Singularity Health Law Blog

IRS SPOILS PHYSICIAN RECRUITMENT CONTRACTS

One of the hallmarks of physician recruitment contracts offered by hospitals and physician groups is the incentive of "foregiveness" of "loans" offered t phy;sicians who are financially underwritten as an inducement to relocate and entier profesioal practice ina particular location. Typically, there is a subidiy of the practice for a few years followdd by a three year or so period of continuing practice ofbligaiton in the community, during which the origional subsidy "loan" is written of over time and the physician is given Form 1099C (cancellation of dept) in the later years of the guarantee arrangement.

Last April, a United States District Court judge in the State of Washington, agreed with the Internal Revenue Service that those kinds of "loans" were in fact compensation and not loans at all. It held that the physician group was liable for failure to withhold from the payments to its physicians. The case was The Vancouver Clinic, Inc. v. The United States of America, 111 AFTR 2d paragraph 2031-632 (2013 DC Wash.).

The Hon. Rondal B. Leighton entered summary judgment in favor of the IRS,holding that because both the group and the physician at the inception had no expectatoin that the incentives would be repaid and that there would never be a repayment of the "loan", it was not in fact a loan.

These kind of incentive arrangments will in the future likely to be designed to have the look and feel of actual loans with effective promissory notes and periodic payments over the term of the loan agreements, including the early years. This is just aother level of complexity in the three dimensional chess game of the multiagency oversight regulation of health care systems.

INDIAN CARDIOLOGISTS CAN PURSUE DISCRIMINATION CLAIM

 On November 30, 2012, Judge Greg Costa of the U.S. District Court for the Southern District of Texas, on remand from the 5th Circuit Court of Appeals, allowed three Indian cardiologists to move forward with their discrimination claim against David P. Brown, the administrator of Citizen’s Medical Center, finding that under the McDonnell Douglas shifting burden framework, the plaintiff’s had met their burden of showing a prima facie case of discrimination through circumstantial evidence  on 4 out of 8 adverse employment actions alleged by the plaintiffs and that the justifications offered by the defendant were pre-textual.

 

$2M RETALIATION VERDICT FOR CARDIOLOGIST UPHELD

The First U.S. Circuit Court of Appeals has upheld a $ 2 Million Dollar Jury Verdict in favor of a San Juan Puerto Rico Cardiologist who claimed he had been retaliated against for filing an age discrimination case five years earlier.  In actual fact, the plaintiff Dr. Munoz was fired within days of giving a deposition in the case wherein he recounted his evidence. The defendants appealed on the basis that the decision to fire him had been made well before his deposition and could not be the basis for establishing a retaliation claim under the Age Discrimination Act of 1967 (ADEA), 29 U.S.C. Section 623 d. The Court agreed, to a point, but found that the retaliation could relate back to the original filing, given other facts.

 

SMILE: HOSPITAL PHOTO BANNED UPHELD BY NLRB

Given the ubiquity of cell phone cameras, it is not an infrequent experience for relatives visiting patients in hospitals to take pictures of the patients, nurses and others present in the facility.  Doctors and nurses have even been known to pose with patients for group photos.  In 2007, Flagstaff Medical Center in Flagstaff,  Arizona became concerned about the use of cameras in the hospital and banned the “use of cameras for recording videos of patients and/or hospital equipment, properties or facilities.

 

FACEBOOK FIRING FRENZY?

The rise of the Facebook generation with its attendant practice of sharing its secrets and concerns with friends and foes in social media has lead to a whole new area of potential employment litigation.   More employers are now looking at social media interchanges like Facebook and LinkedIn to develop background information on potential hires.  From an employer’s perspective that makes a great deal of sense. There are amazing things that are shared on the Internet.

 

HEALTH CARE IS A BUSINESS

There is a saying going around that “Healing is an art, medicine is a profession and health care is a business.”  The New York Times today had an article about more M.D. physicians going to school for an M.B.A. as well as an M.D. In the 1990s there were about six academic programs that provided for joint M.D./M.B.A degrees. Now there about 65.  The business of health care is complex and growing more so. More and more physicians are opting out of independent practice to join hospitals and even insurance companies and paid employees.  Many new physicians are looking beyond the practice to management positions in the business of health care, which of course is where the potential “action” of the future is located. It is not enough any more to to provide the professional expertise as a physician without understanding and commanding the larger business of health care, if you want to be a player in health care.

 

SINGULARITY LAW BLOG SCOOPED ON OWN CASE BY FORBES BLOG.

 What can I say?  I have been scooped by Forbes on my own case, but I do have the missing pieces it refers to. It seemed somewhat unseemly to discuss my own case against Lincoln Financial Distributors regarding Continuing Education of brokers regarding long term care insurance mandated by state Departments of Insurance. It may perhaps explain the paucity of posts in July and early August as we were preparing for a nasty arbitration in Detroit.  More to come on this case. Here below is the blog article by Bill Singer of Forbes.