Pierce & Mandell, P.C.

11 Beacon Street, Suite 800
Boston, Massachusetts 02108-3002

Phone: (617) 720-2444
Fax: (617) 720-3693

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Bill Mandell was Quoted in the April 2017 Emergency Department Legal Letter Article

Joseph Coupal - Thursday, April 06, 2017

Pierce & Mandell, Curtis DoolingBill Mandell was quoted in the April 2017 Emergency Department Legal Letter article on visitors and guns in hospital emergency departments and suggested a useful policies for hospitals to consider.



Bill Mandell: Faculty at the MCLE Annual Massachusetts Health and Hospital Law Conference 12 years in a Row

Joseph Coupal - Tuesday, December 06, 2016

Pierce & Mandell, PC, Bill Mandell, Boston, MAFor the 12th year in a row Pierce & Mandell, P.C.’s Bill Mandell, was a faculty member at the MCLE Annual Massachusetts Health and Hospital Law, 2-day conference on November 21 and 22, 2016.  Bill co-presented the panel on the law of physicians. He is also a co-author of the related MCLE publication, the Massachusetts Health and Hospital Law Manual. Bill just finished working on an update to the Chapter on Physicians and it will be published sometime next year when MCLE issues the 2017 edition of the Massachusetts Health and Hospital Law Manual. For more information about this publication, click here.

Mass HIway likely to see changes in the near future

Joseph Coupal - Thursday, December 01, 2016

By Karen Rabinovici

The state-sponsored Health Information Exchange, known as the Mass HIway, was launched in October 2012, offering doctors’ offices, hospitals, laboratories, pharmacies, skilled nursing facilities, and other healthcare organizations a method by which to securely exchange information electronically with each other.  The aim of the Mass Hiway was to improve care coordination and delivery, avoid readmissions and medical errors, reduce administrative costs and duplicative testing, enhance communication among providers, increase patient engagement, and improve public health reporting and analytics.  One of the Mass HIway’s main functions is secure direct messaging between participating users, and the Mass HIway plans on soon offering “Event Notification Services,” which will allow for the transmission of notifications to a patient’s health care providers when the patient is admitted to any participating hospital in the state.  All providers, regardless of affiliation, location, or differences in technology, may use the Mass HIway.

The Mass HIway is now likely looking at some changes in the near future.  On Friday November 4, 2016 the Executive Office of Health and Information Services released proposed regulations specific to the requirement for all providers to implement a fully interoperable (meaning, having the ability to send and receive HIway direct messages) electronic health record that connects to the Mass HIway, and the establishment of a mechanism that allows patients to opt-in or opt-out of the MassHIway.  The proposed regulations require specific providers (acute care hospitals, medical ambulatory practices with ten or more licensed providers participating in health care delivery, and all community health centers) to connect to the MassHIway between 2017 and 2019, while other types of providers (behavioral health entities, dental clinics, nursing homes) will be required to connect at a date to be specified, with at least one-year notice (and no earlier than January 2018).  Connection requirements will be established through future regulations.  The proposed regulations would require that providers that are required to connect to demonstrate compliance by attesting to implementing at least one “Use Case of HIway Direct Messaging.”  Examples of this are a hospital using the Mass HIway to send discharge summaries to a receiving facility, or a primary care physician practice using the Mass HIway to send referrals.  The proposed regulations require acute care hospitals to send Admission, Discharge, and Transfer messages using the Mass HIway.

Regarding the opt-in or opt-out mechanism, the proposed regulations will require that a provider must provide written notice to patients that it will use the Mass HIway, and must include in this written notice instructions in the event the patient chooses to opt-out.  Thereafter, either the provider will inform Mass HIway of the patient’s decision to opt-out, or will provide the patient with instructions on how to do so.

A public hearing was held by the EOHHS on Monday November 28, 2016, and public comments were accepted until Tuesday November 29, 2016. Additionally, the EOHHS accepted electronic written testimony.

The proposed regulation can found here.

Bill Mandell Revisits the Need for Clarity under Massachusetts Law for Permitted Health Provider Disclosure to Protect Public Safety

Joseph Coupal - Friday, June 17, 2016

by Bill Mandell

In the wake of yet another senseless mass killing tragedy I am posting an article I wrote in 2013 for the Boston Bar Association Health Law Reporter on the need for a new law in Massachusetts allowing health care providers to report dangerous persons or situations. Click here to read the article.

Pierce & Mandell Sponsor St. Camillus Health Center Golf Tournament

Joseph Coupal - Tuesday, May 31, 2016

Pierce & Mandell was  a proud sponsor of the third annual St. Camillus Health Center golf tournament held at Blissful Meadows Country Club in Uxbridge on May 24.  The tournament raised thousands of dollars for St. Camillus, a non-profit facility located in Whitinsville that provides rehabilitation, skilled nursing and short and long term care to the poor, sick and elderly.  Pierce & Mandell lawyers Robert Kirby, Bill Mandell, Michael Fee and Scott Zanolli braved challenging weather conditions in support of this very worthy charitable endeavor.

Bill Mandell will be Boston Bar Association Featured Panelist

Joseph Coupal - Wednesday, April 13, 2016

Health Law Practice leader, Bill Mandell, will be a featured panelist on April 28, 2016 at the Boston Bar Association’s seminar entitled: “New DOI Guidance on Direct Primary Care Practices in Massachusetts.”

Pierce & Mandell Participated in Yankee Dental Congress 2016

Joseph Coupal - Tuesday, February 02, 2016

For the seventh consecutive year, Pierce & Mandell, P.C. was proud to be part of the Yankee Dental Congress, held January 28th through January 30th at the Boston Convention & Exhibition Center.

Yankee Dental Congress is a trade show and convention that draws thousands of dental professionals each year.  Pierce & Mandell attorneys William M. Mandell, Michael C. Fee, Hannah Schindler Spinelli and Karen Rabinovici met with dental professionals who were interested in legal advice on all dental law and ethics, including dental practice transitions and sales, associate buy-ins, leases, employment and service agreements, and staff employment issues.

Click here for more information on Yankee Dental Congress. For more information on Dental Law contact Pierce & Mandell, P.C.

Bill Mandell Will be a Featured Panelist at the Boston Bar Association Seminar

Joseph Coupal - Thursday, December 24, 2015

Health Law Practice leader, Bill Mandell, will be a featured panelist on Thursday, January 7, 2016 at the Boston Bar Association’s seminar entitled “Accountable Care Organizations: How They Work, Do They Work?”

More Substance Abuse Treatment Beds Needed to Take on Opioid Crisis - Boston, MA

Joseph Coupal - Wednesday, November 18, 2015

By Thomas Kenney and Brandon Saunders

If the image of the crumbling state hospital in the Leonardo DiCaprio film Shutter Island seems eerily familiar, it may be because the building used in the film was the former Medfield State Hospital, itself shuttered along with most state hospitals as the Commonwealth moved away from institutional care in favor of a community-based treatment model several decades ago.

While that image might spark a debate about the wisdom of deinstitutionalization, it also may provoke dialogue about how these facilities could be restored to productive use as addiction treatment centers to grapple with a rising opioid crisis that will likely get worse before it gets better.

Much of the current debate over a comprehensive legislative proposal by Governor Charlie Baker focuses on limiting prescriptions physicians may write for these highly addictive drugs, and a measure that emergency room medical staff be permitted (or even required) to place a 72-hour hold on an addict who appears in the ER if the treating physician judges that person to be a danger to him or herself or others.

What hasn’t received as much attention is what occurs after that patient is released – whether it is the same day they appeared in the ER or 72 hours later. What happens next?

There is much that should be done on the front end of the addiction crisis, but little will change unless we also expand treatment beds in a system that is already beyond capacity.

What is also undermining the effort to get addicts into treatment, according to Health Policy Briefs, is a pattern of insurer denials of mental health and substance abuse treatment claims as compared to other medical claims, despite efforts by Congress to close that inequity.

The drug addiction crisis in Massachusetts goes beyond the 1,200 accidental opioid deaths reported in 2014. The state’s Bureau of Substance Abuse Services (BSAS) reports that 107,358 people in Massachusetts were admitted into an alcohol or drug substance abuse program in fiscal year 2014.

Under existing Massachusetts law, those suffering from severe drug or alcohol addiction can be involuntarily committed to a treatment program for up to 90 days by a district court judge when all other efforts have failed.  The state’s highest court has recently ruled that hearings on these so-called “Section 35” commitments require a lower burden of proof, with hearsay evidence allowed, and a “clear and convincing” standard applied, as opposed to the stricter “beyond a reasonable doubt” standard utilized in criminal proceedings.

As attorneys who obtain and enforce involuntary commitments of those with alcohol and drug addictions, we see the impact of an acute shortage of treatment beds. We have successfully petitioned the courts for the involuntary commitment of those so afflicted with a drug or alcohol addiction that they are in danger of significant harm to themselves or others, only to see them leave the treatment facility within a few weeks and then reappear at hospital emergency rooms. Local emergency medical leaders are rightfully concerned that short stays in ERs after commitments may do more harm than good to access to care in many instances.

The state’s two facilities for treating addicts are chronically overcrowded and underfunded and can barely cope with alcohol addiction, never mind a rising narcotic and opioid addiction crisis. Those in treatment under an involuntary commitment are typically discharged after as little as 20 days in what amounts to a “spin dry” detox that has little chance of curing the addiction.

In our opinion, the Commonwealth’s plan to open new secure treatment facilities at Taunton State Hospital and Lemuel Shattuck Hospital in early 2016 will not be nearly enough to handle the overwhelming increase in the demand for substance abuse treatment beds.

One promising approach, developed by Beth Israel Deaconess in Plymouth and other key local stakeholders, is broader in scope. BID Plymouth CEO Peter Holden recently argued that this pandemic needs to be addressed with a community-based approach that includes local hospitals, police and the courts, in a coordinated approach and doesn’t just rely on hospitals treating the opioid crisis simply as a medical issue.

There is no panacea, and none of these well-meaning measures alone will change the arc of this crisis unless they are pursued together with longer-term substance treatment resources - inpatient beds, residential programs and specialty treatment centers to treat addicted patients and keep them long enough to provide meaningful treatment and a reasonable chance for recovery.

Thomas Kenney and Brandon Saunders are attorneys at Pierce & Mandell, P.C., Boston, who specialize in involuntary commitment proceedings.

Bill Mandell was Quoted in ED Legal Letter – Boston, MA

Joseph Coupal - Wednesday, October 14, 2015

Bill Mandell was quoted in the attached article Are ED Policies Inflexible? featured in the publication ED Legal Letter (November 2015), discussing the importance of having good EMTALA policies for hospitals and their medical staffs. To see the article click here.

 

 


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