Journal of Urgent Care Medicine

What Could Possibly Replace CPT Codes? CMS Is Asking.

The nonprofit PatientRightsAdvocate.org (PRA) has filed a lawsuit against the American Medical Association (AMA) seeking to make Current Procedural Terminology (CPT) codes available to the public and health organizations free of charge, according to an announcement. Federal law requires healthcare entities to use CPT for Medicare claims, and most payer policies—including among state Medicaid programs—use CPT codes for billing as well. AMA has held the copyright for CPT since 1966, and it charges organizations for …

NPs In Texas Say Physician Oversight Is Unconstitutional

Two nurse practitioners (NPs) in Texas and the state’s NP professional association have filed a lawsuit to challenge Texas laws that require NPs to maintain “delegation agreements” with physicians who must oversee their clinical work. According to the complaint, the key plaintiff, who owns her own practice, is paying $96,000 per year for physician oversight services, which the physician can terminate at any time for any reason without state review. The suit argues that the …

Carbon Health Settlement Serves as Warning Shot For MSOs

A freshly inked settlement involving Carbon Health Technologies—a primary care and telehealth provider—is getting attention because it represents a new era in enforcement of stricter corporate-practice-of-medicine rules in California enacted last year. At issue was Carbon Health’s operational approach, which the state attorney general alleged violated the law because the company acted as an unlicensed corporate entity effectively owning and controlling medical practices. In other words, the state believed the corporation itself directed practical medical …

Urgent Care Operators Sue Digital Health Platform

More than a dozen urgent care operators across New York, New Jersey, and Connecticut have filed a federal lawsuit against Solv Health, a platform that hosts a directory of urgent cares with digital features allowing consumers to book appointments. The urgent cares allege in Excel Urgent Care of Astoria PLLC et al. v. Solv Health, Inc. that Solv misrepresented their services, including claims that certain centers did not offer online scheduling when in fact they …

Patients Confused by ‘Urgent Care’ Label on Hospital EDs

How free-standing emergency departments (EDs) present themselves to the community continues to cause confusion for patients, ultimately leading to unexpectedly higher medical bills and negative overall experiences. Some free-standing EDs have the term “urgent care” in their name, which many believe is misleading. And now there is at least one effort to investigate a class action lawsuit for patients who accessed what they believed was urgent care—based on the facility’s sign out front—only to find …

Dealing with the Disruptive Doctor

Urgent message: When a physician is dubbed “Tom the Terror,” turning a blind eye can send patients and staff heading for the exit, wreck your reputation, and spark a lawsuit. Here’s what to do instead.LEONARD D. GOODSTEIN, PHD, ABPP, and JOHN SHUFELDT, MD, JD, MBA, FACEP Tom P. is a competent, board-certified emergency physician. He is liked and respected by his patients. But Tom‘s relationships with staffers at the urgent care center where he still …

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