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Private Equity in Orthopedics: Before, During, and After the Transaction Webinar Recording

https://www.youtube.com/watch?v=fB23dMzbBtY&feature=youtu.be   As private equity looks to replicate its successes across specialty physician services, significant investment activity has begun to occur in the orthopedic sector. The goal of these transactions is to create an alignment between clinically leading orthopedic groups and private equity firms to position the practice for growth and success in the ever-changing health care environment. This webinar provides an update on the current state of the market,...

New York’s Highest Court Reaffirms that Insurers May Deny Claims from Professional Corporations that are Improperly Controlled by Non-Physicians

New York's Court of Appeals recently upheld prior rulings, statutes, and regulations in order to confirm that only licensed physicians may practice medicine in New York. The Court's ruling in Caruthers v. Progressive Insurance Co. (2019 Slip Op 04643) upheld the finding in the much-cited case of State Farm Mut. Auto. Ins. Co. v. Mallela (4 NY3d 313 [2005]) that an insurer may withhold payment for medical services provided by...

Healthcare Organizations and Entity Types: What You Need to Know About Benefit Corporations

When deciding on an entity type for a healthcare organization, including physician practices and specialty groups like oncology practices, many different aspects of the organization should be taken into consideration, including funding, taxability, profit distribution to owners, social objective/non-profit mission, and limitation on activities, among others. One option, incorporating as a benefit corporation, may legally protect an organization's goals by creating accountability towards the organization's social and environmental commitments. Benefit...

CLIENT ALERT: Compliance with New Jersey’s New Out-of-Network Law

On June 1, 2018, New Jersey Governor Phil Murphy signed the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act" into law.  The law contains a number of provisions which will have a serious impact on all licensed New Jersey healthcare providers, as well as healthcare facilities such as Ambulatory Surgical Centers (ASCs). Many medical practices and healthcare facilities have excellent internal controls ensuring that patients understand their financial commitments,...

New CMS Final Rule Adds Non-Skilled In-Home Care as Medicare Advantage Benefit in 2019

The Centers for Medicare & Medicaid Services (CMS) recently announced a final rule allowing Non-skilled in-home care services as a supplemental benefit for Medicare Advantage (MA) plans in 2019. This is first time CMS has allowed supplemental benefits that include daily maintenance in Medicare Advantage. The announcement is a part of CMS' expanded definition of "primarily health related," which allows supplemental benefits if they compensate for physical impairments, diminish the...