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Physicians and Group Practices Archives

What is an “elective” medical procedure?

Governor Greg Abbott recently issued an executive order that requires medical professionals to postpone all surgeries and procedures that are “not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician.”

3 things to know about TMB’s response to Executive Order GA-09

Governor Abbott recently issued Executive Order GA-09 in response to the current coronavirus pandemic. The order essentially requires all licensed health care professionals to postpone elective procedures in an effort to better ensure the availability of hospital facilities and protective equipment to assist those who fighting COVID-19.

TX court allows relief for malicious medical peer review

In addition to years of schooling and practical education, countless examinations and continued education courses throughout one's medical professional life, doctors must also keep their medical license active and in good standing in the state they practice. A failure to do so can end their career.

Judge sentences hospital owner, doctor to prison for fraud

It is not uncommon for physicians to take a business interest in a health care facility. Such business relationships must be entered into carefully or the physician could face allegations of illegal kickbacks and other criminal violations. A recent case provides an example.

Doctors take note: 3 ways to reduce the risk of a med mal suit

Data shows approximately half of all physicians will face a medical malpractice lawsuit at some point during their professional career. Top causes for a lawsuit include a failure to diagnose an illness or a poor outcome after a medical procedure.

Whistleblower lawsuit against neurosurgeons moves forward

Two physicians and an operating room technician filed a whistleblower lawsuit against a group of neurosurgeons and the medical facility where they operated. The whistleblowers accused the medical professionals of falsely inflating the number of spinal surgeries in an effort to increase their earnings and patient referrals. The hospital countered that the practices used were standard throughout the profession. If the whistleblower can support the claim, the allegations result in a violation of the Stark Law and the Anti-Kickback Statute (AKS).

Three things to know about Texas’ new health care billing law

Private practices in Texas must navigate federal, state and local health care regulations. They must stay current and make sure their businesses are in line with any changes to the law. As a result, private practices throughout the state are likely reviewing their billing practices to make sure they are in line with a newly passed law designed by lawmakers to limit surprise billing.

How does the claim CMS overpaid $500 million affect your practice?

The United States Health and Human Services Department (HHS) Inspector General states the Centers for Medicare and Medicaid Services (CMS) overpaid claims by $502 million from 2011 through 2014. The error was allegedly due to a malfunction in the outlier payment review process.

TX physicians take note: New law may impact health care billing

The Texas Legislature has recently proposed a new rule that will limit health billing options. Lawmakers state the new law, scheduled to go into effect January 1, will help protect patients from surprise medical bills. But medical professionals have voiced concern the law may have unintended, negative consequences for patients.

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