Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly returning to creative means to provide coverage and to improve collections. Both are laudable goals. However, some groups cross the line from collaboration to fraud via pass-through billing. Pass-through billing is the healthcare industry term used to describe billing by one entity for services or…
There’s a reason why Medicare Advantage is fertile ground for fraud enforcement.
Imagine a pharmacy operation so brazen that it paid doctors millions in kickbacks to prescribe compound creams mixed in the backroom by untrained teenagers—then billed the government as much as $16,000 per tube.
In healthcare, size used to signal strength. Bigger meant more services, more specialists, more veritas. But what if all that bulk is actually a liability? Hospitals have gorged on acquisitions—buying up physician practices, merging with competitors, and adding layers of complexity. But when you stuff too much into a system, it doesn’t become more resilient—it…
Why doctors must prioritize compliance—and legal advice—before signing anything.
As healthcare payers, tech platforms, and pricing vendors increasingly collaborate through sophisticated analytics, this case is a clear reminder: if you’re coordinating decisions that competitors used to make…
Here’s the latest on H.R. 2191, the legislation to amend the Stark Law in regard to physician investment in or ownership of hospitals.
Supervisory requirements aren’t just administrative niceties; they’re the difference between compliant practice and a lawsuit waiting to happen.
New bill in Congress seeks to amend prohibitions on physician ownership of hospitals.
On March 21, 2025, the Treasury Department’s Financial Crimes Enforcement Network (“FinCEN”), the agency charged with enforcing the CTA, issued a new interim final rule removing the requirement for U.S. companies and U.S. persons to report beneficial ownership information under the Corporate Transparency Act.