


    BOARD CERTIFICATION EXAM STUDY GUIDES
    Lower Extremity Trauma
    [Click on Image to Enlarge]

  • ME-P Free Advertising Consultation

    The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [770.448.0769]

    Product Details

    Product Details

  • Medical & Surgical e-Consent Forms

    ePodiatryConsentForms.com
  • iMBA R&D Services

    Commission a Subject Matter Expert Report [$250-$999]January 1st, 2019
    Medical Clinic Valuations * Endowment Fund Management * Health Capital Formation * Investment Policy Statement Analysis * Provider Contracting & Negotiations * Marketplace Competition * Revenue Cycle Enhancements; and more! HEALTHCARE FINANCIAL INDUSTRIAL COMPLEX
  • iMBA Inc., OFFICES

    Suite #5901 Wilbanks Drive, Norcross, Georgia, 30092 USA [1.770.448.0769]. Our location is real and we are now virtually enabled to assist new long distance clients and out-of-town colleagues.

  • ME-P Publishing

  • SEEKING INDUSTRY INFO PARTNERS?

    If you want the opportunity to work with leading health care industry insiders, innovators and watchers, the “ME-P” may be right for you? We are unbiased and operate at the nexus of theoretical and applied R&D. Collaborate with us and you’ll put your brand in front of a smart & tightly focused demographic; one at the forefront of our emerging healthcare free marketplace of informed and professional “movers and shakers.” Our Ad Rate Card is available upon request [770-448-0769].

  • Reader Comments, Quips, Opinions, News & Updates

  • Start-Up Advice for Businesses, DRs and Entrepreneurs

    ImageProxy “Providing Management, Financial and Business Solutions for Modernity”
  • Up-Trending ME-Ps

  • Capitalism and Free Enterprise Advocacy

    Whether you’re a mature CXO, physician or start-up entrepreneur in need of management, financial, HR or business planning information on free markets and competition, the "Medical Executive-Post” is the online place to meet for Capitalism 2.0 collaboration. Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds. ******************************************************************** THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
  • OIG Fraud Warnings

    Beware of health insurance marketplace scams OIG's Most Wanted Fugitives at oig.hhs.gov

GROUP “Drop-In” DOCTOR VISITS ARE EVOLVING?

Join Our Mailing List

ST. LOUIS STADIUM VACATED BY RAMS TO BE USED FOR GROUP DOCTOR VISITS

By Winona Woodward [Health TurnUp News]

AFTER THE NFL APPROVED relocation of the Rams football team from St. Louis to Los Angeles, Edward Jones Dome stadium administrators knew they faced a big task in front of them, trying to find a new major tenant for the facility. Stadium officials have just announced the Greater Saint Louis Purchaser and Provider Coalition has entered into an exclusive lease for the stadium to be used for group doctor visits.

Group doctor visits, a relatively new innovation garnering increased interest in the past few years, typically involve up to a dozen patients or so and offer various efficiencies as well as benefits of shared discussion and experiences. Warn Kurter, Executive Director of the Greater Saint Louis Purchaser and Provider Coalition says

“we have decided to take group doctor visits to a whole new level, in partnership with area health plans, employers and providers, to create the world’s largest group doctor visit venue. Now tens of thousands of patients can undergo a visit with a team of doctors stationed at midfield and televised over the JumboTron. How cool is that?”

***

ImageProxy

***

The Coalition’s Kurter points out that the savings in terms of dollars, time and resources from combining patient visits on a group scale in the tens of thousands will be, in Kurter’s words, “Ginormous.” Not only that, but the Coalition has negotiated financial participation in the stadium food and beverage concessions during the group visits, according to Kurter.

“We’re also going to ensure the group visits are produced as an event that patients won’t want to miss. We will start each session with a rousing Star Spangled Banner performed by a major recording artist, and we’ll provide engaging halftime entertainment in the middle of the session while the doctors and their staff take their break,”

Kurter added.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct Details

***

US and International Healthcare Comparison

Join Our Mailing List

By http://www.MCOL.com

As a Percentage of GDP and Spending Per Capita 2013

ImageProxy

Assessment

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct DetailsProduct Details

***

THE REAL BLIZZARD OF 2016 FOR STOCKS

Join Our Mailing List

On Mean Reversion

Michael-Gayed-sepiaBy Michael A. Gayed CFA
[Portfolio Manager]
www.pensionpartners.com

Mean reversion is perhaps the one and only constant when it comes to markets and life.  Mean reversion is as old as the Bible – he who is first shall be last, and last first.  We go from 75-degree weather on Christmas day, to one of the most historic blizzards on the east coast ever nearly a month later.

Somehow, nature (and markets) return to balance by moving from one extreme to the other. Mean reversion is dependable, but tough to remember when living in the extreme.  This is so because it is hard to imagine that everything can change in the not-too-distant future.  When dealing with markets, study after study concludes that if you take the worst performing asset classes, country indices, or strategies over the last three years, the next three years tend to be very good ones.

Fund Flows

Yet, in looking at fund flows for those areas, inevitably most exit those investments towards the tail end of that cycle which did not favor those particular investments. With volatility on-going, it is worth asking if we are on the cusp of a mean reversion moment in quite literally everything.

The iShares MSCI Emerging Market ETF (EEM) is down 8.8% year to date, with the iShares China Large-Cap ETF (FXI) down 12.92%.  Looks like a crisis, until you look at the performance of the US iShares Russell 2000 ETF (IWM) which is down 9.98%.  Emerging markets more broadly are actually down less than the average small-cap US stock despite continuous hammering of the idea that a global slowdown and fears over China are the source of market volatility. The narrative lags reality, no different than how money flows lag in response to changing cycles.

The real blizzard in 2016 is one of significant mean reversion

There are major investment themes which can change this year.  First and foremost is the theme of passive over active.  For the past several years, passive investment vehicles have been all the rage as ETFs of every stripe came out, allowing for more index allocation options.  Indeed, indexing can be a strong strategy, but what is forgotten is that as more money goes into passive strategies, the less money there is taking advantage of active anomalies and opportunities.

Mean reversion here suggests that we may be entering an environment where passive investors don’t perform as well as they had, as new momentum opportunities and risk-off periods allow for tactical trading to really shine beyond the small sample. Whether stocks have bottomed or not is irrelevant for now.

The greatest opportunities will come from 1) avoiding or minimizing the impact of more frequent corrections in stocks (not one week extremes like the start of 2016), and 2) positioning in reflation trades through commodities and emerging markets which have been left for dead as being investable.

***

Bell Curve

***

Should mean reversion begin to take hold this year, betting against those areas can result in significant loss.   Investors in those areas now are suffering and doubting their investments, which may be precisely why tremendous money can be made.

Assessment

As 2016 unfolds, we will continue to address these potential opportunities in our writings (click here to read).  The thing about the future is that it’s hard to predict what happens next…except at extremes.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Top Healthcare Trends of 2015

Join Our Mailing List

By eVisit

A Guide to the Changes

***

Top-Healthcare-Trends-of-2015-Infographic

 ***

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct DetailsProduct Details

***

ON-CALL AND EMERGENCY DEPARTMENT RISKS

Join Our Mailing List 

The  growing revolt

[By staff reporters]

There is a growing revolt of specialists against hospital on-call duties that threatens to violate Federal law and lose status as trauma centers. Specialties most likely to refuse include plastic surgery, ENT, psychiatry, neuro-surgery, ophthalmology and orthopedics.

And, refusing to respond to assigned call is a violation of Federal law and carries fines as much as $50,000 per case.

In contrast, refusing to sign up for call does not violate the law, and more physicians are taking this option. The problem opting-out problem is especially acute in California where hospitals are combating the issues with compensation, reporting the miscreant docs to the authorities, or threatening to remove them from staff completely. In turn, doctors are fighting back with lawsuits.

As an example, essayist Jeff Goldsmith, President of Health Futures Inc, and Associate Professor of Public Health Sciences at the University of Virginia opined back in 1980, that:

*** tracheobronchial+foreign+body+aspiration

[Foreign Body Aspiration]

“We can expect intensified conflict with private physicians over the hospital’s 24-hour mission and service obligation, specifically providing physician coverage after hours and on weekends. Younger physicians have shown decreased willingness to trade their personal time to cover hospital call in exchange for hospital admitting privileges as their elders did. Those admitting privileges are either less essential or completely unnecessary in an increasingly ambulatory practice environment. The present solution is for hospitals to pay stipends to independent practitioners for call coverage or to contract with single specialty groups large enough to rotate call internally.”

Source: Goldsmith, Jeff: The Long Baby Boom, by Johns Hopkins University Press, May 2008.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors

[Best Practices from Leading Consultants and Certified Medical Planners™] Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

***

The PP-ACA’s Impact on Medical Liability Insurance?

Join Our Mailing List 

A SPECIAL ME-P REPORT

robert-cimasi

BY ROBERT JAMES CIMASI; MHA, ASA, FRICS, MCBA, AVA, CM&AA, CMP

HEALTH CAPITAL CONSULTANTS, LLC

www.HealthCapital.com

Aside from differences in insurer behavior, malpractice lawsuit rates, and political responses at the state level, the ACA may also have an impact on the medical liability insurance market. Following several months of partisan controversy and political debate during President Obama’s first term, Congress passed the ACA in March 2010.[1] While not achieving a universal coverage insurance program or a single payor system, the 2010 healthcare reform legislation marked the beginning of a new era in healthcare reform, resulting in a paradigm change in the way healthcare services are delivered and paid for in the U.S.

Some of the ACA’s initiatives have already had significant impact upon many aspects of the healthcare delivery system, including: (1) increased regulatory scrutiny aimed at combating fraud and abuse and antitrust violations; (2) health plan regulation; (3) addressing physician shortages; (4) access to and quality of care initiatives; and, (5) increased attention to public health and wellness activities, among others.[2]

In contrast, the ACA’s impact on the medical liability insurance market, and the medical malpractice system, is relatively unknown. The Medical Liability Monitor’s 2010 annual rate survey noted that 41% of medical liability insurers did not believe that the ACA would impact medical liability insurance markets;[3] however, by 2011, as stated above, this attitude had changed to reflect increasing concerns about provider consolidation and self-insurance for professional liability by providers.[4] These concerns continue to reflect the thinking of medical liability insurers, in part, because there have been few, if any, answers to alleviate their concerns and measure the ACA’s impact on the incidence and cost of medical malpractice.

Some of the medical liability insurer concerns regarding the ACA’s impact stems from the reality that the only one of two sections of the ACA directly relating to medical liability insurance and the current medical malpractice system have been implemented. Section 6801 of the ACA simply provides a policy statement regarding medical malpractice, stating that the U.S. Senate believes that “health care reform presents an opportunity to address issues related to medical malpractice and medical liability insurance,” and encourages Congress, as a whole, to develop demonstration programs with the goal of discovering alternatives to the current civil litigation system for medical malpractice.[5] Additionally, Section 10607 of the ACA authorizes HHS to award grants to states “for the development, implementation, and evaluation of alternatives to current tort litigation” for medical malpractice claims.[6] This section allows HHS to make $50 million available for these demonstration projects subject to Congressional approval.[7] To date, neither Congress nor the President has requested funding for these projects.[8]

Even without these direct impacts, the medical malpractice system may still face changes as a result of the ACA. First, as providers consolidate with larger health systems, medical liability insurers fear the medical liability insurance market “will shrink as their former customers become their competitors.”[9] From 2011 to 2014, medical liability insurers consistently noted to the Medical Liability Monitor that hospital or ACO acquisitions of physician practices act as “the biggest threat to their market share” because of the entity’s ability to better absorb the risk related to malpractice liability.[10] In theory, this ability to absorb medical professional liability risk will allow higher rates of self-insurance, which can affect the rates of straight indemnity insurers.  Second, the number of malpractice claims is expected to increase as more individuals gain health insurance coverage as a result of ACA enactments.

Obama Care

A 2007 Journal of the American Medical Association study concluded that insured persons who suffer a chronic condition receive higher quality and increased care compared to non-insured persons; reinforcing earlier studies suggesting insured persons receive more care than uninsured persons.[11] Building on this premise, a RAND report on the ACA and liability insurance relationships estimated that with the expected influx of newly-insured individuals, particularly in states expanding Medicaid, more physician-patient encounters will increase the volume of overall medical errors, leading to an increase in medical malpractice lawsuits.[12] Consequently, the RAND report estimates that the number of liability payments in medical malpractice actions will increase by 3.4% between pre-ACA insurance plan enrollment and enrollment post-ACA implementation.[13]

Additionally, the RAND report argues that, due to an increase in insurance plan enrollment, medical malpractice payments per claim will actually decrease in states adopting limitations to the collateral source rule. Under the collateral source rule, the damage awards for injured parties do not take into account payments previously received from other sources; consequently, the damage award includes the value of funds collected by another source (e.g., insurance) while allowing the injured party to keep the benefits of that previous value received.[14] In the medical malpractice context, plaintiffs in states adopting the collateral source rule can collect from the physician (or his medical liability insurer) as well as keep the benefits of healthcare reimbursed by their own health insurer. However, some states limit the application of the collateral source rule in medical malpractice cases where the plaintiff’s health insurance already paid for care resulting from the negligent actions of the physician, thereby preventing the plaintiff from receiving this double windfall. As insurance rates rise, RAND estimates that payouts per claim will decrease by 0.6% nationally.[15] Considering the three effects together, RAND projects that total liability claim costs will increase by 2.8% nationally by 2016 as a result of the ACA.[16]

Conversely, other healthcare industry commentators argue that the ACA’s expansion of coverage to previously uninsured individuals, as well as quality of care initiatives, will actually decrease malpractice costs by reducing the number of adverse events suffered by patients.[17] In a 2010 editorial in the Journal of Law, Medicine, and Ethics, Mark A. Rothstein, the Director of Institute for Bioethics, Health Policy, & Law at the University of Louisville – Louis D. Brandeis School of Law, argued that quality and infrastructure initiatives such as increased EHR usage, expansion of outcomes research and use of evidence-based medical standards, and better care coordination, will limit the number of adverse events that provide the basis for a medical malpractice claim.[18] Further, Rothstein posited that, by simply being insured, “significant numbers of injured patients are likely to forego medical malpractice claims.”[19]

Although President Obama signed the ACA in 2010, the effects of this landmark law on the medical malpractice market remain hazy. The current trend toward healthcare consolidation, accountable care, and self-insurance mirrors similar consolidation practices in the mid-1990s, which increased competition in the medical liability insurance market and eroded proper underwriting practices. Nevertheless, other critical ACA effects remain unknown. The impact of the expansion of health insurance coverage will likely remain unclear for the near future because new enrollees began receiving coverage through health insurance exchanges in 2014, limiting the amount of exposure to healthcare interactions that could give rise to an adverse event and result in a medical malpractice suit. Additionally, the average length of litigation surrounding preventable adverse events lasts 43.1 months from the date of the incident to the date of resolution,[20] which limits medical liability insurers from realizing the full costs of a claim and the aggregate of claims in its risk pool.

RISK

Assessment

Now, assuming that increased enrollment does not affect the average length of medical malpractice litigation,[21] the average newly insured person who suffered a preventable adverse event in July 2014 will not resolve his or her claim until March 2018. With this lag time of almost four years between adverse events and claims, it is likely that the full impact of the ACA on the medical malpractice market and medical liability insurance premiums will not be fully known until the next decade.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

References 

[1]      “Patient Protection and Affordable Care Act,” Public Law 111-148, 124 Stat. 119 (March 23, 2010); “Health Care and Education Reconciliation Act” Public Law 111-152, 124 Stat. 1029 (March 25, 2010).

[2]       “Restructuring, Consolidation in Health Care Make Reform Top Health Law Issue for 2010,” By Susan Carhart et al., BNA Health Law Reporter, Vol. 19, No. 5 (January 8, 2010).

[3]       “Now Hard & Crunchy on the Outside: Could Strong Financials be Hiding a Market That’s Growing Soft Within?” By Chad C. Karls, FCAS, MAAA, Medical Liability Monitor, Vol. 35, No. 10, October 2010, p. 4.

[4]       “From Crunchy Candy to Simmering Frogs: Waiting and Hoping for a Hardening Market as the Market Trends Slowly, Steadily Softer,” By Chad C. Karls, FCAS, MAAA, Medical Liability Monitor, Vol. 36, No. 10 (October 2011), p. 5.

[5]       “Patient Protection and Affordable Care Act,” Public Law 111-148, 124 Stat. 804 (March 23, 2010).

[6]       “Patient Protection and Affordable Care Act,” Public Law 111-148, 124 Stat. 1009 (March 23, 2010).

[7]       “Patient Protection and Affordable Care Act,” Public Law 111-148, 124 Stat. 1014 (March 23, 2010).

[8]       “Medical Liability Reform – Demonstration Grants,” American College of Physicians, 2013, http://www.acponline.org/advocacy/where_we_stand/assets/iii12-medical-liability-reform-demo.pdf (Accessed 12/23/14).

[9]       “From Crunchy Candy to Simmering Frogs: Waiting and Hoping for a Hardening Market as the Market Trends Slowly, Steadily Softer,” By Chad C. Karls, FCAS, MAAA, Medical Liability Monitor, Vol. 36, No. 10 (October 2011), p. 5.

[10]     “The Slinky Effect: With Medical Professional Liability Insurance Rates Continuing to – Slowly and Steadily – Decline During the Most Recent Soft Market, It Appears It will Take Several More Years Before the Market Hardens and Rates Accelerate Upward,” By Chad C. Karls, FCAS, MAAA, Medical Liability Monitor, Vol. 39, No. 10 (October 2014), p. 6; “Casualty Actuarial Society Session Debates Potential Medical Professional Liability Implications of PPACA,” Medical Liability Monitor, Vol. 39, No. 7 (July 2014), p. 4.

[11]     “Insurance Coverage, Medical Care Use, and Short-Term Health Changes Following an Unintentional Injury or the Onset of a Chronic Condition,” By Jack Hadley, Ph.D., Journal of the American Medical Association, Vol. 297, No. 10 (March 14, 2007), p. 1080.

[12]     “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 30.

[13]     “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 30.

[14]     “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 18.

[15]     “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 18.

[16]     “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 37.

[17]  “How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?” By David I. Auerbach et al., RAND Corporation, 2014, p. 40-41

[18]     “Currents in Contemporary Bioethics: Health Care Reform and Medical Malpractice Claims,” By Mark A. Rothstein, Journal of Law, Medicine, and Ethics, Winter 2010, p. 871.

[19]     “Currents in Contemporary Bioethics: Health Care Reform and Medical Malpractice Claims,” By Mark A. Rothstein, Journal of Law, Medicine, and Ethics, Winter 2010, p. 872.

[20]     “On Average, Physicians Spend Nearly 11 Percent of their 40-Year Careers with an Open, Unresolved Malpractice Claim,” By Seth A. Seabury et al., Health Affairs, Vol. 32, No. 1 (January 2013), p. 114.

[21]     This assumption is faulty, as it is unknown at this point whether or not claims will increase, whether insurers will or will not enter the market, and whether malpractice caseloads will increase due to the ACA.

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors

[Best Practices from Leading Consultants and Certified Medical Planners™]

   Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

***

On Criminal Penalties for Acts Involving Federal Healthcare Programs

Join Our Mailing List

AN UPDATE

Carol S. MillerBy Carol Miller RN MBA

Individuals and entities are prohibited from “knowingly and willfully” making false statements or presentations in applying for benefits or payments under all federal and state healthcare programs. Individuals also are prohibited from fraudulently concealing or failing to disclose knowledge of an event relating to an initial or continued right to payments. There is also prohibition against knowingly and willingly soliciting or receiving any remuneration (including any kickbacks, bribes, or rebates) directly or indirectly, in cash or in kind, in exchange for referrals. Violations may result in felony convictions with penalties including imprisonment and fines.

Individuals or entities can be excluded from Medicare and Medicaid and more than 200 other federal healthcare programs for a minimum of five years if there is one prior fraud or abuse conviction. Thee exclusions last for ten years and if there are two prior convictions, the exclusion can become permanent. The minimum period of discretionary exclusion is three years, unless DHHS determines that a different period is appropriate.

It is just as important to communicate to the employees when laws or regulations do not impact your organization, such as the Family Medical Leave Act (FMLA), the employment provisions of the Americans with Disabilities Act (ADA) or continuation of health benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA). These benefits apply only to organization with a specific number of employees, so smaller organizations are not necessarily required to offer these benefits.

***

Obamacare

***

However, the Patient Protection and Affordable Care Act (PPACA) provides a slightly different situation for the provider’s practice. PPACA mandated coverage, penalizing employers who failed to provide it, and creating mechanisms for people to pool risk and buy insurance collectively.

Further the Act stated: 1) all individuals not covered by an employer sponsored health plan, Medicare or Medicaid or other public insurance programs such as Tricare to secure an approved private-insurance policy or pay a penalty, unless the individual has a financial hardship or is a member of a recognized religious sect exempted by the Internal Revenue Service and 2) businesses, including larger medical practices which employ 50 or more people but do not offer health insurance to their full-time employees will pay a tax penalty if the government has subsidized a full-time employee’s healthcare through tax deductions or other means.

Assessment

This is known as the employer mandate. What this means for the provider’s practice is that if the provider is offering healthcare benefits to their staff, the coverage needs to be comparable with the requirements stated in the PPACA and if the practice is not offering healthcare benefits, then the practice must direct the individual to one of the Health Insurance Exchanges that are offering individual coverage plans.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors

[Best Practices from Leading Consultants and Certified Medical Planners™]

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

%d bloggers like this: