Compounding pharmaceuticals, specific drugs for specific patients, offers tremendous benefit. The problems arise when the benefit is for the prescribing physician. Then, we’re dealing with analyses under the federal Anti-Kickback Statute (AKS), the Stark Law, and their state law counterparts.
Kickback
Opting Out to Opt-In for Yourself – Podcast
I’m no enemy of fast food. I just don’t want to eat it. I don’t care if you do. I wouldn’t make it illegal. But some mayors would.
Greasy Kickback Residue Is All That’s Left of Pain Cream Fraud
This past week, the U.S. Department of Justice announced the arrest of ten additional defendants – doctors, pharmacy owners, and marketers – charged in connection with an alleged $100 million compounded pain and scar cream scam on TriCare. The ten join two other defendants charged in the same scheme earlier this year. The government alleges…
Physician Talks Out of His (not)Mouth – Brags of Kickbacks – Podcast
It was 9:00 p.m. The restaurant was clearing out. I was eating alone after returning to the hotel following a meeting.
A Naive Anti-Kickback Question Answered
Every once in while I get someone who asks me the following type of question: “Can you give me the name of one person who has gone to jail for violating the federal Anti-Kickback Statute in the context of . . . ” and then they go and describe some very specific fact situation, for…
An Alternative Structure for Medical Group Compensation
Most medical groups have a two-level physician engagement/compensation structure: owners and non-owners. They also tend to have a ladder to ownership status along which physicians advance to the top rank. In some groups, all it takes is time; unless someone goes off the deep end, his or her partnership status is just a few years…
Aetna Obtains $37 Million+ Judgment Against ASC Manager – Podcast
Earlier this year, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives.
An Antitrust Exemption for Physicians? – Podcast
Major League Baseball has an antitrust exemption. It also has a level playing field. The players, as employees, can collectively bargain.
A Naive Anti-Kickback Question Answered – Success in Motion
The federal Anti-Kickback Statute is a criminal statute. The fact that someone exactly like you hasn’t (yet) gone to jail for violating it shouldn’t provide any comfort.
Aetna Obtains $37-plus Million Judgment Against ASC Manager
This past Friday, April 15, 2016, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives. The ASCs were out of network as to Aetna plans….