Mid-Atlantic Health Law TOPICS

Medicaid Providers: Did you know that a federal appeals court in San Francisco recently became the second federal appeals court to interpret the federal Medicaid laws "free choice of provider" provision to bar any state from excluding from the state's Medicaid program any qualified health care provider, other than in narrow circumstances? The court explained that federal law permits states to exclude only those otherwise licensed providers who are suspected or convicted of felony crimes or of health care fraud and abuse, such as improper billing or recordkeeping, or violation of self-referral or anti-kickback laws. The court therefore invalidated a state ban on abortion providers from that state's Medicaid program.

Physician Repays Hospital: Did you know that a North Carolina appellate court recently forced an OB/GYN to repay relocation incentives paid by a hospital? The physician moved to the Roanoke Rapids, North Carolina area, joined a practice there, and the hospital paid the physician an income subsidy of about $200,000 (plus a $20,000 relocation fee) contingent on the physician remaining in the area for three years. When the practice fired the physician before the end of those three years, the physician moved out of the area. The hospital then sued the physician to recover some of the subsidy and loan. The physician argued that the physician should not be held liable because the physician did not leave the former practice voluntarily, but the court held that whether the physician left the area voluntarily or involuntarily did not matter, since the hospital itself did not make the decision to fire the physician.

Group Homes: Did you know that a federal appeals court in California recently held that the Americans with Disabilities Act prevents municipal governments from discriminating in zoning against group homes for recovering substance abusers? The court permitted a lawsuit to go forward that claimed Newport Beach enacted an anti-group home ordinance with the intent to drive recovering substance abusers out of the residential areas of the city. The court relied on previous decisions holding that substance abusers count as disabled under the ADA.