The Business of Healthcare

Uncompensated Medical Directorship Leads to $3.2 Million False Claims Act Settlement

You may have seen their websites: Anesthesia “practice management companies” that advertise “no stipends!” to obtain facility contracts.

Or, you may have seen the RPFs, usually drafted by “consultants” or “management companies”  (and others specializing in perhaps unknowingly committing federal crimes) who promise the surgeon-owners of ASCs that they’ll get anesthesia groups to provide a plethora of coverage and directorship services for free.

Oops. Nothing just became $3.2 million. Plus legal fees. Plus the continued risk of being criminally prosecuted.

Yes, the type of stupid compliance mistake underlying these idiots’ thinking just led to a $3.2 million civil settlement of a False Claims Act (i.e., whistleblower) suit brought against (among others) an orthopedic surgery practice, Georgia Bone & Joint (“GBJ”) and its related surgery center, Southern Bone & Joint a/k/a Summit Orthopaedic Surgery Center (“Summit Surgery Center”), as well as against CRNA David LaGuardia (“LaGuardia”) and anesthesia entities Southern Crescent Anesthesiology, PC (“SCA”) and Sentry Anesthesia Management, LLC (“Sentry”).

The suit was initially brought by Sharon Kopko, the former practice/facility administrator for both GBJ and Summit Surgery Center.  Upon investigation by the U.S. Department of Health & Human Services Office of Inspector General, the FBI, and the U.S. Postal Service Office of Inspector General, the federal government took up the prosecution of the case.

From the settlement announcement of the U.S. Attorney for the Northern District of Georgia, the allegations against the defendants apparently grew from those originally contained in Ms. Kopko’s complaint to include  that LaGuardia, Sentry, and SCA provided a free medical director to Summit Surgery Center  in order to induce it to choose to perform more procedures at the surgery center rather than in the GBJ office.

In the words of the U.S. Attorney, “Kickbacks should never play a role in medical decision-making. It is critical to our health care system that patients seeking health care know that their providers’ recommendations are based on what is in the patient’s best interests and not influenced by illegal kickbacks or arrangements.”

Stay tuned. It’s yet to be seen who’ll now be criminally prosecuted.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.weisspc.com

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Compliance

Your Independence Day

July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain.

But July 4th wasn’t the day of actual separation: The separation came into effect on July 2nd, 1776, the date on which the Second Continental Congress approved a resolution declaring the “united States of America” as free and independent states.

In fact, historians believe that the Declaration of Independence wasn’t fully signed on July 4th. Some signatures were apparently obtained on July 2nd and there is a record of a signing ceremony in August 1776.

But the exact date doesn’t matter. It’s the construct that counts, the construct of independence.

Independence, and its antipode, dependence, are constructs equally applicable to your business, and to yourself.

Independence is a break, a fresh start. A fresh start in terms of leaving a prior arrangement or relationship and beginning one anew. A fresh start in terms of business strategy. A fresh start in terms of redoubling efforts. A fresh start at tackling problems or setting new goals. And so on.

Every year people around the world celebrate January 1, New Years Day, as a fresh start. For our country, July 4th celebrates its new start. But it easily could have been July 2nd or some date in August.

You, too, are free to choose your own independence day, or even a few of them, as a time to renew and reflect and restart.

Hot dogs, parades, and the red, white and blue are all a part of our nation’s Independence Day. You get to choose what’s a part of yours.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.weisspc.com

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Philosophy

Your Independence Day

July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain.

But July 4th wasn’t the day of actual separation: The separation came into effect on July 2nd, 1776, the date on which the Second Continental Congress approved a resolution declaring the “united States of America” as free and independent states.

In fact, historians believe that the Declaration of Independence wasn’t fully signed on July 4th. Some signatures were apparently obtained on July 2nd and there is a record of a signing ceremony in August 1776.

But the exact date doesn’t matter. It’s the construct that counts, the construct of independence.

Independence, and its antipode, dependence, are constructs equally applicable to your business, and to yourself.

Independence is a break, a fresh start. A fresh start in terms of leaving a prior arrangement or relationship and beginning one anew. A fresh start in terms of business strategy. A fresh start in terms of redoubling efforts. A fresh start at tackling problems or setting new goals. And so on.

Every year people around the world celebrate January 1, New Years Day, as a fresh start. For our country, July 4th celebrates its new start. But it easily could have been July 2nd or some date in August.

You, too, are free to choose your own independence day, or even a few of them, as a time to renew and reflect and restart.

Hot dogs, parades, and the red, white and blue are all a part of our nation’s Independence Day. You get to choose what’s a part of yours.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.weisspc.com

Continue Reading...