von Briesen Health Law Blog

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January 10, 2012

Providing Health Services Under TRICARE No Longer Creates Affirmative Action Requirements for Health Care Employers

Filed under: Labor & EmploymentDoris Brosnan @ 2:05 pm

On December 31, 2011, President Obama signed the National Defense Authorization Act for Fiscal Year 2012. A conference report in this Act ends OFCCP’s push to expand its jurisdiction by way of TRICARE contracts. The new Section 715 of the conference report states that TRICARE managed care support contracts will not be considered contracts to provide health care services such that these providers become subject to OFCCP jurisdiction.

TRICARE is the Department of Defense health care program for active duty and retired military and their families.  Prior to the law, the OFCCP took the position that hospitals and other health care providers that provided health care services for TRICARE were subject to affirmative action obligations and were subject to OFCCP jurisdiction because they were “subcontractors” under federal law. This legislative action should prevent the OFCCP from continuing to invoke jurisdiction over health care employers on the basis of their being TRICARE network providers.

Over the past few years, OFCCP has expanded its jurisdiction over the health care industry by taking the position that all providers who provided health care services under TRICARE network contracts were subject to OFCCP jurisdiction. In OFCCP v. UPMC Braddock, ARB Case No. 08-048 May 29, 2009 and in OFCCP v. Florida Hospital of Orlando, Case No. 209-OFC-00002 the OFCCP successfully argued that affirmative action obligations exist when a hospital provides health care services pursuant to a TRICARE contract with an HMO. As a result, a hospital that merely provided health care services to TRICARE recipients was subject to affirmative action obligations as well as subject to OFCCP jurisdiction.

While TRICARE should no longer create the basis for affirmative action obligations or OFCCP jurisdiction, the OFCCP may find other ways to expand jurisdiction.  Further, health care providers may become subject to OFCCP jurisdiction due to other federal contract or subcontract obligations. For that reason, health care employers should always review their contracts with counsel to determine if they will create new OFCCP compliance obligations.

March 25, 2011

Peer Review Protections Broadened Under New Law

Filed under: Medical StaffDoris Brosnan and Michelle Frazier @ 8:43 am

Wisconsin recently expanded its peer review protection through the enactment of the Wisconsin Health Care Quality Improvement Act (WHCQIA). This new legislation is part of Wisconsin’s tort reform bill and revises Wisconsin’s current peer review statutes, Wis. Stat. §§ 146.37 & .38. In particular, WHCQIA broadens peer review protections for health care providers by, among other things, allowing related entities to share peer review information and explicitly protecting incident reports created as part of an organization’s peer review process. These helpful additions to state peer review protections not only ensure that related entities can work together in monitoring quality patient care, but also add comfort to peer review processes.

The revised statute will apply to disclosures and releases made on or after February 1, 2011, even if the peer review sessions took place prior to that date.

Read more…

June 14, 2010

New Wisconsin Law Creates Reporting Obligations for Physicians – And Concerns for Peer Reviewers, Managers, and Treatment Providers for Physicians

Filed under: Medical StaffDoris Brosnan @ 2:44 pm

On June 2, 2010, a new Wisconsin law became effective that expands reporting obligations for providers licensed by the Medical Examining Board (”MEB”). 2009 Wisconsin Act 382 created a new statute under Wisconsin Chapter 448 (”Medical Practices”) requiring a person licensed by the MEB to “promptly” submit a report to the MEB when the person has reason to believe any of the following about another physician:
Read more…

June 3, 2010

New Wisconsin Law Creates Reporting Obligations for Physicians – And Concerns for Peer Reviewers, Managers, and Treatment Providers for Physicians

Filed under: Labor & Employment, Medical StaffDoris Brosnan @ 2:22 pm

On June 2, 2010, a new Wisconsin law became effective that expands reporting obligations for providers licensed by the Medical Examining Board (“MEB”).  2009 Wisconsin Act 382 created a new statute under Wisconsin Chapter 448 (“Medical Practices”) requiring a person licensed by the MEB to “promptly” submit a report to the MEB when the person has reason to believe any of the following about another physician:

1.  The other physician is engaged in acts that constitute a pattern of unprofessional conduct.

2.  The other physician is engaged in an act that creates an immediate or continuing danger to one or more patients or to the public.

3.  The other physician is or may be medically incompetent.

4.  The other physician is or may be mentally or physically unable to engage in the practice of medicine or surgery.

The law further expands the definition of “unprofessional conduct” under Wisconsin Stat. § 448.014(4) to include failure by a physician to make such a report. Previously, Wisconsin physicians had only an ethical, not legal, duty to make such reports under the American Medical Association’s and Wisconsin Medical Society’s codes of ethics.  The new Wisconsin law further provides that physicians who make such reports to the MEB “in good faith” may not be held civilly or criminally liable or guilty of unprofessional conduct.

This law raises several serious questions for physicians who have dual roles as peer reviewers, medical managers, and providers for physicians, since failure to report can lead to discipline for unprofessional conduct by the MEB.  Unfortunately, the new law does not address the dual role certain physicians play as managers of medical staff and employed physicians. It also does not address the scenario of a physician treating another physician, for example, for mental health or substance abuse issues.  Finally, and perhaps most importantly, there is the issue of how this law will interact with the privileges, immunities, and obligations of the Wisconsin peer review law as well as the federal Health Care Quality Improvement Act.  We are told that guidance on these issues from the MEB is forthcoming, perhaps in the form of regulations.

Other provisions of 2009 Wisconsin Act 382 grant the Chair of the MEB or his or her designee and two other MEB members the power to summarily suspend a credential without the previous 30-day and 72-hour limitation.  The law also includes a provision allowing physicians holding a temporary educational permit to practice medicine and surgery the ability to prescribe narcotics, as well as a provision allowing the MEB to change Continuing Medical Education (CME) requirements by rule rather than by legislation.

To read the entire Act, click here.

von Briesen’s medical staff lawyers will provide updates on these issues as the MEB’s interpretation of the law is developed.

October 19, 2009

von Briesen & Roper Law Bulletin Medical Staff Update: October 2009

Filed under: Medical StaffDoris Brosnan and Michelle Frazier @ 2:31 pm

As health care regulations and accreditation standards continuously evolve, so do medical staff requirements. This Update covers the following topics: The Joint Commission’s Telemedicine Standard; Board Certification Requirements; History & Physical Requirements for Medical Staff Documents; The Joint Commission’s Statement of Duties and Privileges Standard; and, Recent Development in Economic Credentialing. Read more…

July 8, 2009

von Briesen & Roper Legal Update: Wisconsin Expands WFMLA Rights to Domestic Partners

Filed under: Labor & EmploymentDoris Brosnan @ 1:18 pm

The new Wisconsin Budget, signed into law on June 29, 2009, expands leave rights under the Wisconsin Family Medical Leave Act (“WFMLA”) to same-sex and opposite-sex domestic partners. Wisconsin employers who are subject to the WFMLA should immediately update their practices and policies to comply with these new requirements.

The amendment defines “domestic partner” to include same-sex couples who have registered their domestic partnership with the Register of Deeds in their county of residence and same-sex or opposite-sex couples who are not registered but who must meet more stringent requirements. Read more…

June 9, 2009

von Briesen & Roper Legal Update: Chance for Increased Employment Damages With New Wisconsin Law

Filed under: Labor & EmploymentDoris Brosnan @ 1:19 pm

Yesterday, Wisconsin Governor Jim Doyle signed a new law that allows plaintiffs in Wisconsin discrimination cases to recover compensatory and punitive damages, if they jump through certain procedural and evidentiary hoops. The new law will take effect after the publication of the 2009-2011 budget bill.

Prior to this new law, the only damages available in a Wisconsin discrimination claim were back pay, reinstatement, potential front pay, and attorney’s fees. Punitive and compensatory damages were only available in federal court. Punitive damages are “punishment” damages, and under the new law must be awarded in the amount the court or jury finds appropriate, subject to certain caps. Compensatory damages are also known as “actual damages” and in employment cases typically involve medical bills, pain and suffering, and emotional distress. Read more…