Categoris

100 Great Reasons To Read Blawg Review #100

Sunday, March 18, 2007

Don't miss the special 100 anniversary edition of Blawg Review hosted by it's anonymous editor. This week's edition features posts from the past 100 hosts of Blawg Review. Blawg Review is a featured "blog carnival" this week at BlogCarnival.com.

A quick thanks to the Editor for allowing me the opportunity to host Blawg Review #44 and Blawg Review #97.

WV Passes (Almost) E-Prescribing Bill

Thursday, March 15, 2007

The West Virginia Legislature passed (almost) SB 69 (HB 2289) allowing West Virginia to join the majority of states that allow e-prescribing. It appears that technical errors that occurred as a result of the House and Senate mistakenly passing separate versions of the bill will be cleaned up in a special session on the state budget.

For more information check out the State Journal article, E-Prescribing Soon to Be Reality in W.Va. or iHealthBeat article, West Virginia Likely to Pass E-Prescribing Bill.

Charleston Area Alliance: The Value of Blogging In Business

Tuesday, March 13, 2007

The Charleston Area Alliance will be holding its CEO Roundtable Luncheon on April 4 where the topic for discussion will be "The Value of Blogging In Business."

I will be participating on a panel of Charleston area business bloggers along with Matt Ballard, CEO of the Charleston Area Alliance who blogs at the CAA Blog and Skip Lineburg, Chief Creative Officer of Maple Creative who blogs at Marketing Genius from Maple Creative.

I'm looking forward to sharing my ideas on business blogging and providing some practical tips to help local CEOs, professionals and other small business owners leverage the use of blogs in today's business market.

For more information about the event and how to register go to this link. The event is limited to 30 participants so don't wait to register.

The Ying and Yang of Health Privacy

Christina's Considerations posts a quote by Dr. William Yasnoff from a recent New York Times article, Warnings Over Privacy of U.S. Health Network. The quote caught my eye because it highlights what I'll refer to as the ying and yang involved in the conversion to a more comprehensive interoperable health information system and how you and I as patients may react.

The quote reads:

"Anything you do to make information more accessible for good, laudable purposes will simultaneously make it more accessible for evil nefarious purposes. People intuitively understand that, and they are worried."
Those of us working on health privacy and e-health issues should regularly consider and reassess this principal as we move forward to transform the way health information is collected, stored, used, disclosed and aggregated. Over the years to come health lawyers will play an increasingly important role in the process of addressing legal issues that arise from the concept highlighted by the quote.

One Space or Two?

For years I've thought I was right on this one -- but finally -- proof. Should you use one space or two spaces after a sentence? Adams Drafting has the answer in this post, "One Space or Two?".

I can't tell you how many legal secretaries I've tried to convince to stop hitting the space bar twice. I use full margin justification for my legal contracts and documents and adding two spaces after a sentence can leave too much white space between sentences. I remember taking typing in high school and being taught the two space bar rule after each sentence -- but that was on a manual typewriter.

For this and other great posts on contract drafting be sure to check out Adams Drafting, a great lawyer niche blog on contract drafting. I've been a regular RSS reader for a number of months.

Thanks to Alaina Crislip for pointing me to this post.

The False Claims Act: Recent Changes Affecting Health Care Entities

Tuesday, March 6, 2007

Amy Rothman, an attorney in the health care practice group at our firm recently authored an article on the False Claims Act and recent changes brought on by the Deficit Deduction Act of 2005 and West Virginia's fraud and abuse statute that will appear in the Spring 2007 edition of the Defense Trial Counsel of West Virginia Newsletter. Congratulations to Amy on a great article.

The article is titled, The False Claims Act: Recent Changes Affecting Health Care Entities

The False Claims Act (“FCA”), 31 U.S.C. § 3729 et seq., was enacted in 1863 during the presidency of Abraham Lincoln. The FCA, also known as the Lincoln Law, was established to prevent pricing fraud by persons and companies selling supplies to the Union Army during the Civil War. The original FCA contained a qui tam provision that allowed citizens, on behalf of the United States, to sue companies or individuals for false or fraudulent billings submitted to the government. The current version of the FCA still allows for qui tam actions for false or fraudulent claims. While the FCA applies to any false claim submitted to the United States government, the FCA has been actively used as a tool for combating Medicare and Medicaid billing fraud. The Centers for Medicare and Medicaid Services (“CMS”) reports that Medicare and Medicaid spending was over $500 billion for the 2006 fiscal year. In CMS’ 2006 Management’s Discussion and Analysis, administrators at CMS recognized that the best way to cut Medicare and Medicaid spending and maintain the integrity of the programs was to reduce Medicare and Medicaid fraud and abuse. For example, the Department of Health and Human Services reports that it collected almost $2.3 billion in 2006 from false claims suits. By implementing and actively enforcing anti-fraud compliance laws, the government can recover more money and, thus, curb the amount of Medicare and Medicaid spending.

In order to further combat health care fraud and abuse, Congress enacted the Deficit Reduction Act of 2005 (“DRA”), P.L. 109-171. The DRA contains provisions to slow mandatory spending in Medicare and Medicaid. Furthermore, the DRA includes a provision, § 6032, that requires health care entities to address fraud and false claims within the Medicaid system. Section 6032, entitled “Employee Education About False Claims Recovery,” requires entities receiving or making payments of more than $5 million annually in Medicaid reimbursement to establish policies and disseminate information to employees about the False Claims Act and anti-fraud compliance. Notably, the DRA does not contain a similar provision requiring entities to address fraud within the Medicare system.

On December 13, 2006, CMS issued a letter to provide guidance to state Medicaid programs and health care entities on compliance with § 6032. According to CMS, § 6032 applies to any health care entity making or receiving $5 million in Medicare payments, regardless of whether the entity is for-profit or not-for-profit, whether the payments are made at a single location or multiple locations, or whether the payments are made under multiple tax identification numbers. Entities subject to § 6032 must establish policies for all employees, including management, contractors, and agents, regarding false claims and fraud and abuse. Those policies must include detailed information about the federal FCA and any applicable state FCA, as well as the entity’s policies for detecting fraud, waste, and abuse. The entity must also provide information to employees regarding the right of an employee to be protected as a whistleblower in a qui tam action.

According to § 6032, the entity must include this information in its employee handbook. CMS indicates that an entity that does not have an employee handbook is under no obligation to create one. However, CMS does indicate that it is the entity’s responsibility to disseminate the written policies.

All health care entities subject to § 6032 were required to comply with the provisions of § 6032 by January 1, 2007. The penalty for non-compliance is high—health care providers can be excluded from participation in the Medicaid program. In addition, failure to establish and distribute false claims policies could result in false claims exposure. Furthermore, if a false claim action is brought against an entity and the entity is found liable, the entity may have to pay treble damages to the government.

Currently, West Virginia does not have a false claims act governing all governmental transactions. However, West Virginia does have a statute that regulates fraud and abuse in the Medicaid program, West Virginia Code § 9-7-1 et seq. Section 9-7-1 indicates that the purpose of West Virginia’s fraud and abuse statute is to combat the substantial sums of money that have been lost by the state and federal government in operation of the state’s Medicaid program.

West Virginia’s fraud and abuse statute states that “[a] person shall not make or present or cause to be made or presented to the [Department of Health and Human Resources] a claim under the medical programs of the department of welfare knowing the claim to be false, fraudulent or fictitious.” W. Va. Code § 9-7-5(b) (1981). The statute provides for both civil and criminal penalties. In addition, any person or entity that violates the statute is liable to the Department of Health and Human Resources for fines equal to three times the amount of any payments received from which that person or entity was not entitled. W. Va. Code § 9-7-6 (1981).

If history is any indication, West Virginia also may enact false claims provisions that mimic the federal law. The DRA provides an incentive to states that establish false claims statutes. Under the incentive, states with false claims statutes will receive an additional 10% of any funds recovered under that statute. Because of this incentive, it is likely that West Virginia will update its fraud and abuse statute.

In the future, it is likely that all entities, whether receiving more or less than $5 million in Medicaid payments, will be required to comply with § 6032’s false claims and anti-fraud policies. Additionally, if § 6032 helps curtail Medicaid spending, fraud, and abuse, it is plausible that Congress will enact similar policies for the Medicare program. Due to the DRA’s employee education requirements and state incentive to create false claims acts, the future holds a strong likelihood of increased false claims investigation and litigation.

Amy L. Rothman is a health care litigation attorney at Flaherty, Sensabaugh & Bonasso, PLLC. For questions, she can be reached at (304) 345-0200.

UPDATE: On March 20, 2007, CMS issued DRA 6032 - Employer Education About False Claims Recovery - Frequently Asked Questions an additional guidance document on interpretation of the new regulations. Additional guidance materials can be found under the State Medicaid Directors Letters section of the CMS website under Final Guidance Regarding Employee Education for False Claims Recovery.

Bethany College: The Value of Small Liberal Arts Colleges

Friday, March 2, 2007

Today's Charleston Gazette contained a letter to the editor, Not all is negative in West Virginia, that made me proud of my alma mater Bethany College. As the Bethany website says, Bethany is a place that gives you "permission to dream."

The letter by the grandparent of a current graduating student understands the often negative stigma that West Virginia receives and highlights the important role that places like Bethany play in the future of our state. Interestingly, I was reading this NYT article, A Fighter for Colleges That Have Everything But Status, yesterday and would put Bethany in this same category.

The letter prompted me to think about the impact the professors I had while attending Bethany from 1984-1988 had on me in developing learning skills that I apply everyday as a health care lawyer. I want to thank and recognize professors like, Trevor Pierce, Albert Ossman, Larry Grimes, John Taylor, Tony Mitch, Bob Myers, John Hull, Bob Funk, Richard Kenney, Helen Louise McGuffie and others.

These professors changed my life. In fact I wouldn't be writing this blog if I hadn't taken the freshman seminar class, Computers and Society, from Dr. Pierce who introduced me to computers or Dr. Grimes who allowed me to explore how Mac computers, hypertext and computers labs could impact (and improve) writing as a part of my senior project in the English Department.

In 1988 I struggled (probably with Dr. Grimes) trying to understand what hypertext was. It was such a foreign concept. I remember getting books through inter-library loan to try to understand the concept and how it might apply in writing. At that time I didn't imagine that it would become the basic element of today's Live Web. Writing this post has prompted me that I need to search out and find my senior project paper to see what I actually wrote during the spring of 1988 on how hypertext was going to change the way we write and teach English.

For other examples of Bethany grads living out their dreams that probably started at Bethany, check out Greg Jordan, CEO and Dave Egan, Chief Marketing Officer of Reed Smith. You can bet Alexander Campbell, founder of Bethany College in 1840, was living out his dream when he built Old Main in the hills of West Virginia in the 1800s.

I could name more -- but instead I thought I would leave it up to those of you who might read this post to leave your thoughts in the comments.

[UPDATE: I shared a copy of this post with Sven de Jong, Bethany's VP of Adminssion and Advancement (and also a grad) and he pointed me to a post yesterday by Nathan Koppel on the WSJ Law Blog titled "Almost Heaven, West Virginia." The post declares Wheeling WV as the law-firm capital of the world and highlights the impact that current West Virginians are having on the world legal community.]

Here is the letter to the editor:

Not all is negative in West Virginia

Editor:
I sometimes find it depressing that so many people in our state take at total face value negative results of research and misleading statistics that are quoted in newspapers and elsewhere. Maybe one should check their sources before automatically assuming that the information is totally accurate. I refuse to allow this sort of negative publicity to deter me from giving accolades to deserving individuals who dedicate their lives to teaching and institutions that help prepare our youth so that they have the necessary skills to succeed.

My granddaughter will graduate from Bethany College in May with a degree in chemistry and biology. She has been accepted at all of the medical schools to which she applied. Although she is a bright, self-motivated student, she did not accomplish this feat alone. She was guided with the nurturing support of many professors at Bethany, especially the mentoring of her biology professor, John Burns. I publicly offer my thanks and praise to him and to others at this fine institution who have helped her so much.

I understand very well that all is not perfect in West Virginia, but I hope that people will stop perpetuating the myth that we do not offer our youth the skills they need to succeed in life.

Barbara Hutchison-Smith
Cross Lanes

Inside Look At Revolution Health

Tuesday, February 27, 2007

Today's Washington Post has an update and perspective on some of what is happening at Revolution Health in "A Big-Ticket-Start-Up With a Nonprofit Vibe". For more on what Revolution Health is and what it plans to do for consumer driven health care check out my previous posts here and here. Check out this post by a former Revolution Health employee for his perspective on the Washington Post article.

If you've not noticed the Washington Post includes a "Who's Blogging?" block via Technorati built in with each article. I'd like to see other newspapers (Charleston Gazette and Daily Mail) incorporate such features allowing the free flow of commentary on articles published.

Blawg Review #97

Sunday, February 25, 2007

Welcome to another edition of Blawg Review -- where bloggers come for their legal news every Monday. It's good to be hosting another edition of Blawg Review at the Health Care Law Blog. However, it's even better to be done.

First off, thanks to all who submitted posts to this edition. There was wonderful material to work from. Much of the information that I regularly consume online is related to my practice as a health lawyer and I enjoy the opportunity to step outside of that specialty and be a part of a larger legal discussion going on in the blogosphere.

As an active participant in the blogosphere and Live Web I am constantly amazed by the knowledge, skills and imagination of those who create electronic content (written, audio and video) for public consumption. Not just lawyers -- but every profession imaginable. The volume of information conveyed online today through electronic social networking is mind boggling. How much you say? Technorati is now tracking approximately 69.4 million blogs with 175,000 new blogs created per day. The world live web is being updated with 1.6 million new posts per day, for an average of 18 per second. Could Johannes Guttenberg have ever imagined this phenomenal transformation in communication.

Lately I've been thinking and posting more about the impact that blogging and web 2.0 is having on the health care industry. It is a time of change for the health care industry. Likewise, I think many of you will agree that fundamental changes are occurring in the delivery of legal services as a result of the rise of the new social networking technology movement. For more of what this may mean for health care check out some of my materials from a presentation I did to introduce health lawyers to the basics of Health Care Blogging and Web Health 2.0. [Note: I'd also suggest watching (if you haven't already) "Web 2.0 . . . The Machine is Us/ing Us," created by Michael Wesch, Assistant Professor of Anthropology Kansas State University. The video visually explaining Web 2.0 and how today's digital technology influences human interaction.]

To begin with let's highlight a few of the submissions that reflect some of these fundamental technology changes which we are all experiencing as a result of the social networking phenomenon, the availability of new technology tools and the shift toward living our lives out on the web.

Bruce MacEwen gives us a tour of the The Law Library of the Future? at Adam Smith, Esq showing us all the differences that exist within today's law firms. From the traditionalists/silent generation to the Boomers to theGenXers to the Millennials.

Online political social networking hits full speed at My.BarackObama.com covered by Susan Cartier Liebel at Marketing Genius - the "Obama Principle" and suggests that lawyers have something to learn from observing the process as it unfolds.

Mike Madison and Denise Howell will be hosting a public conference call today, February 26 at 1:00 p.m. PST to gain insight on ownership considerations and issues of governance and liability that are critical to the creation, maintenance and long term health of business communities (corporate use of Web 2.0 technologies). The call is being held to help them prepare for the upcoming Community 2.0 Conference.

Overlawyered looks at the liability of curb cuts and wheelchairs vs. jaywalkers in Jury blames hit-run death on wheelchair curb cut (fascinating to me is the comment discussion and the use of Yahoo Maps to support user comments on whether the jury made the right decision).

Brent Trout at Blawg IT touts the ideas of Seth Godin and the application of his concepts to the practice of law in his post Law Firms - Small is the New Big.

Scott Felsenthal at The Legal Scoop, a new law student collaborative blog by three students from Tennessee law schools, provides a look at the what's happening across campuses as a result of students living their lives out online in Facebook and MySpace- Quickly Becoming Breeding Grounds For Disciplinary Actions and Arrests. If you or your kids are on the edge of becoming the next one hit wonder, don't miss reading So you want to be a Recording Artist . . . by another of The Legal Scoop team members, Tim Bishop. David Lat examines a recent survey at UVA Law School and my question is -- what about Tennessee law schools?

Watch and read the post on Prosecutorial Indiscretion (or the lack thereof) at Sui Generis--a New York law blog. She looks at a Virginia "rage road" incident that resulted in an ice throwing felony conviction. The video clip also includes a discussion of a series of posts on the newly promulgated lawyer advertising rules in New York which forbid the use of a nickname, moniker, motto or trade name that implies an ability to obtain results in a matter." The post series uses actual video clips of lawyer advertising clips from various jurisdictions to demonstrate application of the new rules.

Dmitriy Kruglyak founder of Trusted.MD reports on two articles appearing in the East Bay Business Times. One about Kaiser's ongoing encounters with blogging and social media and the other examining how hospital administrators and executives should use blogs.

On February 8, 2007, Wendy Seltzer in In My First YouTube: Super Bowl Highlights or Lowlights conducted an experiment to determine whether copyright overreach would trump her fair use rights when exercised to teach about copyright overreach. Five days later she received the DMCA Takedown Complaint courtesy of the NFL and YouTube.

If you're an RSS fan don't miss Justia Federal Court Filings which allows you to see new filings by state, court or subject matter. Reported at Robert Ambrogi's Lawsites and The IllinoisTrial Practice Weblog.

And now on with the rest of the submissions for this week's Blawg Review.

The most highly talked about topic this past week was the Supreme Court's ruling on punitive damage awards in Philip Morris USA v. Williams. SCOTUSBLOG reports that the 5-4 decision found that it is "unconstitutional for a jury to award punitive damages out of a desire to punish a company for harming individuals other than those directly involved in the lawsuit -- that is 'strangers to the litigation'". The Court held that punishing a defendant for harming persons who are not before the court amounted to a taking of property from the defendant without due process of law. EricTurkewitz of New York Personal Injury Law Blog covers the decision in Court Tosses Philip Morris Verdict, And Further Confuses Punitive Damages Issue and Philip Morris Punitive Damage Decision - Why It Was Good For Plaintiffs indicating that the decision requires judges to now tell the jury in a punitive damage case that they can consider the reprehensibility of the defendant's conduct toward others, but not the harm to them. The South Carolina Appellate Law Blog says the decision creates an unworkable standard in After Philip Morris: What can a jury consider for punitive damages purposes? SCOTUS sets an unworkable standard and sets out some options that trial judges have when considering evidence of harms to non-parties. More on the decision from Law Prof on the Loose with Tobacco Verdict Goes Up In Smoke.

Bill Watkins at South Carolina Appellate Law Blog looks at a the interplay of the Controlled Substance Act and a recent South Carolina senate bill proposing that Marijuana be considered a prescription drug in South Carolina lawmakers review bill to legalize marijuana for medical use.

Ilya Somin at The Volokh Conspiracy disagrees with a recent Slate column that contended that split decisions make bad law and, in the specific context of the current Supreme Court, undermine the Chief Justice's admirable goal to promote unanimity amongst the justices.

The HR Lawyer's Blog looks at the continuing trends on alternative billing arrangements in Alternative Billing - Clients Want It - Big Law Firms Hate It.The post highlights that a recent survey of corporate counsel indicate that 90% of outside counsel still resist the suggestion to consider alternative fee arrangements.

Kevin Jon Heller at Opinio Juris covers a running battle between Glenn Reynolds and Paul Campos, law professor at University of Colorado, over one of Instapundit's posts arguing that selective assassination of Iranian nuclear scientists is both legal and advisable. Eugene Volokh also weighs-in with some worthwhile comments.

Charles Green questions the "legal tip" included in Business Week's SmallBiz magazine which suggests that retail sales slips should include a written statement to protect the interests of your business in his post From Our Legal Experts... posted at Trust Matters.

David Maister gives interesting insight into his experience as a juror in a 5 day trial involving a pastor, a parishioner and $80,000 in Jury Duty posted at Passion, People and Principles. He offers some simple lessons for litigators to remember.

Charlie Weis, Notre Dame's football coach, appears headed back for seconds in his trial over an allegedly botched gastric bypass surgery. Quizlaw has an entertaining post about the events that lead to the mistrial. Only one can speculate what would have happened if the physicians chose not to respond.

Are you an avid T.J. Maxx or Marshalls shopper? If so, check out Law Practice Management's post Identity Theft Begins with Access to Your Information discussing on of the latest electronic data breaches. The post offers practical advice on how to better protect your personal information in this growing age where everything is electronic.

Overlawyered writes about Dr. Vatura who saved the life of a 400 pound man thrown from a motorcycle in a high speed accident in Treating the morbidly obese (redux). Due to his obesity it was impossible to stabilize the man with typical cervical spinal precautions and as a result he ended up a quadriplegic. One of my favorite medical bloggers, Kevin, M.D., covers this same topic and what he believes the impact these events have everyday on doctors.

For another perspective on the impact of medical malpractice on physicians, consider hospital CEO and blogger Paul Levy's recent post The Shame of Malpractice Lawsuits at Running a Hospital. Also, Kevin, M.D. mentions an interesting issue coming before the Virginia Supreme Court of Appeals in his post Should academic physicians be protected against malpractice suits? Don't miss Quizlaw's Wacko gets Jacko'd providing evidence that you can be sued for almost anything -- the family of a 73 year old woman is suing Michael Jackson and Marian Medical Center claiming that the hospital's VIP treatment of Jackson resulted in the death of the woman.

PointofLaw Forum links to David Rossmiller's Insurance Coverage Law Blog which covered Mississippi Attorney General Hood's press conference call where State Farm was called "a cult," "decadent" and "robber barons".Rossmiller questions much of what was said during the call and makes a good point -- if you think that that much of the company why would you want them to stay and provide insurance to citizens of Mississippi.

If you regularly draft contract language you shouldn't miss That" and "Which" by Ken Adams at AdamsDrafting who looks at the confusion over the distinction between that and which and a New York case, AIU Insurance Co. V. Robert Plan Corp. that considered the differences.

Ben D. Manevitz who writes IP Notions looks at Mike Carroll's "Fixing Fair Use" made at the Some Modest Proposals 03 Conference in Fair Use and Fee Shifting and adds a suggestion that the proposal needs to be given teeth by tying the payment of attorneys feed to the process.

A reason to let your associates get sleep from Davit Lat at Above the Law.

Mike Madison at madisonian.net reports in IP and Insurance on a breakthrough partnership among insurers, the Standford Fair Use Project and a network of practitioners willing to discount their rates to documentary filmmakers to lower the cost of insurance for documentary filmmakers who rely on fair use doctrine for portions of their content. Lessig Blog has additional details of the announcement.

This week Eugene Volokh notes that Ohioans are presumptively protected from being fired for off employer property (and presumably off duty and lawful) possession of guns. The decision in Plona v. UPS involved the termination of a UPS employee who was found to have a handgun in his vehicle wile at work. The gun was disassembled, unloaded and locked in his care in a public access parking lot used by UPS employees and customers of UPS. The court held that the public policy permitting Ohio citizens the right to bear arms under the Ohio constitution was enough to form the basis of a wrongful termination claim. More on the Second Amendment from Jacob Sullum who notes that the FAA has revised its thinking on its justification for its ban on carrying firearms aboard spaceships.

My Hosting Blawg Review #97 post mentioned Kevin O'Keefe's post about the term "blawg" and the fact that it is still facing an uphill road at being recognized and understood. The post relates that Wikipedia editors have again dropped the term "blawg" (but, Blawging is still listed but redirets to Blog). Another Wikipedia term that I have referenced in the past has also been dropped by the Wikipedia editors -- Live Web. Hmmmm . . . is a Wiki-conspira-edia going on?

David A. Giacalone at f/k/a says, "move over Anonymous Lawyer," and suggests I introduce Blawg Review readers to BabyBarista, an anonymously written account of the "pupillage" of a pupile barrister in London. May I suggest TidySum and Scandal. At shlep Giacalone provides a link to Babysitting and the Law in his post about when can you leave your children at home?

In SOX Slaps Lawyers Leon Gettler looks at the tough rules of Sarbanes-Oxley the the impact on attorneys. Suddenly lawyers are going down like nine pins because of the crackdown on backdating. Likewise, the Wired GC discusses how the perceptions of the general counsel's responsibility are changing in the wake of the backdating scandals.

Ann Althouse considers the wisdom of Eric Alterman's passing suggestion that the blogosphere needs a council of bloggers to police what's being said on the most controversial subjects.

Kaimipono Wenger at Concurring Opinions looks at Anna Nicole Smith's will as a real-life law school exam.

That's all for this edition. Blawg Review has information about next week's host, and instructions how to get your blawg posts reviewed in upcoming issues.