As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more
8/22/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Compensation ,
EMTALA ,
Fair Market Value ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Healthcare Workers ,
Independent Contractors ,
Medicaid ,
Medicare ,
OIG ,
Penalties ,
Physicians ,
Private Equity ,
Regulatory Standards ,
Stark Law ,
Wages
Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more
2/28/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cost-Sharing ,
Eliminating Kickbacks in Recovery Act of 2018 (EKRA) ,
Ethics ,
Fraud and Abuse ,
Inducements ,
Medicare ,
OIG ,
Patient Referrals ,
Patients ,
Reimbursements ,
Stark Law ,
Waivers
Physicians and other healthcare providers often structure their group compensation formulas on an “eat what you kill” basis, i.e., a provider is paid based on the services he or she performs in addition to items or services...more
After three years, the federal public health emergency (PHE) will expire May 11, 2023. Most of the relaxed regulatory and payor standards will end on or within a few months after the deadline, including many relating to: ...more
3/21/2023
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
DEA ,
Department of Health and Human Services (HHS) ,
EMTALA ,
Expiration Date ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicines and Healthcare Products Regulatory Agency (MHRA) ,
Public Health Emergency ,
Public Readiness and Emergency Preparedness Act (PREP Act) ,
Ryan Haight Act ,
Stark Law ,
Telehealth ,
Virus Testing
On November 20, 2020, CMS and the OIG published their much anticipated amendments to the federal Stark and Anti-Kickback laws. As summarized in our recent client alert, the changes open the door to value-based contracting...more
Many healthcare employers may want to incentivize or compensate their employees for referring patients to or generating business for the employer, but they (appropriately) fear application of the federal Stark law or...more
Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more
A good contract with an employed or contracted physician or other practitioner may help you avoid regulatory violations and future disputes. Here is a brief summary of some terms or issues that you should consider in your...more
Unless structured properly, a hospital’s financial relationship with referring physicians or other providers may violate the federal Ethics in Patient Referrals Act (“Stark”) and Anti-Kickback Statute (“AKS”), resulting in...more
At this time of year, healthcare providers may want to give gifts to patients, referring providers, or other sources of business, but such gifts may violate federal and state fraud and abuse laws and result in civil or...more
Most Idaho healthcare providers are—or should be—aware of federal fraud and abuse laws, including the False Claims Act, Anti-Kickback Statute, Ethics in Patient Referrals Act (“Stark”), and the Civil Monetary Penalties Law,...more
It’s that time of year when many healthcare providers offer free or discounted sports or student physicals as a community service or marketing ploy. If you participate in such programs, make sure you consider the legal...more
8/9/2018
/ Anti-Kickback Statute ,
Contractual Safeguards ,
Electronic Medical Records ,
EMTALA ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Malpractice ,
OIG ,
Physicians ,
Standard of Care ,
Student Athletes ,
Students