Marshall R. Burack

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New ACA Rules Could Require Broader Provider Networks

“If you like your doctor, you can keep your doctor.” President Obama repeated this assurance to the American public numerous times, and the statement was prominently featured on the White House web site prior to and after adoption of the Affordable Care Act in 2010. The Obama administration is developing regulations to address the concerns … Continue Reading

The Doc Fix: Do We Finally Have a Permanent Solution?

Will physicians finally be free from worrying that their Medicare payments will be severely slashed?  During the first week in February, Republicans and Democrats in the U.S. House of Representatives and Senate agreed on a bill which would repeal the SGR formula and thus avoid the necessity for a recurring, last minute stop-gap fix, known … Continue Reading

Electronic Health Record (EMR) Systems – One of the Many Ways Technology is Changing Medicine

A Conversation with Brian Foster, Director of Client Solutions at CareCloud The availability of incentive payments to providers from the Centers for Medicare and Medicaid Services (CMS) to implement electronic medical records (EMR) systems is a hot topic these days among healthcare providers. Marshall Burack, a partner in Akerman’s Healthcare Practice Group sat down with … Continue Reading

Why Are We Not Surprised? Hospital Charges Are The Largest Driver of Medical Cost Inflation

In a recent front page report, The New York Times provided multiple examples of outrageously high hospital charges and pointed the finger at hospitals for being one of the principal drivers of rapidly increasing healthcare costs. Examples of excessive charges included a charge of $2,229 for three stiches and a charge of $1,696 for a … Continue Reading

Healthcare: It’s Complicated

A popular 2009 movie, called “It’s Complicated,” was about relationships. The title of that movie also applies to solving the problem of providing affordable healthcare in the United States. It’s complicated. A recent article in The Wall Street Journal criticized the Affordable Care Act (a/k/a ObamaCare) as being too complicated. According to the WSJ, “the … Continue Reading

Failure to Comply with Physician Supervision Requirements Can Be Costly

The Department of Justice recently announced two large settlement agreements with provider organizations and individual physicians based on failure to provide proper physician  supervision for diagnostic imaging and radiation therapy procedures. In the first settlement, announced on August 27, 2013, Imagimed, LLC, a New York based diagnostic testing company, and certain individuals formerly associated with the … Continue Reading

Inpatient or Outpatient Surgery: False Claims or Legitimate Difference in Medical Judgment?

It can be financially costly for hospitals to submit claims for inpatient surgical procedures which can be performed safely and effectively as an outpatient procedure. The Department of Justice recently announced a settlement in which 55 hospitals in 21 states agreed to pay a total of $34 million for performing kyphoplasty procedures on an inpatient … Continue Reading

Supreme Court Rules Pharmaceutical “Pay For Delay” Agreements Are Subject to Anti-Trust Review

The Supreme Court struck a blow for consumers when it ruled the Federal Trade Commission may file suit to prevent pharmaceutical companies from agreeing to pay generic drug manufacturers to keep generic drugs off the market for a specified period of time. Federal Trade Commission v. Actavis, Inc. (June 17, 2013). The Court ruled that “pay … Continue Reading

Regulatory Roulette: How Much Will A Violation Of The Healthcare Statutes Cost You? The Answer Is Not Always Clear

Two healthcare cases announced during the first week of April, 2013, vividly illustrate the uncertainty of how much a violation of applicable healthcare statutes or regulations might cost a provider. On April 3, 2013, the Department of Justice announced that Intermountain Health Care, Inc., which operates the largest health system in Utah, had agreed to … Continue Reading

Controlling Healthcare Costs is Key Say Panelists at Akerman’s 2013 Healthcare Briefing

On Friday, March 15, 2013, approximately 100 healthcare executives, physicians and other persons interested in learning about the future of healthcare in Florida, attended Akerman Senterfitt’s second annual Healthcare Briefing at the Westin Hotel in Fort Lauderdale. The Briefing was co-sponsored by BB&T and McGladrey, LLP, and featured a discussion with four prominent Florida healthcare … Continue Reading

Supreme Court Upholds FTC Disapproval of Hospital Merger

In a decision issued on February 19, 2013, the U.S. Supreme Court upheld the Federal Trade Commission’s efforts to prohibit a hospital merger which would substantially reduce competition.  Federal Trade Commission v. Phoebe Putney Health System, Inc. involved the acquisition by a public hospital in Georgia of the only other hospital in the county.  The … Continue Reading

Controlling Healthcare Costs-A New Direction

Historically, federal and state regulations designed to control healthcare costs have focused on preventing fraud and abuse and self-referrals. Prior to adoption of the Patient Protection and Affordable Care Act in 2010, the Anti-Kickback Statute and the Stark Law were probably the most frequently referenced healthcare statutes.  Both of these statutes, which have been in … Continue Reading

OIG Approves Co-Management Arrangement

In its final Advisory Opinion of 2012 (OIG Advisory Opinion 12-22, issued:  Dec. 31, 2012, posted: January 7, 2013), the Office of Inspector General (“OIG”) approved a co-management arrangement in which a hospital paid a cardiology group to manage the hospital’s cardiac catheterization laboratories (the “Arrangement”).  The compensation paid by the hospital included a fixed … Continue Reading