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When insurers, health plans and health care systems retaliate against physicians, surgeons, and other health care providers (which is...
What Type of Conduct Can Be Retaliatory Under California’s Law That Protects Physicians and Surgeons
California Business & Professions Code 2056 protects physicians and surgeons (and similar laws protect other health care providers)...
A Termination ‘Without Cause’ Can be Legally Challenged.
If you’re a physician, a “without cause” termination is just as harmful as being terminated for cause. In many cases it can be legally...
Is Telehealth here to stay?
Telehealth (telemedicine) seemed like it was here to stay when the pandemic hit. Being stuck at home and needing the advice or services...
Theresa J. Barta selected to California Super Lawyer list
Theresa J. Barta has been selected to the 2020 California Super Lawyers list for health care law. Each year, no more than five percent of...
Are Medical Directors who work for health plans and insurance companies Medical Doctors (M.D.s)?
The answer is, “Kind of.” While Medical Directors have a medical degree, their focus is not on providing patient care. Instead, they...
Determinations by insurers of ‘not medically necessary’ are used to punish doctors
Letters and Explanation of Benefits (EOBs) sent by insurers to patients stating that the medical services their doctor provided were “not...
Beware of silent PPOs: they are of NO benefit to doctors or patients
When a physician joins an insurer’s PPO network, they agree to accept discounted rates for their services in exchange for the insurer...
Insurers often violate law when terminating Medicare Advantage plan doctors
Are you a doctor who provides services to patients through Medicare Advantage plans? IF SO . . . you should know that a federal law (CFR...
Focus on productivity by health care systems affects quality of care
I’m sure you’ve heard the term “productivity” and know that increased productivity is a goal in most, if not all, businesses. But, did...
Narrow Network Health Plans are NOT What’s Best for the Patient
Beware patients (which means everyone!). Only health insurers and employers who sponsor health insurance for their employees benefit from...
How Insurers Profile and Punish Physicians
Physicians are tracked on performance measures, which are NOT to be confused with economic or efficiency profiling. Health insurers use...
Doctors Cannot Be Arbitrarily Excluded From Insurers’ Provider Networks
Health insurers have long used exclusion of doctors from provider networks as a means to increase their bottom line. When there are fewer...
California Health Care Providers have Strong Whistleblower Protections
This law came to mind because there are doctors, nurses and health care providers who are reporting unsafe conditions relating to...
California Doctors Enjoy Special Protections When Advocating for Patients
California law specifically protects physicians and other health care providers who advocate for patient care from any kind of...