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LAW REPORT
A Newsletter from the Health Care Law Practice Group
LEGISLATIVE ALERT
Editor’s Note… Action Vital to Post Joint Negotiation
Legislation on Assembly Board List
By Alma L. Saravia
Physicians’ efforts are critical to the
T
hrough the efforts of the State’s
physician community, including the passage of this bill and in securing the
New Jersey Association of posting of the joint negotiation bill
Alma L. Saravia Osteopathic Physicians and Surgeons and (which is part of Acting Governor
This new issue of the Health Law the Medical Society of New Jersey, New DiFrancesco’s 24 bill health care package)
Report is dedicated to the State’s 21,000 Jersey is positioned to be the second state on the Assembly Board list.
licensed physicians — physicians who are in the nation to enact joint negotiation You may call or write to your local
calming our fears and treating patients legislation. This important legislation,
concerned about exposure to biological Assemblyman (to find out, for example,
terrorism. Once again, physicians are SCS-1033/1098, passed the Senate, and see NJAOPS web site at ww.njosteo.com),
responding to an unforeseen medical crisis its companion bill ACS/2169/2241/464, or call or write the Speaker to have this
with skill and compassion. Yet, as critical sponsored by Assemblymen Chatzidakis, bill posted on the Assembly board list.
as their care is to the patients’ well-being, Asselta, Doria, Conaway and Connors was The Honorable Jack Collins
physicians are hindered in their ability to released from the Assembly Health 63 East Avenue, Suite C
practice medicine by restrictions placed Committee.
upon them by third parties. Woodstown, NJ 08098-1499
This edition of the Report highlights The legislation would create an Phone: 856-769-3633
legislation that would allow physicians antitrust exemption, through state action Fax: 856-769-0049
and dentists to engage in joint negotiations immunity, to allow physicians and dentists Texas is the first state in the nation to
with managed care entities thereby granting
to negotiate over fee and non-fee based allow physicians to engage in joint negoti-
them more power in the market place.
Also read the update on why a matters with managed care entities. In this ations and a group of physicians have just
compliance plan is something every managed care environment, the ability to been certified by the State Attorney
medical practice must implement. negotiate with a managed care entity will General’s office to engage in negotiations
A summary is included on legislation benefit patients. This legislation allows with one of the large managed care
moving rapidly through the New Jersey physicians and dentists to jointly negotiate organizations. While the managed care
Legislature that will expand the authority with insurance carriers and managed care
of the New Jersey State Board of Medical
organizations are not obligated to negotiate
entities over contractual terms and under these bills, physicians look forward to
Examiners (B.M.E.). The legislation will
also mandate that physicians be required conditions. Physicians need to be permitted the managed care entities’ agreement to
to take continuing medical education to negotiate about such important matters discuss issues of concern to patients and the
courses in order to be a licensee in good as access to health care for their patients. health care delivery system.
standing with the B.M.E. Finally, we
update you on the new Estate Law’s
implications.
Flaster/Greenberg continues to
In This Issue…
lead the way in representing physicians
and other health care companies by Action Vital to Post Joint Pending Legislation Would
providing cutting edge information on Negotiation Legislation on Grant B.M.E. Sweeping
developments at the state and national Assembly Board List ................1 New Authority to Regulate
level. Please visit our web site or call any Physicians ................................2
one of the members of the Health Law Compliance Plans Protect
Practice Group if you have a question Against More Than New Estate Tax Law
about our services. Just Audits ..............................2 Holds Surprises ........................3
A information
about corpo-
rate compliance
to work for a competing practice in the employee’s improper unemployment
same town. The practice sued its former compensation claim. The former
employee for violating his restrictive employee alleged that she was forced to
plans seem to be covenant. In his quit her job due to
everywhere in the defense, the physician fraudulent activities of
health care arena claimed that he was the practice, which, if
these days. This forced to quit because …a compliance true, would have
Stephen M. Greenberg
publication is no of billing fraud com- entitled her to
mitted by his former
plan is important for unemployment benefits.
exception: past issues have addressed
the importance of putting a compliance employer, which, in all physician practices, The provisions of the
plan in place in your practice. (See effect, invalidated his practice’s compliance
“Corporate Compliance Programs Employment regardless of size… plan and her attendance
Provide Best Defense Against Federal Agreement and hence, at training sessions,
False Claims Actions” Issue No. 1, the restrictive covenant. with documentation
Summer 2000; “Office of the Inspector The practice was able to rely on the to that effect, provided
General Mandates Corporate Compliance billing compliance plan it had adopted the practice with an effective defense
Programs for All Physicians” Issue No. to refute the claims of its former against her claims.
2, Winter 2001.) Aside from avoiding employee. The compliance plan stated These examples demonstrate that a
or defending an action by the Office of that all employees were under an affir- compliance plan is important for all
the Inspector General or the Justice mative duty to report any suspected physician practices, regardless of size,
Department, a compliance plan can fraud issues. Moreover, the physician for a variety of reasons. If you are
provide very real benefits where you had signed a statement attesting to the interested in exploring the possibilities
might least expect them, as evidenced fact that he understood this duty and for your practice, please give us a call.
by the following two examples. related plan provisions. The fact that he We can design a compliance plan
In one instance, an employed (i.e., had failed to report the fraud while he tailored to your practice and its individ-
non-owner) physician left a practice was employed invalidated his argument ual needs and assist you in all stages of
and breached the restrictive covenant in that he had to quit because of the its implementation.
www.flastergreenberg.com
PRSRT STD
U.S. POSTAGE
PAID
Bellmawr, NJ
Permit No. 247
BREAKING NEWS
NJ Governor-Elect
Jim McGreevey has
named Alma L. Saravia, an
attorney with the Health
Care Practice Group of
Flaster/Greenberg, to
co-chair the transition
committee for the
Department of Human
Services.
Office Locations
Commerce Center 190 S. Main Road Health Care Law
1810 Chapel Avenue West Vineland, NJ 08360
Cherry Hill, NJ 08002-4609
(856) 661-1900
(856) 691-6200 Practice Group
216 North Avenue Kristine M. Byrnes
Three Mellon Bank Center Cranford, NJ 07016 Richard J. Flaster
Thirty Ninth Floor (908) 245-8021 Kenneth S. Goodkind
1735 Market Street Stephen M. Greenberg
Philadelphia, PA 19103 2900 Fire Road, Suite 102A Pasquale Guglietta
(215) 569-1022 Egg Harbor Township, NJ 08234 Markley S. Roderick
(609) 645-1881 Steven B. Sacharow
Alma L. Saravia
Laura B. Wallenstein
Alan H. Zuckerman
Practice Areas
Business and Corporate Services • Taxation • Commercial Litigation
Commercial Real Estate • Land Use • Construction Law • Environmental Law
• Employment and Labor Law • Closely-Held and Family Businesses • Visit our Web site at:
Technology and Emerging Businesses • Securities Regulation • Bankruptcy
• Financial Work-Outs • Health Care • Pension and Retirement Plans • www.flastergreenberg.com
Estate Planning and Administration • Family Law and Adoption