Jeff Segal, MD, JD, FACS

We have written recently about social networking group discount programs – like Groupon. We cautioned that such programs might be deemed fee-splitting; a practice prohibited by federal law, state law, and licensing bodies. We now have some additional data points to share.

Not everyone knows what Groupon is. Here’s how it works. A local merchant, like a restaurant or hair salon, offers a discount – often 50% off or more. This gets a lot of attention. But, the discount isn’t activated until a critical mass of Groupon subscribers ‘tip” the deal. Enough people must commit to “paying” for the discount. That’s how Groupon gets paid.

I’ll illustrate a Groupon offered by a restaurant. The deal is 50% off a meal valued at $100. The deal is sent to thousands of people in the restaurant’s draw area. The deal requires 20 takers to “tip the deal.” Once 20 people commit, those patrons are charged $50 on their credit cards. Groupon will then give the patron a $100 “gift certificate.” Groupon then pays the restaurant a sum – which might be $25; maybe more; maybe less.

So, Groupon gets paid a handsome sum. The patron gets a great discount. And the merchant delivers products or services at a discount. The restaurant “pays” twice: a discount to the patron; and a fee, deducted by Groupon, for the marketing. The marketing fee correlates with the volume of business the restaurant receives.

In healthcare, this can be perceived as fee-splitting.

The federal government prohibits fee splitting for specific transactions unless there is a safe harbor. There is no safe harbor for social networking group discount programs.

State governments often have anti-kickback statutes, and to date, we know of no state that has carved out safe harbors for social networking group discount programs.

Finally, licensing boards have long standing policies against fee-splitting. And two such boards have recently spoken.

From the Oregon Board of Dentistry: Continue Reading »

Michael Kirsch, M.D. – author, MD Whistleblower

Medical malpractice reform is in the news again. Of course, for the medical profession, the medical malpractice system is the wound that simply will not heal. For the plaintiffs bar, in contrast, the medical liability system is the gift that keeps on giving. I have argued that the current system fails on four important fronts.

• Efficiency
• Cost
• Fairness
• Quality Improvement

I admit readily that my profession has not been as diligent as it should be in holding ourselves accountable. We have not been forthright in admitting our medical errors, although can you blame us under the current medical liability construct? There is merit to the argument that tort reform is championed by medical malpractice insurance companies who have an economic agenda in this issue. Continue Reading »

Michael J. Sacopulos, Esq.

Recently, Texas House Bill 300 was signed into law by Texas Governor Rick Perry.  The new law, which will become effective on September 1, 2012, expands privacy rights of patients beyond those contained in the HIPAA privacy standards. The law was created in order to better secure patients’ protected health information (PHI) that is sent electronically.

Notably, the new law bans the for profit sale of PHI, requires employees of covered entities to undergo training regarding health privacy law, requires that health care providers supply individuals with access to their PHI within 15 days of a request, increases penalties for the wrongful electronic disclosure of PHI, and requires the Texas Health Services Authority to develop privacy and security standards for the electronic sharing of PHI.  Also, the Office of the Attorney General must create a complaint system and maintain a website that includes patients’ medical privacy rights under federal and state law.

House Bill 300 received the support of the Texas Medical Association, which is a physician advocacy group representing over 45,000 physicians in Texas.  The complete text of House Bill 300 can be found online at http://www.capitol.state.tx.us/tlodocs/82R/billtext/pdf/HB00300F.pdf

Looking for just the right gift for the dentist in your world?  We here at Dental Justice thought we’d put together a Wishlist for dentists.  (That was the initial plan, anyway.)

We ran the gambit, from personalized golf balls and club covers, to new office instruments, equipment, and even designer jackets.  All too quickly, though, it became apparent that there was really only one thing that a dentist truly wants these days: To be able to practice without having to worry about a patient suing or trying to steal services.  But how can you give that gift?

The answer is literally right in front of you.  A membership in Dental Justice can provide peace of mind, because the proven techniques Dental Justice provides to its members stave off the opportunists.   For over 99% of our members, dental malpractice suits are a thing of the past, if they follow the methods we provide.  When a patient’s attorney sees that the healer is a member of Dental Justice or Medical Justice, he realizes that’s one doc who isn’t going to just roll over and hand out money for the asking.  In this sense, membership is kinda like a car alarm.  Thieves move on to easier pickings. Continue Reading »

Tags: dental malpractice, internet defamation, Unwarranted demands for refunds

Dentists chose this profession because they wanted to help people look and feel better, and feel better about themselves.   They recognized that our mouth and teeth are an essential aspect of overall health and felt they could make a difference in people’s lives.  They realized that one doesn’t have to be in the limelight birthing babies in a taxi to make a difference.  To be sure, one of the attractive aspects of the profession is more regular office hours, and a reduced likelihood of being sued for a missing spleen.  That helped make the choice too.

What most did not come into dentistry for was to become millionaires off of fillings.  Nor did they enter the profession to cause unnecessary pain, to be despised for the fact some pain may be necessary to repair the degradation to teeth that have not enjoyed the most thorough of care.  They certainly did not come into the profession to ruin a smile.  No, dentists, like all doctors, are there to help.  But they’re also human, and sometimes things don’t go as we’d like.  The vast majority of the time a bad outcome is neither the fault nor the responsibility of that healer.   Very often, teeth have been abused by foods that eat at their surfaces, gums that have not been given proper care, and even dental work performed years ago which has eventually failed.  When a patient comes into the dentist’s office with three sides of a molar collapsed, the dentist did not create that problem.  But he is there to help. Continue Reading »

Tags: dental malpractice, Dental Practice, Dentist, Lawsuit

Dentists are strong proponents of preventative measures.  Brush your teeth for two minutes after each meal, floss between the teeth, brush your tongue, get regular checkups…  The simple truth is that an ounce of prevention IS worth a pound of cure.  It’s our hope that dentists will start taking that sound advice to heart when it comes to their practices and careers.

Like teeth, practices and careers can benefit greatly from just a few easy steps.  Like teeth, dentists are vulnerable to attacks if preventative measures aren’t taken.  Patients can — and do — sue them for what they perceive as cosmetic flaws.  They came in to look better.  You worked on their teeth, but they still don’t look like J-Lo or Justin Timberlake and now it’s all your fault and they’re demanding a refund!  Or better yet, typing trash about you all over the Internet.
It isn’t just those who actually were patients either.  On the Internet, one can say anything.  So when a disgruntled employee decides to trash your good name and hard-earned reputation, they impersonate a patient and lie.  Doesn’t matter that none of it is true. The damage has already been done.  And the longer it stays up there, the more exposure those lies get, and the more damage is done to you.

Oh, and don’t forget about the risk of you being sued for dental malpractice, too.

What to do about it?  How do you protect yourself?  Continue Reading »

Tags: dental malpractice, prevention, unwarranted demands for refund

Many assume that Dentists are less likely to be sued for malpractice, it would be unwise to presume on that position.  Tough financial times (and a surplus of lawyers) have the wolves at many doors they wouldn’t have bothered with in the past.  One firm found advertising via Google even goes so far as to admit as much , writing “In the past, it was assumed that suits against dentists would result in such minor damages that they were not worthwhile.”*  They go on to say that some suits against dentists have resulted in large jury verdicts, so attorneys are increasingly willing to give it a shot, toss the dice, and hope for a jackpot win.  As times get tougher for them, it’s likely they’ll howl louder for new clients.  Continue Reading »

Tags: attorneys, dental malpractice, trial lawyers

Medical Justice has been helping dentists and oral surgeons through it’s subsidiary, Dental Justice, since 2008, but they haven’t been bragging about it much.  The Dental Justice program is especially important to this type of health care professional.  Though both physicians and dentists are doctors, dentists’ practices tend to be more cash based (and therefore more vulnerable to damages in their reputation, etc.)  Dental Justice members enjoy the same awesome services.  Since some of you may not have heard about those benefits, we’ll recount them here:  Continue Reading »

Tags: demand for refund, dental malpractice, internet defamation, reputation