THE LIJ MEDICAL STAFF SOCIETY LEGAL PEARLS 2023
LEGAL ISSUES RELEVANT TO THE PRACTICE OF MEDICINE IN NEW YORK.
The issue of a physician’s sexual relationship with a patient is always challenging and an opinion of New York’s highest court on the question should be of interest.
The defendant in this case was a family practice physician and the
plaintiff patient was receiving treatment for depression and anxiety while undergoing marital problems. A consensual sexual relationship ensued and plaintiff was ultimately divorced. Patient then sued physician alleging medical malpractice relating to their affair.
United Health, as a plan administrator of many ERISA governed benefit plans refused to pay a facility fee to out-of-network physicians performing surgery at their own medical offices contending that none of their plans stated that a physician’s
office qualified as a “facility,” which would have entitled them to receive a separate facility fee.
This determination was challenged by MSSNY and the Society which represented office-based surgical facilities. A five-day trial ensued in the federal court and resulted in a victory for the carrier.
We offer the following fact pattern for your consideration in a pending litigation which has not yet been decided by the court.
McKesson offered oncology practices which guaranteed to purchase a specific quantity of drugs from McKesson the free usage of two management tools developed by McKesson. One program compared reimbursement rates for interchangeable drugs and the other calculated the profit margins for the prospective course of treatment.
The New York Legislature is nearing what will probably be the half-way mark of its Session for this year and we thought it appropriate to discuss the impact a Legislature has and the best way to attempt to affect its outcomes.
It is interesting to note that in the past fifty years every Democrat who was named Speaker of the Assembly, came from New York City- an acknowledgement that the greatest majority of Democrat Assembly members come from this area.
As one constantly reads and researches the numerous reports of cases and Departmental rulings pertaining to medicine one must remain alert to the activities of
the New York Attorney General and her actions concerning the many commercial players interacting with health care.
Example- Verizon Wireless has many cooling towers located in New York State
and there was a determination reached by the Attorney General (AG) that the towers could cause the spread of Legionnaires’ disease based upon the water droplets emanating from the towers which might contain the Legionella bacteria.