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What's the ROI on the Medical Malpractice Claim Pending Against You? Print E-mail
Written by Michael Sacopulos, JD   
Thursday, 26 May 2011 16:49


Medical Justice Medico-Legal Q&A

Q: I have recently been told there are a number of organizations investing in medical malpractice suits in the State of Florida. As I understand it, these organizations invest large sums of money with plaintiff's attorneys in hopes of a big return. Is this true? If so, is it legal?

A: I am sorry to be the one to tell you, that in fact there are firms putting money into lawsuits against physicians. For a variety of legal reasons, the investment is typically in terms of a loan. A quick Google search will turn up a number of firms willing to loan money to plaintiff's attorneys engaged in medical malpractice litigation. These loans are not for an insignificant amount. For example, LawCash sets its lending parameters of a minimum Ten Thousand Dollars ($10,000) maximum One Million Dollars ($1,000,000.00) per case. LawCash promises to decide whether or not to fund a particular case within forty-eight hours.

Organizations investing in litigation or organizations extending loans to attorneys typically charge two to four percent interest per month, compounded annually. This can result in effective annual interest rate in excess of fifty percent. Often this interest rate is justified on the basis that the loans are "non-recourse loans." This means that if the plaintiff's litigation is unsuccessful, there is no obligation to repay the loan. We will leave it to you to speculate as to the impact of high dollar non-recourse loans upon medical malpractice claims.

As to the second part of your question regarding the legality of these types of loans, there is not a universal answer. It appears that there is a basis under Florida to believe these types of loans are in fact permissible. Certainly firms engaging in making these loans believe that there actions are permissible under Florida law. Other states prohibit this practice. Finally, there are some states, such as Kentucky that currently have legislation pending which would address the issue head on. I am unaware of any legislative efforts in Florida to prohibit the trafficking in medical malpractice litigation, at the present time.

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos may be reached at

Last Updated on Thursday, 09 June 2011 09:01
Creating the Ideal ACO Print E-mail
Written by Jeffrey L. Cohen   
Tuesday, 24 May 2011 08:59

The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things:  (1) talking, and (2) inactivity.  Yes, the concept of delivering care in a manner that reduces or at least controls costs is important and interesting.  Yet, the marketplace is replete with people and businesses that have adopted a wait and see approach, which is really no approach at all.  Businesses and people who will thrive (especially in dynamic times) are those who, as always, take a lesson from sharks:  swim ahead or drown.

            So what about ACOs?  What the best "thing"?  How do you make one?  First, you have to do away with the focus on ACOs, since they are more of a concept than a thing.  Focusing on ACOs as a thing merely paralyzes the viewer because they are, by definition, not subject to such limitations.  What is clear, however, is what they're supposed to do:  reduce costs and improve quality in a demonstrable way.  How do you do that?  Easy...squeeze the toothpaste tube backwards.

            The most expensive end of the toothpaste tube is acute care-hospitals.  Reduce patient admissions and readmissions and reduce costs.  The next most expensive part of the tube is specialist care.  Coordinate care and reduce specialist involvement in the first place and reduce cost.  So where does all this toothpaste get plopped?  Primary care!  Businesses or systems that place more control and focus on primary care and on prevention stand to save the most.  But that's not enough! 

The missing piece in the entire healthcare reform debate and yet the most effective piece in terms of reducing costs and improving quality is (drum roll....) patient accountability!  So (the punch line), healthcare businesses and systems which empower primary care physicians and which create patient accountability are best suited to reduce cost, improve quality and hence to become an ACO, the core part of one or at least remarkably effective.  How do you do it?  A million ways, but as Americans probably the most effective way  More money for the "right" behavior and less money for the "wrong" behavior.  

            Information technology (e.g. EMR) is the glue for the whole thing.  Without it, one cannot effectively measure or control cost or quality.  Right fit is the key issue with IT.  Hire a consultant who has no product to sell!

            Physician responsibility and leadership is critical.  For change to be effective, we cannot repeat the experience of the 90s with PHOs for instance.  Physicians failed and refused to effectively bring colleague behavior in line.  With the right financial incentives, however, that can be changed.  In fact, the very core of any business which effectively adapts to the call for change is the alignment of financial incentives.  Which is why we are having this discussion and experiment in the first place, right?

            The most effective ACOs are not the ones with the best lawyers or consultants.  They are the ones which have:

1.     A strong primary care core;

2.     Patient incentives for healthy patient behavior and disincentives for unhealthy patient behavior;

3.     Effective IT to track, measure and control cost and quality;

4.     A culture where the physicians and other components (e.g. hospitals) are committed to the best quality with the smartest expenditure of resources; and

5.     Physician leadership to ensure the "right" behavior.

Even if the "answer" isn't ACOs, even if the healthcare reform law is found to be unconstitutional by the US Supreme Court, any organization which does what's described here, in whole or in part, will be better off.  The best and most reliable thing one can say about healthcare reform and ACOs is that it is causing many people to move and improve.  It may not be an ACO, it may not do everything, but any improvement is good and right at this time.


With over 20 years of healthcare law experience following his position as legal counsel for the Florida Medical Association, Mr. Cohen is board certified by The Florida Bar as a specialist in healthcare law. His practice immerses him in regulatory, contract, corporate, compliance and employment related matters.  Mr. Cohen is the founder of The Florida Healthcare Law Firm. | 888-455-7702

Last Updated on Wednesday, 01 June 2011 15:15
MGMA Study Reports Most Physicians Are Satisfied With Their EHR Systems Print E-mail
Written by William Maruca   
Thursday, 05 May 2011 09:10

A study conducted by MGMA indicates most doctors surveyed who have implemented electronic record systems are satisfied or very satisfied, and many report increased productivity and reduced costs as those systems are optimized, according to Modern Healthcare.   The full MGMA study may be downloaded here (registration required).  This report is highly recommended reading.

 The study, funded by PNC Bank, tabulated over 4,500 responses from a variety of organizations representing over 120,000 physicians, over half of them in independent private practice. Of the respondents, 16.3 percent believed they had optimized their EHR.   One surprising finding - independent physicians are farther along in the process than hospital-employed physicians: 

"Finding independent practices further along in EHR optimization than IDS- and hospital-owned practices might seem surprising at first glance. As components of larger systems with greater access to financial and technical resources and expertise, IDS- and hospital-owned practices would seem more likely to lead rather than trail independent practices in EHR adoption. Yet, aspects of hospital and IDS-ownership may slow EHR adoption; it also may slow integration of EHR with other technologies."

The leading barrier to implementation of EHR cited was "Expected loss of productivity during transition to the EHR system", followed closely by "Insufficient capital resources to invest in an EHR."  Most telling is Figure 12 in the report, which shows 85.8% of "optimized" EHR users satisfied or very satisfied with their systems overall; 56.5% of such users satisfied with the ability of the EHR to decrease practice costs; 61% of such users satisfied with the ability of the EHR to increase provider productivity; and 60.8% satisfied with the ability of EHR to increase practice revenue.  MGMA concludes:

"These data indicate that EHR users find reaching full optimization of their system produces benefits, and that they are more likely to perceive these benefits than other users. Efforts to optimize an EHR implementation are likely to produce tangible benefits for a majority of EHR users."

About the author:  Mr. Maruca is a partner with Fox Rothschild.  To learn more, click here.

Cyber Discrimination: A New Frontier of Liability for Healthcare Providers Print E-mail
Written by Jeff Segal, MD, JD, FACS and Michael Sacopulos, JD   
Sunday, 01 May 2011 12:56

Pause for a second, stop reading this article and close your eyes. Imagine living life as one of the 1.3 million blind people in the United States. Think about how you would access information exchanged over the Internet. For 60-year old New York resident Mindy Jacobsen, this is her reality. She has been blind since birth.

Thanks to the American for Disabilities Act (“ADA”) it is easier for Mindy to navigate around New York City. She can walk sidewalk to sidewalk, hop on a train and live a fully functional life, except when it comes to navigating through the internet.

“You go to a hospital’s website and want to get the pre-op information there, but it isn’t available and if it is, it is in a format we can’t read. Then we have to ask people to read it to us and it becomes such a big deal,” Jacobsen said.

Mindy uses a screen reader to read web pages to herself. It is a helpful tool that allows her to navigate the World Wide Web.

“We have computers that take advantage of the speech kit that is built into all computers. Instead of using that speech kit to show a movie, which it certainly can do, we have a program that uses that speech kit to read the screen. So every time the screen refreshes, the software sends the information to the speech kit and it is read aloud to us,“ Jacobsen said.

Section 508, added to the Rehabilitation Act in 1986 and amended in 1992 and 1998, requires Federal agencies to make their website accessible to people with disabilities.  Outside of Federal agency websites, the U.S. government policy is to encourage self-regulation of the Internet wherever possible.  Only if self-regulation is insufficient does government involvement become necessary.

Self-regulation hasn’t fared well for a handful of public companies nationwide. The most famous and commonly cited case was litigated several years ago, when the National Federation of the Blind filed a suit against the retail giant, TargetThe plaintiffs alleged Target's website was not compliant within the outlines of the ADA.   National Federation of the Blind v. Target Corp., 452 F. Supp. 2d 946 (N.D. Cal. 2006) asserted the requirements that Title III of the ADA imposes on places of public accommodation also applies to e-commerce websites.  The plaintiffs were blind individuals who claimed the Target website discriminated against them since the website did not work well with screen reading software.  The case was the first lawsuit applying the ADA to a website that survived a motion to dismiss.  The Target case was recently settled out of court for reportedly six million dollars. Quite a sum. 

To Finish the Article, CLICK HERE.

Last Updated on Thursday, 26 May 2011 16:48
And the Winners are… Print E-mail
Written by Jeffrey Herschler   
Wednesday, 27 April 2011 16:16

Recently the South Florida Business Journal announced their 2011 Ultimate CEO Awards for Palm Beach County. There were ten honorees; four were healthcare leaders. According to the SFBJ, top CEO's from the Palm Beach area medical community are:

Scott H. Adams, CEO, Integrity Tracking LLC dba MobileHelp - The company's website describes the  firm as a "healthcare technology company that developed and distributes the MobileHelp medical alert provide emergency assistance to users while in their homes or away."

Davide M. Carbone, CEO, St. Mary's Medical Center and the Children's Hospital at St. Mary's

Cathy Cohn, president/CEO, Healthy Mothers Healthy Babies Coalition of Palm Beach County

Jerry Fedele, president and CEO, Boca Raton Regional Hospital

Last Updated on Wednesday, 27 April 2011 16:24
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