Mid-Atlantic Health Law TOPICS
Did You Know? Winter 2023
Nursing Home Contracts: Did you know that the Illinois Supreme Court recently ruled that an arbitration clause in a nursing home contract was not available to resolve a claim brought by the decedent’s estate, where the nursing home contract contained a termination-on-death clause. In Clanton v. Oakbrook Healthcare Centre, Ltd., the court held that where a contact contains a termination-on-death clause, the entire contract is terminated unless certain clauses are specifically exempt.
Medicare Advantage Preemption: Did you know that the California Supreme Court recently found that the statutory language of Medicare Part C (Medicare Advantage) contains an express preemption of “any state law or regulation” that concerns Medicare Advantage plans? The court held in Quishenberry v. UnitedHealthcare that the federal preemption applied to both state statutory and common law duties. This is a broader interpretation than other federal standards that only preempt state law when the state law differs from the federal standards.
Corporate Practice of Medicine: Did you know that a federal district court in New York recently held that medical clinics owned by licensed physicians may violate criminal federal health care fraud laws where the actual ownership and control of the clinic is vested in non-physicians? In U.S. v. Pierre, the court found that physicians made false statements to automobile insurers by submitting claims from clinics that included attestations that the clinic was in compliance with New York law requiring that medical practices be owned by licensed physicians. The clinics were actually owned and operated by non-physicians who paid licensed physicians to “own” the clinics on paper. The physicians had no real understanding of the clinics and their operations. This decision is significant since management services arrangements are often used to circumvent state corporate practice of medicine laws. Therefore, at least in New York, physician owner(s) should retain control of such medical practices.
Darci M. Smith
410-576-4153 • dsmith@gfrlaw.com