December 09, 2014 Articles

Emerging Litigation Threats for Physician Relationships in a Post-ACA World

Healthcare providers have historically not viewed physicians as likely whistleblowers, but that is changing.

By Emre N. Ilter and Thomas A. Ryan

Four years after its adoption, the Patient Protection and Affordable Care Act (ACA) has transformed the landscape of litigation for healthcare providers. Those who have watched the healthcare market have seen the major wave of consolidation that has been triggered by the ACA. Despite the additional patients now in the system, providers are vying for a diminished pool of revenue. This has placed substantial pressure on individual doctors and small practices to consolidate with larger entities to survive. But with these increased market pressures, litigation risks have increased as well, and the past years have seen an apparent uptick in large-scale litigation against healthcare providers. Many of these cases have been brought by physicians, often in the role of “whistleblower,” against both competitors and colleagues for a variety of financial and emotional motivations. Although it is perhaps not surprising that litigation by physicians and hospitals against new “competitors” created by ACA-inspired consolidation is increasing, what is perhaps surprising is that the litigation is increasingly targeting business models.

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