Posts tagged Nossaman Healthcare.
Peer Review Hearings Are Not Court Trials: California Reaffirms Flexible Nature Of Fair Procedure

The California Supreme Court recently issued its decision in Boermeester v. Carry.  Though the case deals with fair procedure within a private university’s internal disciplinary proceedings, it provides helpful guidance for peer review bodies navigating medical disciplinary hearings.

Boermeester reiterated the long-standing admonition that courts should not try to impose “rigid procedures” upon private organizations’ administrative proceedings.  Rather, the organizations themselves should develop methods for providing the fundamentals of fair ...

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017. Timely access to health care providers has long been an issue, but appears to be worsening in certain geographies and provider types. Until recently, timely access to care was regulated at the state level; however, in April, the Centers for Medicare & Medicaid Services (CMS) unveiled its proposed rule to address the issue. The Notice of Proposed Rulemaking Managed Care Access, Finance, and Quality (CMS-2439-P) (NPRM) only ...

California’s New Apology Law and Its Impact on Peer Review Hearings

Parties in peer review hearings can present a wide range of relevant evidence, regardless of its admissibility in a court of law.  But California has passed a new “apology law” that modifies that standard, erecting a potential hurdle for medical staffs to admit relevant evidence against practitioners in peer review hearings.

Under California law, statements, writings, or benevolent gestures expressing sympathy or a general sense of benevolence relating to the pain, suffering, or death of a person involved in an accident are inadmissible in civil trials.  (Evid. Code, § 1160.)  ...

A Friendly Reminder: Friendly PC Arrangements are Subject to Scrutiny

As healthcare grows increasingly complex, delivery structures continue to evolve.  A popular arrangement is the “Friendly PC” model, where large medical groups are backed by private equity or health system investment and administrative support.  But courts and lawmakers have become concerned that certain Friendly PC arrangements encroach on physician autonomy and violate the century-old prohibition on the corporate practice of medicine (“CPOM”).  A recent lawsuit—American Academy of Emergency Medicine Physician Group, Inc. v. Envision Healthcare Corporation ...

Posted in Managed Care
DMHC and DHCS Fine L.A. Care $55 Million in Enforcement Actions

The California Department of Managed Health Care (DMHC) on March 4, 2022, assessed the largest penalty against a health plan in the Department’s history. DMHC and the California Department of Health Care Services (DHCS) jointly announced the results of enforcement actions against Local Initiative Health Authority for Los Angeles County, more commonly known as L.A. Care. The penalties assessed by DMHC and DHCS against L.A. Care include $55 million in fines, which consist of a $35 million fine from DMHC and a $20 million sanction from DHCS. The amount is by far the largest penalty ...

On September 21, 2017, the Medical Board of California adopted new regulations related to the training of midwife assistants, the administration of midwife assistant training, and the requirements for approved, midwife assistant certifying organizations. The Board took this action to implement and interpret Senate Bill 408 (2015), which added new requirements and prohibitions to the Licensed Midwifery Practice Act of 1993 under Business & Professions Code § 2516.5.

SCOPE OF PRACTICE

Business and Professions Code § 2516.5(a)(1) defines midwife assistant as:

A person, who may ...

Our Health Law Ticker is a one-stop resource for everything new and noteworthy in healthcare law. We cover recent developments in healthcare legislation, healthcare reform, Medicare/Medicaid, managed care, litigation, regulatory compliance, HIPAA, privacy, peer review, medical staffs and general business operations for healthcare companies and licensed healthcare professionals.

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