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The problems of poor-quality or unnecessary care were caused, in part, by the fee-for-service payment system that was in effect for generations. The fee-for-service model unfortunately offered the wrong incentives to dishonest or poor-quality providers to maximize revenue by maximizing services regardless of the quality or the medical necessity of the services provided.

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Discussion of two recent important rulings.

TheUnited States Court of Appeals for the Seventh Circuit recently held that merely "authorizing" medically necessary services can constitute illegally "referring" patients under the AKS, if improper payments are made to the authorizing doctor.

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Discussion of a case in which the Judge cleared up the intersection of MCARE and the Tort Claims Act.

Features

The admission of evidence of a health care provider's customary practices to prove that he or she acted in accordance therewith in a specified plaintiff's case is not necessarily guaranteed. Last month, in Part One, we began looking at how New York's courts have handled the issue of admissibility when such evidence was offered. We conclude that discussion here.

In order to assess the validity of economic losses within the field of medical malpractice, a number of variables must be taken into consideration. And depending on the alleged loss advanced, there exist subjective elements that make it difficult to gauge and evaluate those allegedly caused by the medical malpractice.

In-depth discussion of several key rulings.

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Discussion of several pivotal rulings.