Clark County Medical Society

County Line

Newsletter XXIII  December 2001

 

Contents

Asset Protection for the 21st Century – A Lawyer’s Perspective

Member News

President’s Message – Help Others This Season

SB 99 – Nevada’s Prompt Payment Act; The Waiting Game May Finally Be Over

Executive Director Notes

MDSP Findings

Clark County Health District Disease Statistics – October 2001

CME Calendar

Classified Advertising

 

Asset Protection for the 21st Century – A Lawyer’s Perspective

Robert L. Bolick, Esq., Bolick Boyer & Fine, Attorneys at Law

As the son of a doctor, I grew up on a steady diet of how our income tax structure is regressive by penalizing the producers and subsidizing the indolent.  Later, I got an earful on how Medicaid and HMOs were ruining the practice of medicine by pulling control from doctors and giving it to bureaucrats who were as clueless about medicine as they were about politics.  When I began my practice 20 years ago, I decided that my focus should be on how to keep the bad guys (IRS) from bleeding the good guys (doctors) dry.  I felt good about what I did.  Now, much of the focus has shifted to asset protection.  Even the IRS doesn’t take 100%, which is what today’s bad guys are trying to do.

The latest assault against physicians has been launched by personal injury attorneys chasing not only ambulances, but doctors’ malpractice policies as well.  Outrageously high jury verdicts, and paralleling settlements, have led to astronomical increases in malpractice insurance premiums.  Many physicians are considering reducing their professional liability insurance coverage limits just to be able to afford the premiums.  Doing so will only increase their exposure.  For example, if coverage is reduced from $1,000,000/3,000,000 to $250,000/750,000, a physician is personally liable for any money excess of $250,000 on a single claim.  How many malpractice lawsuits or settlements are for less than $250,000?  The physician’s assets are on the line to cover any overage.

Asset protection is one of the hottest topics for doctors today.  The following is a checklist of various types of assets and ways to protect them. 

·        Home.  A homestead offers protection of up to $125,000 in equity in your residence.  However, a homestead is more of a deferral than it is an avoidance.  A homestead prevents a creditor from foreclosing on your primary residence as long as your equity is less than $125,000.  Your home can be liened against, thereby preventing you from (1) refinancing, (2) taking out a second mortgage, or (3) moving.  As soon as the equity exceeds $125,000, your creditor can begin legal action to foreclose. 

An allodial title exemption protects an unlimited value of your home.  To obtain an allodial title, you must own your residence “free and clear” (unencumbered) and prepay estimated future property taxes calculated on the life expectancy of the youngest person on the title to the property.  Your home may still be liened by the creditor. The creditor is merely precluded from foreclosing as long as any of the titleholders live in the residence.  If the titleholders move or die, the creditor can foreclose on the lien.

A qualified personal residence trust (QPRT) affords a greater degree of protection than a homestead or allodial title exemption.  Unlike those, a creditor cannot lien your home because under a QPRT, you no longer own your home, the trust does.  You can stay in complete control as trustee of your QPRT trust.  You retain all of the income tax benefits of home ownership, such interest and property tax deductions, and the $250,000 for singles or $500,000 for couples capital gain exclusion.  As the trustee, you can sell your home at any time and the proceeds are protected.  When you purchase another home, it can be held in your QPRT and will be similarly protected.  The QPRT can hold a personal residence property in any state.  In essence, you as trustee maintain all of the ownership, benefits and use of your home, but a creditor cannot attach it.  At the end of the term of the trust, the title to the residence passes to the beneficiaries of the trust.  There may be tax consequences to establishing the QPRT depending on the structure and flexibility one selects under the QPRT rules. 

The asset protection benefits of the QPRT are effective immediately.  However, a QPRT established within six months of an event resulting in a lawsuit, and subsequent award or settlement, will likely be viewed by the courts as a fraudulent transfer and be disallowed.  Thus, to utilize the asset protection of a QPRT, it must be established before, in legal jargon, a cause of action accrues.  The costs to create a QPRT range from $2,500 to $3,500.  This is a one-time expense.  There are no maintenance fees or future costs.

·        IRA’s, 401(k)’s, Retirement Plans.  Under Nevada Law, funds held in an IRA, SEP, 401(k), pension, profit sharing, or other retirement plan are exempt up to $500,000.  Funds in excess of this amount are subject to attachment.

·        New Nevada Asset Protection Trust.  Nevada is one of only four states to adopt laws enabling you to create a trust specifically permitting asset protection.  The others are Alaska, South Dakota, and Delaware.  You can be the investment co-trustee of your  trust established under the Spendthrift Trust Act of Nevada (NRS 166) and maintain control over how your funds are invested.  You cannot be the “distribution” trustee who must have absolute discretion as to any distributions from the trust.  These “asset protection” trusts have not yet been challenged in any of the four states’ Supreme Courts to date. 

This distribution trustee may be a relative (but not a spouse), trusted friend, or a trust company, and, by law, has absolute discretion regarding distributions from the trust.  The trust may be structured so that the distribution trustee may not distribute assets to anyone other than you, as beneficiary, or to someone you designate in the trust.  The trust may be structured so that you, as creator of the trust, may have the ability to remove the distribution trustee, directly or indirectly, and appoint a new trustee with absolute discretion to make distributions. 

The trust is effective against claimants beginning two years after the trust is created and assets are transferred.  There are no limits as to the amount of assets that can be transferred into the trust.  Because of the two year window of opportunity afforded creditors, one may use Family Limited Partnerships (FLPs) and/or Limited Liability Companies (LLCs) (which have no two year window) in conjunction with his or her asset protection trust (APT).  The cost of creating a Nevada Spendthrift Trust ranges from $2,500 to $3,500.

·        Stocks, Bonds, Mutual Funds, CDs.  The first assets a judgment creditor will go after are liquid assets – cash and securities which are not held in an IRA or other qualified retirement plan.  A family limited partnership (FLP) may be used to protect these assets.  Assets held in a valid FLP are beyond the reach of creditors.  No creditor can attach your assets, force you to distribute your assets or dissolve your FLP.  You maintain 100% control and ownership of your FLP.  Costs to create an FLP range from $1500 to $2500, plus initial filing fees of $360.  The annual fees to the Secretary of State to maintain the FLP are currently $85.

·        Rental Property.  Rental property may be protected using a limited-liability company (LLC).  By transferring your rental property into an LLC of which you are the sole shareholder, you are not personally liable for anything that may happen on the property.  The LLC is.  Conversely, no creditor of yours can lien the property because you do not own the property, the LLC does.  The asset protection benefits are effective immediately.  The costs to create an LLC range from $1,500 to $2,000, plus initial filing fees and costs of $420.  The annual fees for the Secretary of State to maintain the entity are currently $85.

·        Medical Equipment.  An LLC can also hold medical equipment which you use in your practice.  Your LLC can lease the medical equipment to your professional corporation.  This removes the equipment as a personal asset to be attached in a malpractice claim. 

·        Life Insurance.  A creditor can attach any cash value in a whole life or universal life insurance policy.  Life insurance cash values can be protected in an irrevocable life insurance trust (ILIT).  Holding insurance in an ILIT not only places the cash values beyond the reach of creditors, but also removes the proceeds from your taxable estate.  Most people are aware that life insurance proceeds are income tax free.  Many do not realize that the proceeds are not estate tax free unless held in an ILIT.  It really doesn’t make much sense to own insurance with cash values individually where it thereby is exposed to attachment by creditors and will be included in your taxable estate when an ILIT will address both problems.  The costs of creating an ILIT range from $1,500 to $2,500.  It is a one-time expense.  There are no annual maintenance fees or expenses other than perhaps paying a trustee to make payments on the insurance policy annually.

·        A Living Trust Will Not Protect Assets.  A common misconception is that living trusts provide asset protection during your life.  This simply is not the case.  A living trust can avoid probate, can minimize or eliminate estate taxes and can protect one-half of the estate after the death of a spouse.  While these certainly are desirable objectives, they do not offer any asset protection benefits to a practicing physician during his or her life.  The costs of creating what are know as A/B or A/B QTIP living trusts, which do provide asset protection, range from $1,500 to $2,000.  The costs of creating a “generation-skipping” or “dynasty” type of family trust range from $3,000 to $3,500.

·        Getting it All in Place.    Attorneys typically offer a no cost, no obligation appointment to discuss asset protection strategies with you.  Use an attorney who practices in this area as a significant part of his or her practice.  Remember, the time to avail yourself of these legal protections is well before a problem arises.

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Member News

·        In 1971, Joel F. Bower, M.D., joined the staff of St. Rose Dominican Hospital. Now, thirty years later, he will retire after a distinguished career of providing quality, compassionate care to his patients. He now plans to dedicate much of his time working with programs that help uninsured children.  In addition to his many contributions to the hospital, Dr. Bower has been very active in the community. He served as the Chairman of the state’s Maternal Child Health Advisory Board as well as the president of the Clark County Medical Society.

·        Alan Weissman, M.D., has been named as Desert Radiologists’ Director of PET (Positron Emission Tomography). Dr. Weissman is a double board certified physician, in both diagnostic radiology and nuclear medicine.  “When I came to Las Vegas nearly five years ago, I understood the medical potential of PET,” said Dr. Weissman. “PET will not replace CT and MRI, but rather complement these standard anatomic tests.”

·        The Clark County Medical Society raised nearly $4,000 for local and national charities at a fundraising dinner on November 1. We would like to thank the Clark County Health District for providing an excellent speaker on Bioterrorism Preparedness and Sunrise Hospital and Medical Center for contributing the dinner and meeting space.

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President’s Message – Help Others This Season

Raj Chanderraj, M.D., 2001-2002 CCMS President

The fallout from the events of September has affected the whole nation. We joined the rest of the nation by contributing thousands of workers to the unemployment pool. The crisis in caring for these unemployed people has evoked a community where everyone is coming up with innovative ways to help. The Medical community with very few exceptions like Dr. Villaflor has done very little to become part of this community effort.

The present crisis, in a way, brought into focus the needs of unemployed and uninsured people. This problem is growing exponentially as the valley’s population grows. Today there are nearly 200,000 uninsured people in Southern Nevada. Unless this problem is addressed, caring for medical emergencies will consume a lot of resources that could be otherwise utilized.

As physicians, we should play a vital role in contributing to the welfare of the society. We need to do our share of caring for the uninsured. Many physicians are under the belief that they are doing this by writing off the unpaid balances of the patients unable to pay. Unfortunately this is a business risk and not an act of charity or goodwill. Charity is when you see patients without expecting to be paid for the services you render.

When we physicians step up to the plate in times of need, our efforts will be recognized by the community and the law makers. This will help portray a positive picture of the physician community. They will come to understand that we do care for people and in due time may be inclined to favor us in protecting our ways of practicing medicine.

There are several ways you can be of help. If you need information and are inclined to participate, please call me and I will steer you in the right direction. Have a wonderful holiday season.

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SB 99 – Nevada’s Prompt Payment Act; The Waiting Game May Finally Be Over

Artemus Ham IV, Esq.

Physicians and their patients have traditionally been forced to endure a “waiting game” when submitting a claim to an insurer.  Insurers would take long periods of time before informing a physician as to whether the claim would be approved, and then take even longer before actually paying it.  This trend has caused great frustration for doctors and their patients alike.  In response to these unreasonable delays, the Nevada Legislature has enacted Senate Bill 99 (hereinafter “SB 99”) to place restrictions on the way an insurer must process a claim.  Not only does SB 99 contain strict guidelines regulating payors, but it also contains a provision for calculating damages if these guidelines are ignored.  Therefore, it is imperative that physicians not only become versed in the meaning of this new law, but also that they understand ways to protect against an insurer’s avoidance of the law’s application.   

SB 99, codified in Nevada Revised Statutes at Chapter 600, became effective October 1, 2001.  SB 99 mandates that an insurer shall approve or deny a claim within 30 days after the insurer receives the claim.  This provision provides greater protection to physicians, as insurers must now notify a physician of their intentions within 30 days of receiving a claim.  At the very least, this will certainly minimize the waiting game that physicians have traditionally been forced to endure.  SB 99 also mandates that if the claim is approved, the insurer shall pay the claim within 30 days after approval.  The law now mandates that physicians not only be placed on notice within 30 days of receipt of the claim, but that payment be made within 60 days from the receipt of the claim. 

The intentions behind SB 99 are evident, yet they would be unenforceable without a provision to punish insurers who chose to ignore it.  NSMA convinced the legislature to include a provision in SB 99 which mandates that if the insurer fails to pay in the 30 day period after approval, the insurer shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada immediately proceeding the date on which the payment is due, plus 6%.  In other words, the interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid. 

This is a monumental victory for physicians in Nevada as the law now requires timely payment by insurers and health plans, and contains a provision to enforce non-compliance.  Nevada now has a law that stands as one of the strongest and clearest in the country regarding prompt payment of claims submitted by physicians.

Recently, some insurers have contended they never received the claim(s), or that the claims are incomplete and that more information is necessary.  Because the clock does not begin to run until the insurer has received a complete (clean) claim, physicians need to be aware of some simple measures that can ensure their protection if litigation does in fact result from an insurers failure to timely pay clean claims as contemplated by SB 99. 

The most reliable method to defeat an insurer’s avoidance of SB 99 is to send a claim by “certified mail with return receipt.”  This requires the insurer’s signature before a claim is received, and would serve as proof of service.  Physicians would then have a record of exactly when an insurer received the claim(s).  The cost of this method of protection is minimal, and Judges are accustomed to seeing certified mail receipts as proof that the item was received.  

Another method of protection would be to include a “certificate of mailing” along with the claim.  This would simply require an individual in the physician’s office to sign and date a certificate indicating the claim(s) sent, and send a copy of this certificate along with the claim(s) to the insurer.  The original certificate should be kept by the physician as proof that the claims were sent on a date certain via depositing then in U.S. Postal mail.  Judges are also accustomed to seeing certificate’s of mailing, as they are accepted methods of service in the legal community.  The expense associated with this method is also minimal, and insurers would have a difficult burden of trying to establish that a certificate of mailing is invalid.

A physician may also choose to include a “notarized affidavit” along with a listing of each individual claim mailed as another method of protection.  In other words, a physician would prepare an affidavit (a statement under oath, signed by a notary public) stating that the claim was indeed mailed on a given date.  After this affidavit is notarized, a copy would be mailed along with the claim, and the original would be kept by the physician as proof of mailing.  While the expense and burden associated with this method might be unnecessary at the present time, a Judge will likely, consistent with the Nevada Rules of Civil Procedure, deem the mailing received three full days after the affidavit indicates the package was placed in U.S. Postal mail.  Should insurers be so recalcitrant as to push the  received” issue, this method maximally protects the physician’s rights as to proving receipt of the claim(s) by the insurer.  The Clark County Medical Society maintains several Notary Publics on staff to serve the needs of members to assist in this process.

Even if a physician follows the precautionary measures mentioned above, an insurer may still refuse to follow the requirements of SB 99.  Therefore, physicians may be required to file a lawsuit in order to recover damages for an insurer’s wrongful behavior.  However, before filing a lawsuit, physicians need to first be aware of the jurisdictional requirements of Nevada’s courts so as to determine the proper forum to bring a claim.  Since SB 99 concerns state, rather than federal, issues, physicians would need to seek relief in Nevada’s state courts.

Nevada presently maintains three distinct state  courts; Small Claims Court, Justice Court, and District Court.  Each of these courts has different jurisdictional prerequisites.  Small Claims Court requires that the amount in controversy may not exceed $5000.  This means that if a physician contemplates damages of under $5000 associated with an insurers violation of SB 99, then this Court would be the proper forum to bring a claim.  Award of attorneys’ fees are not permitted in Small Claims Court.  This particular court does not require great legal sophistication, and finality occurs relatively quickly as the formal procedural requirements of a larger state court do not exist here.

Justice Court, on the other hand, has the power to determine matters involving contracts for the recovery of money of less than $7500.  Justice Court is more formal than the previously mentioned Small Claims Court.  Justice Courts have detailed and sometimes complex legal rules, but are still less formal than their District Court counterpart.  Therefore, if a physician determines that they have suffered damages in an amount less than $7500, Justice Court would be the proper forum to bring a claim.  Attorney fees and costs are routinely awarded to the prevailing party in Justice Court.

All cases excluded by law from the jurisdiction of Justice Court will be required to be filed in District Court.  Generally, this includes matters involving more than $10,000.  This Court also serves as the appellate court for decisions rendered at a Small Claims Court or a Justice Court.  The procedural rules of District Court are complex and this Court requires some level of sophistication in order to avoid sanctions.  Physicians are advised to seek the assistance of a lawyer when filing a lawsuit in Justice Court as well as in District Court. 

The thought of initiating litigation is undesirable to most physicians.  However, the Nevada Revised Statutes do permit reimbursement of all attorney’s fees when the amount of recovery is less than $20,000.  (In some cases, Nevada’s statutes also allow for recovery of attorney’s fees when the amount of recovery is more than $20,000. See N.R.S. 18.010 - Offer of Judgment.)  This attorney fees and costs rule applies to all of Nevada’s courts mentioned above, and should serve as a deterrence to insurers.  While there are exceptions to this rule, generally, a physician would be able to recover all of their attorney’s fees for an insurer’s failure to follow SB 99, if the amount ultimately recovered is less than $20,000.  

Despite a few minor problems associated with SB 99, its enactment must be seen as a significant victory for Nevada’s physicians.  The time has finally arrived when a physician can expect consistency and uniformity when submitting a claim to an insurer.  As with any new law, it may well be tested by those whose interests have been diminished.  Therefore, it is imperative for physicians not only to be aware of ways in which they can protect themselves, but also to understand the jurisdictional differences of the types of courts existing in our legal system, as the need for litigation may arise.  Through understanding the law provisions in SB 99, and following a few simple preemptive measures, physicians should be able to avoid past offenses occasioning the necessity of promulgating SB 99.

Artemus Ham IV, Esq. is a Former Law Clerk to the Honorable Michael A. Cherry, District Court Judge and is currently an Associate Attorney for Harrison, Kemp & Jones Chartered.

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Executive Director Notes

Weldon (Don) Havins, M.D., J.D., CCMS Executive Director and Special Counsel

·        This issue of County Line contains an overview of current asset strategies for physicians.  The mere mention of “asset protection” sends some attorneys into a tizzy.  Many attorneys feel that all a person’s (i.e., physician’s) assets should be available to satisfy a creditor (i.e., winning plaintiff in a medical malpractice lawsuit).  At least one medical specialty is now actively considering asking hospitals to lower professional liability insurance (PLI) limits required for staff membership.  Some physicians in this specialty have PLI premiums approaching un-affordability.  While lowering PLI limits will, at least temporarily, lower premiums, a single case of medical malpractice may render the physician bankrupt.  Ignoring asset protection strategies would appear imprudent.  CCMS intends to address each of the specific strategies in greater detail in future issues of your County Line.

·        Attorney Artemus Ham, IV’s article addresses SB 99 from a strictly legal perspective.  Payors subject to the jurisdiction of the Division of Insurance clearly may not charge a fee for “listing” the physician on a panel provider list.  We believe the Division of Insurance understands that to be listed on provider panesl, the physician must be credentialed or re-credentialed.  Thus, the fee for credentialing should be subsumed in the prohibition against charging a “listing” fee.  A problem arises in certain entities not under the jurisdiction of the Division of Insurance such as the entities known as “stand alone networks.”  These include Mediversal, NPP, MCC, and Prime Health.  Physicians having contracts with these entities and who have been billed for credentialing or administrative fees since October 1, 2001 (when SB 99 became effective) must decide whether to pay the re-credentialing fees or be subject to being dropped from the provider list.  Consider the following: either pay the fee and write on the check “under protest” in the memo area of the check, or return the completed re-credentialing form and refuse to pay the fee (which will subject the physician to being dropped from the provider panel list).  If you are dropped from the provider list in this circumstance, clearly the physician did not voluntarily resign from the panel.  If you are dropped from the panel under this circumstance, please fax or write CCMS’ Executive Director, fax 739-1476, with this information.  I have discussed this situation with a Las Vegas law firm having extensive successful experience in class action lawsuits.  They are interested in pursing a class action lawsuit if we can provide sufficient evidence of damages.  CCMS must accumulate information as to those physicians dropped from panels for simply not paying the re-credentialing fee.  Under no circumstances should a physician simply ignore the re-credentialing form and not send in the fee (assuming the physician wishes to remain on the panel).  Such action will likely be deemed a voluntary resignation from the panel and remove the physician as a member of the class of injured parties in a class action lawsuit.

·        As provided in Nevada Revised Statutes (NRS 41A), the County Medical Society receives from the Division of Insurance the findings of all Medical Dental Screening Panels held in “south” Nevada.  Summaries of these findings are reproduced here for your edification.  From 1998 – 2001 (to date) individual physicians were found to have committed “probable malpractice” in 131 instances, “no probable malpractice” in 296, and the MDSP was “unable to decide” the issue in 137.  Everyone expects findings of “probable malpractice” and “unable to decide” to proceed to a filing for medical malpractice in District Court.  However, surprisingly, when the MDSP finding was “no probable malpractice” the plaintiff filed against the physician in District Court 65% of the time.  Some attorneys were much more likely to file in this situation than others.  A chart of those attorneys, de-identified, with 3 or more MDSP allegations against physicians during this period, along with the rate of filing in District Court, is included. 

In summary, of 564 physicians alleged to have committed malpractice in cases before the MDSP, 459 we filed against for medical malpractice in District Court.  If one assumes a finding of “no probable malpractice” screens out non-meritorious cases, 65% of the time that assumption is not sustained by the plaintiff’s action.

 

MDSP Findings

PANEL FOUND PROBABLE MALPRACTICE

SPECIALTY

# MDSP Cases

Anesthesiology

2

Cardiovascular Diseases

2

Cardiovascular Surgery

2

Dermatology

5

Diagnostic Radiology

2

Emergency Medicine

5

Endocrinology

1

Family Practice

9

Gastroenterology

1

General Surgery

13

Internal Medicine

12

Neurology

3

No Longer Licensed/Unknown

19

Ob-Gyn

16

Ophthalmology

2

Orthopaedic Surgery

8

Otolaryngology

6

Pain Management

1

Pathology

1

Pediatric Surgery

2

Pediatrics

5

Plastic Surgery

4

Pulmonary Diseases

2

Sports Medicine

3

Thoracic Surgery

1

Urology

4

TOTAL

131

 

PANEL FOUND NOT PROBABLE MALPRACTICE

SPECIALTY

TOTAL

# FILED

# NOT FILED

%

Addiction Medicine

1

0

1

0%

Anesthesiology

20

13

7

65%

Cardio. Surgery

8

7

1

88%

Cardio. Disease

11

5

6

45%

Critical Care - Ped.

2

1

1

50%

Dermatology

2

2

0

100%

Diagnostic Radiology

13

5

8

38%

Emergency Medicine

20

13

7

65%

Emergency Med. - Ped.

1

0

1

0%

Family Practice

29

20

9

69%

Gastroenterology

6

5

1

83%

General Surgery

15

11

4

73%

Hematology/Oncology

1

0

1

0%

Internal Medicine

26

20

6

77%

Interventional Radiology

1

0

1

0%

Maternal Fetal Med.

1

1

0

100%

Maxillofacial Surgery

2

0

2

0%

Neonatology

1

1

0

100%

Nephrology

3

3

0

100%

Neurology

8

3

5

38%

No Longer Licensed

28

15

13

54%

Ob-Gyn

22

15

7

68%

Ophthalmology

3

2

1

67%

Orthopaedic Surgery

17

15

2

88%

Otolaryngology

4

3