To paraphrase J.P. Morgan, we always have two reasons for doing anything: a good reason and the real reason.
Tag: self-referral
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.
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.
Citizens Medical Center, a county-owned hospital in Victoria, Texas, paid the United States government $21,750,000 to settle, without admitting wrongdoing, a whistleblower suit under the False Claims Act. The whistleblowers, competing physicians, will receive $5,981,250 from the recovery.
Deal structure. Governance. M&A.
Those were among the subjects of this past weekend’s Advanced Institute For Anesthesia Practice Management in Las Vegas, the premier national conference on actionable anesthesia business issues.
To paraphrase J.P. Morgan, we always have two reasons for doing anything: a good reason and the real reason. The claimed good reason to restrict further physician owned Medicare certified hospitals, and the expansion of existing certified physician owned hospitals, is to prevent over utilization due to profit making motives. But traditional hospitals are induced […]
Healthcare deal compliance, in terms of antikickback, Stark, and tax exempt entities, often turns on the propriety of the consideration paid. And that turns on the concept of fair market value, which is often neither fair nor indicative of value. That’s because fair market value is defined for those purposes in a fashion that ignores […]
According to a report in the January issue of the Journal of the American College of Radiology, a study reveals that the total amount of Medicare payments to non-radiologist physicians for non-invasive diagnostic imaging is greater than that paid to radiologists. The reason: self-referral within non-radiology practices. No real news as to the role of […]
