Medical-Legal Issues Facing Neurologists

The medical-legal landscape for providers is vast. Each specialty has its own nuances, and laws and regulations have specialty-specific applications. For example, if an individual is receiving treatment through a federally assisted substance use disorder (SUD) program, 42 CFR Part 2 applies in addition to the Health Insurance Portability and Accountability Act of 1996. Another example is Alzheimer disease, which presents distinct considerations for neurologists as subject matter experts compared with primary care physicians and other clinicians. Medical-legal considerations affect both providers and patients alike. It is against this backdrop that we are pleased to present this issue of Practical Neurology.

This issue highlights a variety of medical-legal topics, including physician impairment, disability law, neurologic disease, malpractice, employment contract issues, fraud, waste, and abuse compliance, and artificial intelligence (AI)—all highly relevant to the practice of neurology.

First, Ms. Adler provides insights into employment agreements affecting neurologists. Common provisions, such as noncompete clauses, are examined alongside neurology-specific considerations.

Second, Ms. Rose and Mr. Hopkins examine liability and medical malpractice concerns confronting neurologists, highlighting 5 important malpractice and medical liability issues that every neurologist should understand.

Third, Ms. Rose and Dr. Kass address sensitive legal issues surrounding physician impairment, including both SUD and cognitive impairment, as they relate to the Americans with Disabilities Act (ADA), state medical board processes, and available intervention pathways. The authors provide practical examples illustrating how to balance public policy considerations with patient safety across a continuum of clinical scenarios.

The focus then shifts to fraud, waste, and abuse laws, including the Stark Law and the False Claims Act (FCA). Ms. Rose and Dr. Kass present real-world enforcement cases involving the US Department of Justice and the US Department of Health and Human Services and explain the components of an effective compliance program to help mitigate the risk of FCA enforcement and other government actions.

Finally, Dr. Riggins and Mr. Paris raise pragmatic questions regarding the use of AI in neurology. As AI becomes increasingly integrated into clinical practice, understanding its potential benefits, limitations, and associated legal and regulatory considerations is essential.

Collectively, these articles provide unique perspectives from physicians and attorneys. Whether readers approach this issue à la carte or as a dégustation menu, they will find content relevant to their practice. Our goal is to highlight these important issues so that neurologists can continue to provide high-quality patient care while thoughtfully navigating an increasingly complex medical-legal and business environment. We are grateful to each of our authors for generously sharing their time, expertise, and insights.

Editorial Note: This issue contains articles addressing medical-legal topics relevant to neurologic practice. The information presented is intended for educational purposes only and does not establish legal standards of care or constitute legal advice. While the content has been reviewed for medical and legal accuracy, Practical Neurology, its publisher, editors, and authors make no representations or warranties regarding its applicability to any particular jurisdiction or factual circumstance. Readers should consult qualified legal counsel regarding specific legal issues.