Glaser
  • David M. Glaser
  • David M. Glaser, JD, is a health care attorney at Fredrikson & Byron, P.A. He focuses his blog on health care legal issues and policy-related health topics, ranging from how to operate ancillary services to methods for shaping the health care reform debate.

Friday, June 29, 2012

Life post-Patient Protection and Affordable Care Act

David M. Glaser, JD

If you are disappointed by the Supreme Court’s ruling upholding the Patient Protection and Affordable Care Act, don’t be. If the Court had ruled that the purchasing mandate was unconstitutional, then the impact on your day-to-day life would likely have been immeasurable.

I am not suggesting that it is unreasonable to be frustrated with the practice of medicine today. But the issues are larger than, and mostly independent of, the Patient Protection and Affordable Care Act (PPACA). Over my lifetime, the same basic tensions have affected the delivery of health care. There are concerns about increasing cost, preserving freedom of choice, maintaining access to both the system and to new technology and improving quality. The conflict between controlling costs and the other three factors is constant.

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Friday, June 15, 2012

A reason the Supreme Court may uphold PPACA

David M. Glaser, JD

I know that the conventional wisdom is that the Supreme Court is going to declare the Patient Protection and Affordable Care Act unconstitutional. I am not a Supreme Court scholar, but I wonder if the conventional wisdom is wrong.
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Friday, January 20, 2012

A possible end to provider-based billing: What it could mean for you

David M. Glaser, JD

On Jan. 12, The Medicare Payment Advisory Commission (MedPAC) voted 15-2 to recommend that the Centers for Medicare and Medicaid Services (CMS) eliminate provider-based billing. Recommendations from MedPAC are not legally binding, but since Congress created the independent agency, its recommendations carry great weight. If provider based billing is eliminated, it could slow the pace of physicians being hired by hospitals.
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Wednesday, January 4, 2012

Allocate liability among partners to limit the risk

David M. Glaser, JD

Perhaps one of the biggest sources of stress to a physician is liability. Malpractice, Medicare overpayments, employment practices and general liability all prompt anxiety. Many solo practitioners remain on their own in part because of fear of becoming responsible for a colleague’s liability. While it is impossible to totally eliminate the risk of liability, there are two actions you can take to greatly limit the risk. The first and most obvious option is insurance. In addition to malpractice insurance, it is possible to obtain insurance to, at a minimum, cover the defense costs associated with audits and investigations. Employment practices and general liability insurance is readily available. I encourage physicians to carefully consider obtaining coverage for all four.
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Friday, October 14, 2011

How to prepare for — and deal with — Medicare audits and investigations

David M. Glaser, JD

You don't need me to tell you that the number of audits and investigations in health care has increased steadily over the last 20 years. The next few blog entries will deal with how you can prepare for an audit or investigation, and how to respond if you are involved in one.
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Monday, June 6, 2011

AAOE update: Consider new allies as a means to maintain independence

David M. Glaser, JD

I was lucky enough to present at the latest American Academy of Orthopedic Executives (AAOE) conference. Just as the Orthopedics Today Hawaii conference provides physicians with a great opportunity to hear what colleagues are trying, the AAOE conference allows orthopedic administrators to learn about trends, compare notes and brainstorm. If your administrator has not been attending AAOE, you may want to encourage him or her to consider it.
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Friday, May 6, 2011

What do ACOs mean for orthopedists?

David M. Glaser, JD

Discuss in OrthoMind Discuss in OrthoMind
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Thursday, March 31, 2011

The right to appeal disappears: Where is the outrage?

David M. Glaser, JD

You always have a right to go to court to challenge a government decision, right? Wrong. One element of the health reform bill is to explicitly prevent any judicial or administrative review of a number of decisions by Center for Medicare & Medicaid Services (CMS). This should have sparked outrage; but a year after the bill has passed, no one is talking about it.
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Tuesday, March 8, 2011

Who speaks for the independent physician?

David M. Glaser, JD

“Who speaks for independent physicians?” When I read that e-mail question submitted last week, it articulated one of my biggest worries about health reform — independent physicians are lacking a voice at the table. While the American Medical Association (AMA) is a voice for physicians, a significant percentage of its members, quite possibly a majority, are employed by systems.
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Tuesday, December 28, 2010

When the Wall Street Journal says there is too much profit in medicine, you know we are in for a rough ride

David M. Glaser, JD

A series of articles published in the Wall Street Journal (WSJ) during last few weeks have attacked physician “self-referral.” Whether examining a prostate cancer treatment known as IMRT (intensity modulated radiation therapy) or the use of spinal fusion surgery, the paper has suggested that physicians are placing profit over patient care. When I read the stories, I find myself questioning the quality of the research underlying the reports. Most of the articles simply compare statistics, and conclude that if one clinic is using a treatment at a higher rate than another clinic, or one physician is performing more surgeries than other, the most plausible explanation is that the first is "overusing" the service. It is, of course, equally possible that the second has failed to recognize the value of the service and is "under treating" patients. It is also possible that both are using the service appropriately, with the variation a result of differences in the patient mix. The methodology used merely notes a correlation, and then concludes that the causation is readily apparent. Such shoddy analysis is all too common, but that does not make it defensible.
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