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3525 Prytania St, Suite 614 - New Orleans, LA 70115 - 504-891-8454

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"You have turned my life around"
 

I am 87 years old, with a problem of the prostate gland. Before I met Dr. Baum, I went to the bathroom every 30-60 minutes. After Dr. Baum's treatment on my prostate, I go only 5 times per day and only 1 time at night! You turned my life around. I am so very grateful!

-Sidney Daigle


I want to thank you for your due diligence. You saved my life. I highly recommend you!

-Dwight Bastian


Thank you Dr. Baum! Because of you I'm back in the "rodeo"!

-Gerald Wallace

 


Roselyn Koretzky, J.D. and Dr. Neil Baum, M.D.

 

Uncertainty affects everyone, including physicians. Most of physicians want to practice without being encumbered by the business and legal issues that accompany the contemporary practice of medicine. With the uncertainty that accompanies many of the non-medical decisions that we will be forced to make, we will need the advice and counsel of attorneys. The health care industry is swept up in dramatic and unprecedented change. The health care attorney stands watch and is prepared to respond.

Unfortunately, not every attorney can assist physicians and physician groups during this transition from fee-for-service to a managed care method of reimbursement. Just as medicine contains specialization, the legal profession has available individuals that have expertise in the unique concerns for the health care profession. A health care attorney's practice area includes awareness, analysis, and application of the laws, regulations and issues pertaining to the health care industry. These many laws, regulations and issues may impact physicians, hospitals, managed care organizations, integrated delivery systems, and other licensed individual and organizational providers.

Health care attorneys provide many of the same services as generalist attorneys who prepare employment contracts, litigation, and malpractice defense. The distinction is that health care attorneys monitor the laws, regulations, and issues that specifically impact the health care industry. Health care attorneys can identify issues and add a critical dimension to their analysis of such matters. They are mindful of health care specific twists in the fields of contracts, litigation and medical malpractice defense, as well as issues pertaining to managed care, patient care, medical staff, antitrust, credentialing, advance directives, licensure, peer review. For example, those physicians that are forming groups such as an independent physician association (IPA) will need antitrust advice regarding as violations can be very costly. Health care attorneys often sub-specialize, highlighting the complexities and subtleties of the health care legal practice in today's health care environment and can assist us in areas that place most of us out of our comfort zone and allow physicians to do what physicians do best...practice medicine.

Health care attorneys provide various services for physicians (and other providers). The goal is protection of the physicians through compliance with applicable laws, regulations, and issues. Some of these include: review of employment agreements by hospital/provider organizations; review of documents in contemplation of practice acquisition by hospital/provider organizations; review/development of contracts, including managed care agreements; review of merger opportunities and/or development of integrated delivery systems networks; assistance in credentialing and/or appearances before hospital, managed care, and/or licensing organizations in connection with privileges, licensure or peer review issues; review and development of various documents and protocols and arrangements for consideration of reimbursement issues and compliance with fraud and abuse laws and regulations; consent; insurance coverage; advice and counsel regarding privacy and confidentiality issues involved with patient care, medical information and records, and compliance with Stark laws associated with physician ownership of laboratories and diagnostic equipment and other designated health services.

Do you need a health care attorney?
A physician will know that he or she will need a health care attorney for one or more of the following reasons: the impact of new legislation on his or her practice; an angry patient; difficulty obtaining and maintaining contracts or entering into any managed care agreements; contemplating acquisition of his or her practice; employment by health care organization(s); challenges by any regulatory or licensing agencies; threats of legal action; an untoward event or outcome or horizontally or vertically integrating your practice with other practices in the community.

Finding a health care attorney can be easily accomplished. Generally, health care attorneys maintain visible profiles in various health care publications (through advertising and/or articles), participation in medical /legal seminars, presentation of speeches before medical societies and/or hospitals and/or other medically related organizations, local bar associations. Asking a CPA, or hospital administrator may also serve as a helpful referral source. Probably the best resource is to ask a colleague or a practice that you know has had a similar problem or situation for the name of their health care attorney...especially if they were satisfied with their experience. Further, a physician may contact the numerous health law organizations, locally or nationally. ( Louisiana Society of Hospital Attorneys 504 928-0026 and National Health Lawyers Association 202 833-1100) They may provide rosters of health care lawyers included in their respective membership. The attorney's reputation, competence, and responsiveness certainly should all be considered in the selection process.

In this era of managed care, health care attorneys play an important role in the process of identifying issues, negotiating contracts, and drafting language to protect the physician. Goals include maximizing the physician's ability to exercise independent medical judgment, (without any gag clauses) , maximize reimbursement, be sufficiently insured, be protected from onerous indemnification provisions, be selected on various panels. Signing managed care agreements "blindly" without a health care attorney's review and input may result in compromise of the physician's practice and/or limitation to earning potential andor other undesirable consequences. Many physicians have signed contracts only to find out that they have difficulty providing services at the deep discounted rate or at the per member per month allowance. Further, a health care attorney is able to help evaluate the integrity of any plan in which the physician contemplates participation. With so many manage care organizations vying for physician participation, you can be sure that a significant number of them may be insolvent and not able to meet their financial obligations. A health care attorney will evaluate the structural background of the organization and prognosticate its ability to remain a viable entity in the community.

It is not uncommon for attorneys who specialize or limit their professional practice to certain areas to charge higher rates than generalists. However, the maximum "you get what you pay for" rings true in this discussion. The avoidance of the significant potential perils and penalties (including criminal and civil) that may confront a physician who proceeds without appropriate counsel, innocently or not, should serve as an incentive to possibly pay more at the outset rather than suffer higher costs down the road for insufficient advice. An open and honest dialogue with an attorney, whether specialist or generalist, is always advisable. This is certainly the case when discussing fees and costs and embarking upon a professional relationship with an attorney. The possibly higher priced specialist may bring to the table certain efficiencies, thereby resulting in the overall costs being less than otherwise anticipated.

The health care industry is highly regulated. There are numerous laws, regulations and accrediting agency requirements pertaining to it. Physicians are encouraged to carefully select counsel to guide them through the maze of laws and regulations. It is important and cannot be overemphasized. Physicians should check with colleagues, professional societies, local bar associations for health care attorneys. They should carefully interview any attorney before entering into representation. Be comfortable communicating with the attorney. Make sure the attorney understands the physician's goals and expectations and identifies the issues needing resolution. Check the attorney's credentials and the currency and frequency of his or her involvement with medical /legal issues. Ask about fees and costs and what can be expected regarding timeliness of reports. It is important to create an environment of trust and cooperation with the attorney.

By hiring the appropriate health care attorney physicians are allowed the opportunity to do what physicians do best and that is to practice medicine.