Last week, the California Insurance Commissioner and the Orange County District Attorney shut down a $40 million fraudulent medical billing and kickback operation by filing criminal charges against 21 doctors plus 5 others: pharmacists and purported “medical group management company” owners. Involved are Tanya Moreland King and her husband Christopher King, the owners of medical…
Office-based specialists, from ENT’s to urologists, often enter into suite sharing arrangements. No problem! That is, until they make it one.
Measurement of “care” will soon count for more than care itself.
Explore the truth behind value based billing in healthcare. Understand how value is defined by patients, not bureaucrats.
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.
Aetna won a $37M+ judgment against an ASC manager, underscoring insurers’ tactics to secure network integrity and punish providers.
Office-based specialists, from ENTs to urologists, often enter into suite sharing arrangements. No problem! That is, until they make it one. Watch as Mark delves into the unintended consequences of improperly structured office-sharing arrangements.
The next time a hospital tells you that they’ve checked the deal with their lawyers and that it’s okay, don’t take their word for it.
You might not think that you are your brother’s keeper, but in the context of a medical group in which you’re an owner, you certainly are. I’m talking in terms of liability for billing errors.
The Stark Law makes it illegal for a hospital to bill Medicare for certain services referred by physicians with whom the hospital has a financial relationship unless the arrangement falls within one of the law’s specific exceptions.