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.