The Age of 'Regulopathy'
Perhaps it would be better to put doctors in charge of patient care, rather than paint-by-number regulations.
Suspect Joint Ventures under Stark Law and the Anti-Kickback Statute
Here's some simple guidance, from the OIG and a healthcare attorney, on suspicious sales pitches physicians might receive regarding a joint venture.
Ore. Doctors Fined for Failing to Disclose Payments from Implant Firm
State and federal agents are pouring through the books, looking for new and more elaborate ways to fine physicians. Here's a recent example from Oregon.
Health Insurance Exchanges: Good News, Bad News for Physicians
Initial estimates of new patients through health insurance exchanges are good for physicians, but maybe not so good for healthcare on a larger scale.
The Sunshine Act and Continuing Medical Education
CMS has published some excellent guidance for physicians on their involvement in CMEs and how it applies to the Sunshine Act detailing payments.
OIG Opinion on Federal 'Carve Out' May Implicate ACOs
A recent decision by HHS' Office of the Inspector General raises some interesting issues with ACOs participating in the Medicare Shared Savings Program.
Employer Mandate Delay: The Path to a Single-Payer Healthcare
Physician and author Elizabeth Lee Vliet says the real goal behind the latest healthcare reform delay is a federal push toward a single-payer system of care.
Physicians Should Take a Closer Look at Group Purchasing Organizations
Not all group purchasing organizations are alike, so as with any possible Anti-Kickback Statute issue, each arrangement must be scrutinized carefully.
The Paradox of ACO Waivers of Medical Fraud and Abuse Laws
The polar opposite of marijuana laws, waivers for accountable care acts are allowed at the federal level, but can run into problems in individual states.
Healthcare Reform Mandate Delay: History Repeating Itself
So one key provision of the Affordable Care Act - large-employer provided health insurance - is delayed. But the true answer to why can be found 200 years ago.
How ERISA Affects Medical Practices
Here's a primer on ERISA, how it works, and what it means for you and your medical practice.
ABMS: Maintenance of Certification 'Means Something' to Patients
The American Board of Medical Specialties discusses a lawsuit by the Association of American Physicians and Surgeons over ABMS Maintenance of Certification.
Stark, Anti-Kickback Laws Could Get Murkier Under Affordable Care Act
With health insurance exchanges on the horizon, some controlled by HHS, will federal laws fighting fraud and abuse have new teeth for physicians and practices?
Stark Law: Understanding the Rule
Here's an explanation of the rationale behind the Stark Law, the government's conflict of interest statute your medical practice needs to be aware of.
The War on Doctors and Patients
The federal government and private payers have declared war on physicians under the banner fraud, waste, and abuse. The AMA can't help, but you can take action.
Healthcare through the Lens of Socialism, Communism, and Capitalism
Antiquated though the distinctions between socialism, communism, and capitalism may seem, healthcare would do well to keep one eye on lessons learned long ago.
Gloves Are Off in War between Payers, Providers
Healthcare is quickly becoming a war of all, against all, turning physicians, hospitals, insurers, drug makers, and device makers into blood rivals.
Surviving a Payer Claims Review Audit
When it comes to audits, "payers are sneaky and relentless, because they have everything to gain and nothing to lose," notes consultant Angela Miller.
The Government's Not-So-Secret Takeover of Healthcare
Medicare and Medicaid reimbursements have dropped to levels resembling a healthcare takeover. Why takeover, if it costs the same to get somebody else to do it?
AAPS Sues over Maintenance of Certification
The AAPS' Jane Orient discusses the suit's claim that physicians are being "locked out of the ability to treat patients" due to onerous recertification efforts.
Potential Pitfalls of Physicians Owning Compounding Pharmacies
Here are some legal and ethical issues to consider before you own and operate a compounding pharmacy at your medical practice.
Affordable Care Act's Obstacles to Eliminate the 'Uninsured'
The year 2014 was supposed to be the year the "uninsured" became a thing of the past under healthcare reform. That may not be the case now, however.
Health Insurance Exchanges and Physicians
Health insurance exchanges, created under the Affordable Care Act, take effect in 2014. Here's what they are and what physicians need to know.
Affordable Care Act Survival Guide for Physicians
If you are looking for a better understanding of healthcare reform, I recommend a new book by Nick Tate that explains its impact on physicians and patients.
Accountable Care Organization Facts Every Physician Should Know
Learn about ACO formation, rules, contract pitfalls, and physician participation from an expert before you commit to joining a new group.
Medicare Fraud, Waste, and Abuse: A Primer
Here's a primer on how the federal government defines healthcare fraud, waste, and abuse in Medicare.
Ancillary Medical Services: Stark Law and Ethical Issues
Physicians are being presented with chances to invest in ancillary services, but they need to be aware of all the legal issues involved to avoid potential pitfalls.
The Real Reason for the Medicare Crisis
Physicians, it's not your fault that Medicare is in freefall. The federal program is failing for several reasons.
Five Key Areas of the New HIPAA Rules for Physicians
California-based attorney Martha Ann (Marty) Knutson explains five key components of the recently updated HIPAA Omnibus Rule.
Code Correctly to Avoid RAC Audits at Your Practice
Coding expert Mary Pat Whaley offers four key tips to minimize the chances of a RAC audit at your medical practice.