Malpractice, FCA, GME, HIPAA, More State Legislation

Malpractice & FCA Risk - To the educated physician, malpractice should not be your greatest legal fear.  Yearly malpractice payouts across the nation are hanging just shy of $4 Billion annually, but the "up and comer" is the False Claims Act - where payouts now total $3.5 Billion per year.  Provisions of the False Claims Act and the liability associated with Medicare RAC audits are more ominous than medical malpractice.  According to Lisa Noller RAC Audit use is expected to increase.  Remember that "pure" opted out DPC physicians that do not bill any government entities are free of any False Claims Act liability, and medical malpractice in the DPC setting is lower as well.

GME Funding Not Increasing - If you expect Medicare to continue providing more funding for graduate medical education (residency positions) - think again!  See Dr. Fitzhugh Mullan's NEJM article.  Maybe the formation of independently funded DPC residencies could help fill the gap?

HIPAA rules are changing, and not necessarily for the better.  Remember that the "P" stands for portability, not privacy.  As of Feb 5, 2016, HHS will permit "certain HIPAA covered entities to disclose to the National Instant Criminal Background System (NICS) certain personal health information (PHI) related to individuals who are subject to a Federal “mental health prohibitor” that disqualifies them from shipping, transporting, possessing, or receiving a firearm."  This new rule is discussed both here and here.   Here is a great discussion of the importance of cybersecurity regarding medical records.

January state legislative sessions are off and running, and many more states are considering DPC Legislation:
- Wyoming
- Virginia
- Florida