This post is the second in a series on direct contracting by physicians and medical groups. See Direct Contracting By Physicians and Medical Groups for the first post in the series. Before we get too deep into the subject, let’s ask an epistemological question: If you saw one dead raccoon, does that mean that all raccoons…
Ride along while Mark discusses the expanding case involving Insys Therapeutics and kickbacks paid to induce prescription of its drug, Subsys.
In healthcare, middlemen abound. Hospital systems are middlemen for their controlled/employed physicians.
Ride along with Mark as he discusses the need to avoid the trap of viewing the reality of the business of medicine through a tightly focused lens.
Take a seat while Mark discusses the payment crisis adding to hospitals’ woes.
Take a seat while Mark discusses the cure to the “tax” of inflation, cost of living (COLA) adjustments.
A physician is convicted in the Insys/Subsys kickback case, highlighting ongoing risks around pharma deals and compliance for medical group leaders.
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.
Hidden language in payor agreements can trigger False Claims Act liability and criminal risk—understand and avoid the traps.
Mark shares some secrets about negotiations with managed care payors. Payor contracting is about much more than dollars per unit.