28005 Festive Mailer S Tours NY NJ PA...By Barry Liss, Esq., Healthcare Team Leader, Director, Corporate Department Our firm represented a physician group practice that desired to

clinical experience in our campus Speechand Hearing Clinic that provides diag-nostic and treatment services to thecommunity. Physical education teachers,athletic trainers and other health pro-fessionals can pursue our master’s inexercise and sport studies. Our new doctorate in clinical psychology prepares students for clinical practiceand research positions. Numeroushealthcare certifications are offeredthrough our School of Continuing andProfessional Education.

LAW

Callagy Law, PCBy Sean R. Callagy, Esq.,President

One of Callagy Law’s primary areas of practice

is representation of medical providersagainst insurance carriers in No-Faultarbitration, also known as PersonalInjury Protection or PIP. Beginning in

2013, Callagy Law’s PIP Litigation Teamwas at the forefront of challenging thewidespread practice of applying medicalfee schedules to hospital treatment.Automobile insurance carriers wereinappropriately limiting reimbursementsto hospitals for medical services ren-dered to patients injured in automobileaccidents by applying either physicianfee schedule or ambulatory surgery cen-ter fee schedule amounts. In fact, therewas no hospital fee schedule in placeuntil Jan. 4, 2013, and that fee schedulehas very limited application. The result

of this aggressive approach to medicalrecovery taken by the Callagy team on behalf of Callagy Law’s hospitalclients was nothing short of astounding.In 2013, PIP recoveries for our hospitalclients amounted to $8.8 million, anincrease of more than 600 percent over2012. This aggressive and successfulrecovery process has not ceased orslowed down. In 2014, PIP recoveries for our hospital clients totaled $10.8million and in 2015, PIP recoveries total-ed $15.7 million. Needless to say, we arelooking forward to 2016 and what it willbring to our hospital clientele.

Gibbons P.C. By Barry Liss, Esq.,Healthcare Team Leader,Director, CorporateDepartment

Our firm represented a physiciangroup practice that desired to spin offoperations at a satellite location. One ofits employed physicians desired to leave

42 COMMERCE • www.commercemagnj.com

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clear “why” case. The customer interfaceis not the same as the customer experi-ence, and banks need to create a morecompelling story for consumers withtheir platforms.“Even the magic wand of Apple

has not been enough to jumpstart themobile proximity payment market,” says

Ubaghs. “With similar platforms fromGoogle and Samsung now emerging, itwould appear these platforms face sev-eral years of steady slog towards massacceptance.”

Blockchain Technology. As attentionmoves away from Bitcoin as a currencyand towards the longer-term use of distributed ledger technology, Ovum’sreport emphasizes how enterprises,from banks to merchants, need to get to grips with this technology now.Blockchain and distributed ledger tech-nologies are finally approaching practi-cal applications as the regulatory envi-ronment begins to become clear.“Not every organization will need

the Blockchain in the short term, butwhat they will need is an understandingof where it can fit into their organiza-tion. The scale of implications of theBlockchain suggests slow movers arelikely to miss out in the long term,” concludes Ubaghs. n

continued from page 40MOBILE BANKING AND PAYMENTS

HEALTHCARE

the group and create his own solo prac-tice at that location. The parties enteredinto an asset purchase agreementwhereby the group practice would sellequipment located at the satellite officeto the soon-to-be former employee. A few days prior to closing, a UCCsearch revealed that equipment at thesatellite location was used as collateralin an unrelated financing agreementinvolving the group practice. Unless the equipment was unencumbered, the transaction could not proceed. The problem, therefore, was the need tounencumber the equipment on an expe-dited basis, which required timely assis-tance, approval and action from a thirdparty (i.e., bank). The firm solved theproblem by contacting representativesof the bank, explaining the underlyingtransaction, and requesting it to excludeequipment located at the satellite officefrom the collateral listed on the UCCfinancing statement. The financing insti-tution did not object and timely filed an

amendment to the UCC financing state-ment that expressly indicated a changein collateral. The equipment at the satel-lite office was then unencumbered andthe transaction closed on schedule.

Harwood Lloyd, LLCBy Mark D. Marino, Esq.,Counsel

A New Jersey hospitalsought my guidance for

its negotiation of a network agreementwith a private health insurer that previ-ously imposed financially unsustainable“in-network” rates upon the hospital. I advised the hospital that its only lever-age in negotiating fair and sustainable“in-network” rates was to elect to leavethe insurer’s network and become “out-of-network”—a provider with no net-work agreement. Doing so allowed thehospital to take advantage of a regula-tory climate in New Jersey that requiresinsurers to pay enough money for “out-

of-network” emergency hospital servicesto ensure that patients are not balancebilled for the difference between whatthe hospital bills and what the insurerultimately pays. The insurer was thenfaced with the reality that it wasrequired to pay the hospital its fullcharges for emergency room servicesunless and until a new network agree-ment was reached between the parties.This neutralized the insurer’s once dominant position in the contract nego-tiations, thereby allowing the hospitalto negotiate a new network agreementwith favorable rates.

Jackson Lewis P.C. By Martin W. Aron, Esq.,Principal

We won a significant trial victory for a major

healthcare institution in a case underthe state’s “whistleblower” statute, the New Jersey Conscientious Employee




HEALTHCARE

COMMERCE NEWS

NATIONAL PHILANTHROPIC TRUST President and CEO Eileen R.Heisman’s strategies for charitable

giving include several considerations:budget your gift amounts; make fewerbut larger gifts; make unrestricted gifts;

stay with a charity for 3-5 years; go on site visits, if pos-sible; research and narrow down to 3-5 charities; andevaluate a charity’s expenses each year.The work of charitable and philanthropic organiza-

tions is so important, and yet we are tapping into only a small amount of the resources that could be focused on helping those in need. For example,National Geographic notes that Americans have $10 bil-lion in loose change in their homes—that’s real dollarsthat could be invested in helping others. To get thismoney to charities would be a “change” for the good.Researchers from The Center on Wealth and Philan-

thropy at Boston College suggest that every time the

stock market declines by 100 points, charitable givingdeclines $1.85 billion, and charitable donations rise bythat same amount when the stock market increases.This demonstrates the power of business in supportingcharitable causes, groups and nonprofits.Daniel Craig—best known for his portrayal of James

Bond—boarded an ORBIS Flying Eye Hospital flight forMongolia in 2011 to bring attention to the global fightagainst blindness, but you don’t need to be a moviestar to be a hero to the many people in need. Do whatyou can to help others. Give what you can as often aspossible. Make giving back a part of your company’sculture because supporting the communities you serveis truly a worthwhile investment. n

A “Change” forthe Good

BY DEBRA ROMANO

CIANJ EXECUTIVE VICE PRESIDENT

Americans have $10 billion in loose

change in their homes—that’s real dollars

that could be invested in helping veterans and their families.

Protection Act (CEPA). The case wasbrought by an employee of a hospital-based, ambulance company who wascharged with various compliance duties.While the employee's position was elimi-nated due to financial and budgetaryconstraints, in her lawsuit she claimedthat she was a victim of unlawful retali-ation for raising compliance concerns.After a five day trial, the court dismissed

the employee’s claims and found infavor of the ambulance company. The case was pending while the NewJersey Supreme Court was consideringwhether the mere performance of one'sjob duties by compliance employeeswould satisfy the statutory requirementof whistleblowing activity. The case pre-sented a challenging opportunity tohandle cutting-edge legal issues at trial,and we were pleased to correctly antici-pate the issues for our client. Plaintiff’scounsel filed no appeal of the defense verdict.

Lowenstein Sandler LLPBy Kenneth A. Rosen, Esq.,Chair, Bankruptcy, FinancialReorganization & Creditors’Rights Department

Lowenstein Sandler LLP representedEast Orange General Hospital in itschapter 11 bankruptcy proceeding. The hospital suffered as increasingly

more services previously rendered insidea hospital have become available atambulatory care centers and outpatientclinics. It also suffered from industryconsolidation and from limited access tocapital available to community hospitals.In 2014 the hospital agreed to be sold to a for-profit hospital operator fromCalifornia. Closure would have been aneasy solution; however, the hospital’sboard was insistent on maintaining an acute care hospital for the residentsof East Orange. The regulatory approvalprocess for the transfer of a Certificateof Need is a lengthy one. Despite man-agement having made great improve-ments to the hospital’s operations andto its finances, the hospital came dan-gerously close to running out of cashand was compelled to commence achapter 11 bankruptcy proceeding.Lowenstein Sandler represented the hospital in chapter 11 and, along withmanagement and with the hospital’sfinancial advisors, accomplished the




HEALTHCARE

LEGISLATIVE UPDATE

IN NEW JERSEY, MOST BALLOT questions deal with preserving openspace and improving infrastructure.

A few years ago, voters approved the bonding of more than $750 million to help improve the facilities at our state’s

colleges and universities.Ballot questions, which must be approved by the

legislature in the form of a concurrent resolution, are unique in that they do not need to be signed bythe governor. Thus, the executive branch is completelyeliminated from the decision process and—if votersapprove the measure—our state Constitution is amend-ed, removing all flexibility when it matters most.In November, voters will be asked to amend New

Jersey’s Constitution to dedicate all fuel taxes collectedto transportation projects. That is a good thing. Otherballot questions under consideration include expandinggaming to northern New Jersey (which would be good)

and making mandatory state pension payments (which is worrisome).Mandating state pension payments regardless of

economic conditions will force future governors andlegislatures to either cut from critical programs or raise taxes. How can this be good for New Jersey?While pensions should be funded, amending ourConstitution to solve the problem ignores the perils of removing all flexibility in balancing the state budget—giving the governor only draconian options.To the proponents that say ballot questions are the

voice of the people, consider that voter turnout hasgone down in recent years to all-time lows. When onlythree of 10 registered voters cast a vote, these policydecisions are not representative of the people.Legislators and governors are elected to negotiate anddeliberate on issues, from the simple to the complex.They should not abdicate their responsibility, or beforced to do so by ill-conceived ballot questions. n

Legislators should notbe forced to abdicate

their leadership responsibilities by

ill-conceived ballot questions.

BY ANTHONY RUSSOEVP, GOVERNMENT AFFAIRS & COMMUNICATIONS

The Unspoken Perils of Ballot Questions


sale of the hospital to a purchaser which will invest in the hospital andhelp assure that the community retainsaccess to quality healthcare for manyyears to come.

NPZ Law GroupBy David H. Nachman, Esq.,Managing Attorney

NPZ Law Group partnerswith and guides healthcare

employers and HR staff to efficientlybring doctors, medical professionals andresearchers from other countries to theUnited States where they are needed.For example, a hospital in New Jerseywanted to hire a pediatric cardiologistfrom the U.K., and the desired doctorthought she had to seek a waiver of hertwo-year foreign residency requirementand then get an H-1B nonimmigrantwork visa in the United States.Following a review of the physician’s

resume, we determined that the bestway to proceed was to do an O-1 visafor an individual with extraordinary abil-ity. After filing the O-1 visa using premi-um processing, an approval was receivedwithin just a few weeks. The VISASERVEteam sent the doctor to the U.S. Consul-ate in the U.K., where she obtained her visa stamp and she returned to theUnited States in about a week. The hos-pital administrators marveled at thespeed and precision by which the casewas handled. NPZ Law Group navigatedthrough a maze of U.S. immigrationlaws to make this happen.

Wilentz Goldman & Spitzer, P.A.By Michael F. Schaff, Esq.,Healthcare/CorporateLeader

Our client, a start-up telemedicinetechnology and services company based

in New Jersey, wanted to understandand comply with the legal issues sur-rounding the practice of telemedicine in the Garden State. Wilentz helped ourclient navigate this new area of health-care delivery. Telemedicine is vital to thefuture delivery of healthcare, and represents an emerging area of the lawrequiring regulatory review. Numerouslaws and regulatory issues are implicat-ed by telemedicine, including federaland state referral and anti-kickback laws



HEALTHCARE


and state medical and insurance licen-sure and insurance licensing rules.Significantly, telemedicine paymentmodels do not follow traditional medi-cine and must be tailored to address the unique aspects of telemedicine. We worked with our client to addressthese concerns in structuring the client’sbusiness model and agreements. Ourfirm drafted the various arrangementsand template agreements to be used by our client. We also worked with ourclient in preparing a proposal for a man-aged care company and for a hospitaltelemedicine program.

***Large Group Physician PracticesThere is an emerging trend in the

medical industry—independent physi-cians and practices are consolidatinginto larger group practices. This direc-tion boasts a win-win for physicians,who benefit from the reduction in overhead, and for patients who appreciate the added convenience.

Rather than patients traveling tophysicians’ offices scattered throughoutdifferent towns or counties, local health-care providers are realizing that consoli-dating practices and specialities underone large roof can reduce costs and pro-vide a better patient experience.

David Hirschman, presi-dent of David HirschmanRealty Company, under-stands the value proposi-tion and has been assistingphysicians and landlords inBergen County, New Jersey,with mutual objectives.

In fact, over the past four years, he hasleased 127,000 square feet of medicalspace worth some $27 million in BergenCounty for practices who choose to co-exist.“This is a golden opportunity for

local medical professionals to pool theirresources, share office space and providea more professional, full-service, one-stop practice for their patients,” saysHirschman.

Full service medical buildings oftencater to a wide array of patients’needs—from office visits and physicals,to imaging tests and bloodwork. Inaddition, the consortium may includespecialists such as internists, cardiolo-gists, plastic surgeons, gynecologists,gastrointestinal specialists and more.Hospitals are also seeing the value inbuying practices, which allows them tooffer a variety of specialists in one loca-tion, and smaller physicians’ practicesgain added clout with insurance compa-nies because of their hospital affiliation.The real estate business is constantly

evolving and becoming more effective.Smaller medical offices are choosing tomerge with larger, more efficient prac-tices and some larger medical businessesare looking to expand and acquire inter-ested smaller practices. In addition tosaving on leasing expenses, physiciansare able to streamline services such asinsurance, billing and administration,while better accommodating theirpatients. n


HEALTHCARE

Documents

28005 Festive Mailer S Tours NY NJ PA...By Barry Liss, Esq., Healthcare Team Leader, Director, Corporate Department Our firm represented a physician group practice that desired to