The American Health Lawyers Association has joined a growing chorus of healthcare organizations and providers seeking guidance from federal regulatory agencies on how hospitals can "lawfully assist physicians in obtaining malpractice insurance coverage."
The AHLA sent letters seeking clarification on the various agency positions to the Internal Revenue Service's Steven Miller, director of the agency's exempt organizations branch; Lewis Morris, chief counsel to the HHS' inspector general; and Leslie Norwalk, the acting deputy administrator of CMS.
In each six-page letter AHLA director Gerald Griffith, a healthcare tax attorney with the Detroit office of Honigman, Miller, Schwartz & Cohn, pointed out instances in eight states in which malpractice insurance has impacted healthcare access.
While not taking a position in the tort-reform debate, AHLA said its 9,200 members represent thousands of hospitals and healthcare organizations struggling to maintain or recruit physicians hard hit by mushrooming medical malpractice premiums.
"The entire healthcare community is affected by the rising cost of malpractice insurance in many states and the negative effects of these skyrocketing costs on access to care," the AHLA wrote. "The impact of rising malpractice insurance coverage on physicians' ability to practice medicine, and on hospitals' ability to maintain physician coverage of needed services, is of crucial concern to the healthcare entities served by AHLA member attorneys."
Hospital officials hope to help their physicians through direct cash subsidies to physicians or indirectly by bringing doctors under the hospital insurance umbrellas. The letter seeks consensus from the agencies on a number of potential insurance assistance scenarios.
Barring that kind of guidance, hospitals offering such assistance could face liability under the Medicare antikickback statute, the Stark law and IRS rules prohibiting excess benefit transactions and illegal remuneration.