LEGAL: Pro Hac Vice Defined

Posted on December 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Pro hac vice is Law Latin that means “for this time [only]” (literally, “for this turn”). When a lawyer is admitted to a case pro hac vice, a court has granted them a limited license to practice in a jurisdiction where they otherwise would not be licensed to do so.

For example, a lawyer licensed only to practice in California may nonetheless practice in a New York case once a court has granted them admission pro hac vice, so long as the lawyer practices only within the limited scope of their pro hac vice admission. In almost all U.S. jurisdictions, lawyers who practice pro hac vice must do so in conjunction with a local lawyer acting as local counsel. Local counsel typically acts as an anchor to the bar of a foreign jurisdiction, exposing local counsel to liability for the acts or omissions of the lawyer admitted pro hac vice. Local counsel therefore usually assumes, at a minimum, a role of monitoring the lawyer admitted pro hac vice.

READ: https://www.law.cornell.edu/wex/pro_hac_vice

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DAILY UPDATE: Anthem BCBS Controversy as Stock Markets End Flat

Posted on December 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Stocks ended the session little changed on Friday despite Broadcom’s (AVGO) jump to all-time highs driven by the chipmaker’s bullish AI-fueled sales forecast.

The S&P 500 (^GSPC) closed flat while the tech-heavy NASDAQ Composite (^IXIC) gained 0.1%. The Dow Jones Industrial Average (^DJI) slipped 0.1%

CITE: https://tinyurl.com/2h47urt5

The fight between payers and anesthesiologists isn’t over, despite Anthem Blue Cross Blue Shield (BCBS) reversing plans for a policy that would put time limits on commercial claims for anesthesia coverage. The policy would have set a time limit for claims by procedure, with the exception of maternity and pediatric care, in New York, Connecticut, and Missouri starting next year. It called for providers “requiring more time than set or recommended by these standards” to undergo the insurance company’s claim dispute process in order to get paid, according to a statement Anthem provided to FOX61 in November.

The plan received backlash from everyone, from anesthesiologists to New York Governor Kathy Hochul.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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DAILY UPDATE: Stock Markets Slide

Posted on December 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

FRIDAY 13th = Triskaidekaphobia

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The Dow Jones Industrial Average (^DJI) was down and the S&P 500 (^GSPC) were both about 0.5%. The tech-heavy NASDAQ Composite (^IXIC) fell roughly 0.6% while shares of Apple (AAPL) rallied less than 1% to close at a record high.

In bonds, the 10-year Treasury yield (^TNX) added 5 basis points to hit 4.32%, its highest closing level since November 22nd.

CITE: https://tinyurl.com/2h47urt5

On a day where President-elect Donald Trump rang the opening bell at the New York Stock Exchange, Wall Street failed to build on a furious rally that has picked up steam after his election win. In focus was fresh inflation data, which helped cast doubt on investor confidence for the path of interest rates ahead.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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INCENTIVE BIAS? In Medicine and with Physicians?

Posted on December 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

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Incentives: It is broadly accepted that incenting someone to do something is effective, whether it be paying office staff a commissions to sell more healthcare products, or giving bonuses to office employees if they work efficiently to see more HMO patients.  Some experts even suggest there are five specific components1 that should be built into an overall physician incentive program:

  • Appropriate financial incentives.
  • Managed-care efficiency incentives.
  • Group citizenship.
  • Patient satisfaction.
  • Group profitability.

What is not well understood is that the incentives cause a sub-conscious distortion of decision-making ability in the incented person.  This distortion causes the affected person – whether it is yourself or someone else – to truly believe in a certain decision, even if it is the wrong choice when viewed objectively.  Service professionals, including financial advisors and lawyers, are affected by this bias, and it causes them to honestly offer recommendations that may be inappropriate, and that they would recognize as being inappropriate if they did not have this bias. 

According to colleague Dan Ariely PhD, the existence of this bias makes it important for each one of us to examine our incentive biases and take extra care when advising physician clients, or to make sure we are appropriately considering non-incented alternatives.

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DAILY UPDATE: Winter

Posted on December 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Happy First Day of Winter

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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KENNETH ARROW: Information Paradox

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

To sell information you need to give it away before the sale

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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THE FATHER OF HEALTH ECONOMICS

According to Wikipedia, a fundamental tenet of the paradox is that the customer, i.e. the potential purchaser of the information describing a technology (or other information having some value, such as facts), wants to know the technology and what it does in sufficient detail as to understand its capabilities or have information about the facts or products to decide whether or not to buy it. Once the customer has this detailed knowledge, however, the seller has in effect transferred the technology to the customer without any compensation. This has been argued to show the need for patent protection [HIPPA].

CITE: https://www.r2library.com/Resource/Title/0826102549

If the buyer trusts the seller or is protected via contract, then they only need to know the results that the technology will provide, along with any caveats for its usage in a given context. A problem is that sellers lie, they may be mistaken, one or both sides overlook side consequences for usage in a given context, or some unknown-unknown affects the actual outcome.

MORE :https://www.nobelprize.org/prizes/economic-sciences/1972/arrow/facts/

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DAILY UPDATE: Record Stock Market Blast Off Post Trump Presidential Election

Posted on November 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Stocks Up

  • One more group of stocks that soared on a Trump election: Big Tech companies with antitrust problems. Another Trump presidency should go a long way toward clearing up the regulatory hurdles many companies have faced recently, which is why Alphabet popped 3.99% and Amazon rose 3.8%.
  • CVS Health surged 11.33% after meeting revenue forecasts but missing earnings expectations. However, the miss was due to a one-time charge, so shareholders quickly forgave the healthcare retailer.
  • Planet Fitness gained 6.09% on a surprise bid for bankrupt fitness chain Blink Holdings in an attempt to bolster its own gym business.

Stocks Down

  • Super Micro Computer had a chance to show the world it wasn’t committing the fraud it has recently been accused of. Instead, the company announced it is still unable to determine when it will file the quarterly report due August 29. Shares crashed 18.05%.
  • Home builder stocks sank on fears that a Trump presidency will slow the rate of Fed rate cuts, keeping mortgage rates higher for longer. DR Horton fell 3.8%, Lennar dropped 4.84%, Pulte Group lost 3.09%, and Toll Brothers tumbled 1.46%.
  • Cannabis stocks were betting big on a ballot measure in Florida to allow the sale of recreational marijuana. The initiative’s failure sent shares of Curaleaf plummeting 29.17%, Trulieve Cannabis plunged 38.8%, and Ayr Wellness sank 55.87%.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 146.28 points (2.53%) to 5,929.04; the Dow Jones Industrial Average® ($DJI) added 1,508.05 points (3.57%) to 43,729.93; and the NASDAQ Composite® ($COMP) gained 544.29 points (2.95%) to 18,983.47—a new closing high. 
  • The 10-year Treasury note yield (TNX) surged 14 basis points to 4.43%, its highest level since July.
  • The CBOE Volatility Index® (VIX) fell sharply to 16.3 as election-related uncertainty diminished.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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DAILY UPDATE: Ikea & Fidelity Investments with SPX Bank at New High

Posted on October 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Ikea’s revenue fell for the first time in four years after it lowered prices to spark an increase in orders.

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Stocks up

Stocks down

  • Stellantis continued to tumble today, falling another 2.22% after the carmaker announced its CEO will step down in early 2026.
  • A.O. Smith probably doesn’t ring a bell, but there’s a good chance they made the water heater in your basement. Unfortunately, they’re not selling too many these days, and shares sank 6.25% after the company cut its full-year outlook.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The SPX rose 34.98 points (0.61%) to 5,815.03 to end the week up 1.11%; the $DJI added 409.74 points (0.97%) to 42,863.86 to end the week up 1.21%; and the $COMP gained 60.88 points (0.33%) to 18,342.94 to end the week up 1.13%.
  • The 10-year Treasury note yield (TNX) fell two basis points to 4.07% but rose nine basis points this week.
  • The CBOE Volatility Index® (VIX) slipped to 20.41, still up slightly for the week.

CITE: https://tinyurl.com/tj8smmes

Fidelity Investments has notified 77,099 people that their personal information was stolen in an August data breach. he mega asset manager has not disclosed what data the digital crooks nabbed, but assured customers that the security snafu “did not involve any access to your Fidelity account(s).” But hey, no worries, the firm claimed no evidence of data misuse.

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Stocks, Oil, Gold and Bitcoin

Posted on October 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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  • October continues to be a tough month for stocks, with all three major indexes spending yesterday afternoon in the red. The Dow in particular had a horrible day and dropped over 500 points, while major tech stocks were pushed lower by a series of analyst downgrades.
  • Oil continued its hot streak yesterday, rising above $77 on the back of geopolitical conflict in the Middle East. That helped ensure that, while everything else fell, energy was the only positive sector in the S&P 500.
  • Gold has often found itself rising in tandem with crude, though it broke that habit, with the shiny safe haven dropping a hair as investors digest the idea that the Fed’s next interest rate cut may be smaller than they thought.
  • Bitcoin broke above $64,000 for a moment yesterday only to be yanked back down, as crypto traders ride out the recent volatility.

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A Doctor – Economist’s Solution for Health Reform

Posted on July 1, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

My Laundry Wish List for all US Healthcare Stakeholders

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Fox News

As President Obama spoke, prodded and cajoled for Congress to pass HR 3200-3400 in 2008, I believe that for any healthcare reform effort to work successfully for the American people – for the long term – we need to consider the following in no particular prioritized order:

  • Insurance portability uncoupled from patient employment
  • Health insurance regional exchanges with inter-state purchase competition
  • Doctor, drug, DME and hospital pricing and payment transparency for HSAs, and all of us
  • Modifying or eliminating AMA owned CPT Codes®; a huge money maker for them
  • Abandoning ala’ carte medicine for values-based outcomes
  • Reduce JCAHO influence; encourage competition from Norwegian Det Norske Veritas [DNV]
  • Reduce big-pharma influence thru-out the entire medical education, career and care pipeline
  • End DTC advertising from big-pharma
  • Promote wholesale drug purchase competition, MC bidding and generic drugs
  • Encourage evidence-based medicine, not expert-based medicine
  • Less pay for medical specialists with a  re-evaluation of the hospitalist concept
  • Advance the dying art of physical diagnosis, teach and embrace Paretto’s 80/20 rule for clinic issues
  • Reduce lab test, diagnostic imaging and testing
  • Encourage private 24/7/365 medical offices and clinics; and on-site and retail clinics
  • Abandon P4P, medical homes and disease management ideas
  • Give more economic skin-in-game to patients relative to health benchmarks
  • Concretize the “never-event” prohibitions and include a list of patient health responsibilities
  • More pay for primary care docs and internists
  • Adopt digital records and cloud computing for patients
  • Phase in true eHRs incrementally; and abandon CCHIT for open source SaaS
  • Promote Health 2.0 social media.
  • Augmented scope of practice, numbers and pay for NPs and DNPs, etc
  • Reduce pay for CRNAs and increase it for staff RNs
  • Develop step down triage and treatment units to reduce the number of full service ERs
  • Increase medical, osteopathic, dental, optometric and podiatric medical school classes
  • Increased practice scope for dentists, podiatrists and optometrists
  • Make some sort of catastrophic HI mandatory, much like auto insurance for all
  • End pre-existing conditon health insurance contract clauses
  • More choice  and end of life control for the terminally ill patient
  • Increase marketplace competition with fewer political and financial “externalities”.
  • Teach basic healthcare topics in school and encourage physical exercise
  • Health and insurance education should be, but is not, the “answer” for Americans
  • Protect borders and discourage undocumented illegals
  • Adopt medical malpractice tort reform
  • Make all stakeholders fiduciaries
  • No public “option” unless you like food stamps, Section 8 housing, public transportation and schools
  • Budget deficit neutrality
  • Slow down!

Assessment

Recently, while in the Baltimore/Washing area, I was asked by several reporters to opine on the healthcare debate; which I did so freely having never been known as the shy type. And, regular readers will note that many of these items have been used as posts or comments on this ME-P. Unfortunately, my “laundry list” interview was pre-empted by two local but boisterous town-hall meetings with respective passionate politicians. It was redacted no doubt, but never broadcast. Thus, I missed the potential for my “five minutes” of fame. C’est la vive!

Conclusion

There you have it; direct and straight forward. And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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The STEP-UP In Investment Value?

Posted on April 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the TAX loophole of a ‘step up’ in BASIS value

By Dr. David E. Marcinko MBA CMP®

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The term “step-up” refers to the difference in value and tax liability that an asset has when it is acquired and when it is transferred to an inheritor.

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CITE: https://www.r2library.com/Resource/Title/0826102549

EXAMPLE #2: The proverbial millionaire Doctor Joe, for example, could buy a home for $350,000 and sell it for $1 million, after which he’d pay taxes on the $650,000 gain. But if Dr. Joe passes the home onto his daughter Ella, and she has it appraised at $1 million, its value has taken a “step up” in value to $1 million. If Ella sells the home for $1 million or less, she wouldn’t owe anything in taxes.

ASSESSMENT: For billionaires like Jeff Bezos, Bill Gates and Elon Musk who earn far more through their investments than their salaries, this loophole is a perfect way to shield their wealth. Intergenerational wealth has contributed to surging inequality in America, which grew wider during the pandemic. Since 2019, the wealth of the top 400 richest people in the US increased by $1.4 trillion, per research from Gabriel Zucman and Emmanuel Saez, a pair of left-leaning economists at the University of California, Berkeley.

“Often, for these people, wealth accumulates tax-free their entire lives,” Frank Clemente, executive director at the left-leaning advocacy group Americans for Tax Fairness, opined. President Joe Biden proposed ending this loophole and making billionaires “pay their fair share,” so why does it look like his party won’t touch it?

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How Much are the 2012 Presidential Candidates [Net] Worth?

Posted on March 6, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

Surprised or Not?

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As the presidential election continues to heat up for “Super Tuesday” this March 6th 2012 – and candidates are weeded out – we look to their bankrolls to learn who has the most cash in the bank, and who’s funding their campaigns.

Source: creditsesame.com

Assessment

From small donors to large, and donations from men versus women, do these numbers surprise you?

Conclusion

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NEW: Health Industry Indignation Index

Posted on February 13, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Foibles of Industry Movers-Shakers

New Beta Feature

By Staff Reporterssubmission-frenzy3

What it is – How it works

The Industry Indignation Index [III] is an occasional survey feature of the Medical Executive-Post. Our goal is to chronicle the dubious, ironic or humiliating behavior that we humans in the healthcare industrial, financial and health economics complex are prone to do or say. Related sectors are fertile topics, as well.

Our Industry Indignation Score Card

The mathematical scores measured on a scale of 1 [just smelly and cheesy] – to 100 [utterly indignant and totally shameless] are subjective and not-statistically significant. They are non-representative samples however, of the obnoxious behavior of some in the news and their public foibles. 

User Generated Content

Feel free to send in your items, stories or political gossip for consideration.  We will rate-em, rank-em, post-em, and do the rest for you!

Conclusion

And so, your thoughts and comments on this new Medical Executive-Post feature are appreciated.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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