If a doctor is in-network with an insurance company and the patient wants a refund for what they paid out of pocket, what are the mechanics of the transaction? Here, you likely have more than two parties. You have the patient and the physician, of course. You also have an insurance carrier. I’ll explain. First … Read more
Most doctors are aware of what is meant by a “consent to settle” policy. With such language, the carrier will not settle a claim without your explicit written consent. Once you provide such consent, the carrier will make a decision. Settle for an amount it can live with. Or defend the case. If you provide … Read more
Can a patient sign away their rights to sue you in the future for a case that will be performed in the future? Let’s go down memory lane. Back to 1963. Tunkl v. Regents of the University of California. The University of California at Los Angeles Medical Center admitted Tunkl as a patient on June … Read more
Dr. Hassan A. Saad is an orthopaedic surgeon practicing in Michigan. This physician shares the same first and last name as another physician, who worked in the same city. This other Dr. Hassan has a different middle initial. His middle initial is “T” and opposed to our protagonist, whose middle initial is “I”. What a … Read more
We live in a world of deadlines. When I was growing up, I learned the maxim, “Failure to properly plan on your part does not constitute an emergency on my part.” Sound familiar? The excuse “the dog ate my homework” did not work in my childhood home. If you practice medicine (or any licensed profession … Read more
If you’ve been living under a rock for the past few years, take note that there are very effective medications used to treat obesity and type II diabetes. They include products with glucagon-like peptide (GLP-1) activity. The two dominant players in the industry are Novo Nordisk and Lilly. Novo Nordisk distributes semaglutide: Ozempic for Type … Read more
The National Practitioner Data Bank (NPDB) is a federal repository of information detailing specific actions against healthcare providers. It includes settlements and judgments paid by an insurance carrier in your name (you being the defendant). It includes disciplinary actions by state licensing boards, including public letters of reprimand, probation, suspension, and revocations. It includes adverse … Read more
One Medical Justice member recently wrote about a patient pulling out their phone in the middle of a consultation. Then they started recording. This physician works in New York. The practice was reasonably concerned the patient might use this recording for less than honorable purposes. They asked for guidance. New York is a one-party recording … Read more
Gilead is a biotechnology company that develops and distributes HIV treatments. Its compounds have saved and extended countless lives. Gilead is being sued in California by HIV patients for not timely developing a new drug. Some background. Gilead manufactured and marketed its HIV/AIDS drug, tenofovir disoproxil fumarate (TDF) since 2001. Gilead was working on “a … Read more
Doctors fight tooth and nail to avoid being reported to the National Practitioner Data Bank (NPDB). With good reason. If you want to apply for a new job, a new medical license, new hospital privileges, new network status with insurance carriers, or new coverage with a professional liability carrier, a stain on your otherwise clean … Read more
