Stark Integrity

Send us Fan Mail Lean in wherever you have quick wins. In this episode, Captain Integrity Bob Wade talks using AI in physician contracting & payment as they relate to the Stark Law with Scott Lowry, Founder of StarkWatch. Hear how to quickly assess where your organization’s at with its Stark Law compliance program, how to aim for advancement instead of program perfection, why you should use in...

Send us Fan Mail Training goes a long way when it comes to informed consent. In Part 3 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear why you need to document the decision-making capacity, how to make sure AI use is properly disclosed, why policies & procedures p...

Send us Fan Mail The more checks and balances an organization has along the way, the greater the protection for both the patients & the providers. In Part 2 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear how decision-making capacity & inadequate informed cons...

Send us Fan Mail The patent’s right to autonomy is one of the core principles of the patient-provider relationship. In Part 1 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear the recent cases where informed consent & decision-making capacity were relevant, the diff...

Send us Fan Mail You should be able to duct tape your mouth & hands and give your documentation to the payer, and they should still be able to generally understand what happened. In Part 2 of this 2-part episode, Captain Integrity Bob Wade continues his discussion on holistic audits and synchronizing professional & facility reviews under the Stark Law with Kelly Loya & Bruce Truitt of...

Send us Fan Mail You can’t audit the whole ocean. In Part 1 of this 2-part episode, Captain Integrity Bob Wade discusses holistic audits and synchronizing professional & facility reviews under the Stark Law with Kelly Loya & Bruce Truitt of Pinnacle Enterprise. Hear what holistic audits are, the different types of reviews, the benefits of sampling a patient encounter, how to maintain an un...

Send us Fan Mail There is indeed a return on investment (ROI) for an effective compliance program. In this episode, Captain Integrity Bob Wade quantifies that ROI as it relates to the Stark Law. Hear why the ROI can be 2x-5x what the organization is investing, how the cost for non-compliance is 2x-3x higher, why you shouldn’t look at the compliance program as just a cost center, examples of compli...

Send us Fan Mail When analyzing a physician financial arrangement under the Stark Law, you also need to analyze it under the Anti-Kickback Statute (AKS). In this episode, Captain Integrity Bob Wade explains why most of the exceptions under the Stark Law cross-reference the Anti-Kickback Statute. Hear all about the Stark Law & Anti-Kickback Statute dance, the 3 ways to meet the definition of no...

Send us Fan Mail The definition of an “Entity” under the Stark Law includes Managed Care Organizations (MCOs) and the Anti-Markup Rule. In this episode, Captain Integrity Bob Wade details this “Entity” definition under the Stark Law. Hear who the “Entity” usually is, why they expanded the definition, the very narrow exception they came up with, examples of an “Entity” in action, and Bob recite som...

Send us Fan Mail When a physician doesn’t perform 100% of the services covered by a surgical period, you may have to consider splitting out the global wRVUs. In this episode, Captain Integrity Bob Wade talks global wRVUs and personally performed services as they relate to the Stark Law. Hear the 3 separate categories when a service is covered by a global payment, what happens when a physician didn...

Send us Fan Mail False Claims Act settlements (FCA): they just keep getting bigger. In this episode, Captain Integrity Bob Wade details the notable False Claims Act settlements for 2025. Hear how qui tam cases continue to represent the largest source of settlements through the Department of Justice (DOJ) and False Claims Act, what it means if the government declines to intervene, why medical neces...

Send us Fan Mail There are some uses of the isolated transaction exception that are prohibited under the Stark Law. In this episode, Captain Integrity Bob Wade dives into that isolated transaction exception. Hear why the isolated transaction exception has been expanded, the times when it can be used for service arrangements, how it can be used for settlement of a bona fide dispute, the nuances of...

Send us Fan Mail Beware of the enemy within. In Part 2 of this 2-part episode, Captain Integrity Bob Wade talks cybersecurity and the False Claims Act (FCA) with returning guest and Nelson Mullins Partner Bart Daniel. Hear how to guide outside contractors through certification, why you need to monitor & protect any vulnerabilities as they arise, how to disclose any shortcomings when discovered...

Send us Fan Mail Cybersecurity and the False Claims Act (FCA) have more in common than you think. In Part 1 of this 2-part episode, Captain Integrity Bob Wade talks cybersecurity and the False Claims Act with returning guest and Nelson Mullins Partner Bart Daniel. Hear the history of the False Claims Act, fascinating stats on whistleblowers, the impact of Trump’s executive order on cybersecurity f...

Send us Fan Mail There are some exceptions to the broad definition of an ownership interest under the Stark Law. In this episode, Captain Integrity Bob Wade explains what are not ownership interests under the Stark Law. Hear why the definition does have exceptions, how most of the exceptions are deemed to be compensation arrangements, how to treat an unsecured loan, the 7 types of exceptions, and...

Send us Fan Mail Understanding the definition of an ownership interest is crucial under the Stark Law. In this episode, Captain Integrity Bob Wade shares why loans are ownership interests under the Stark Law. Hear why you need to know & understand all definitions under the Stark Law, why ownership interests also include loans & bonds under the Stark Law, why you should always self-report,...

Send us Fan Mail Artificial Intelligence (AI) needs a little pushback. In Part 2 of this 2-part episode, Captain Integrity Bob Wade continues his talk on the intersection of AI, Fair Market Value (FMV), the Stark Law, and the Anti-Kickback Statute (AKS) with HealthValue Group Managing Partner Chris David. Hear why we need to be human to make AI helpful, how to protect your nonproprietary data AI c...

Send us Fan Mail Artificial Intelligence (AI) can save a lot of time, but you need to use it wisely. In Part 1 of this 2-part episode, Captain Integrity Bob Wade talks the intersection of AI, Fair Market Value (FMV), the Stark Law, and the Anti-Kickback Statute (AKS) with HealthValue Group Managing Partner Chris David. Hear how AI is already impacting the healthcare consulting industry, notable ca...

Send us Fan Mail Federally Qualified Health Centers (FQHCs) serve a medically underserved population. In this episode, Captain Integrity Bob Wade talks FQHCs, the Anti-Kickback Statute (AKS), and the Stark Law. Hear whether the Stark Law applies to FQHCs, the wide range of financial arrangements that can happen, why it’s important to document those financial arrangements, the most important rules...

Send us Fan Mail Preparing expert witnesses for their testimony is an arduous process. In this episode, Captain Integrity Bob Wade dives into expert witness selection, preparing, and utilization with White Collar Crime Attorney Sean McKenna. Hear how to select the right expert witness, how to ensure the privileges are maintained, how to perform role playing during cross-examinations, the types of...

Send us Fan Mail Actively use Artificial Intelligence (AI). In Part 3 of this 3-part episode, Captain Integrity Bob Wade talks AI in healthcare law & compliance with Nelson Mullins Partners Bob Coffield & Darren Skyles. Hear why the implementation of AI technology will separate the winners & losers, how to explore AI applications as a Compliance Officer, how to think of AI governance l...

Send us Fan Mail Being unbiased & fair is critical in the healthcare space. In Part 2 of this 3-part episode, Captain Integrity Bob Wade talks Artificial Intelligence (AI) in healthcare law & compliance with Nelson Mullins Partners Bob Coffield & Darren Skyles. Hear examples of how AI can be used in compliance, the key questions to put on the table, where there’s greater risk, whether...

Send us Fan Mail Healthcare laws weren’t designed with artificial intelligence (AI) in mind. In Part 1 of this 3-part episode, Captain Integrity Bob Wade talks AI in healthcare law & compliance with Nelson Mullins Partners Bob Coffield & Darren Skyles. Hear where AI is already delivering real value in healthcare law & compliance today, the governance & risk management building bloc...

Send us Fan Mail Evaluating the effectiveness of a compliance program is a very important step. In this episode, Captain Integrity Bob Wade describes what a compliance effectiveness review is all about. Hear what the 8th element of an effective compliance program is, who should do the reviewing, why it’s all about culture, what Bob looks at in a review, and infamous examples where organizations fa...

Send us Fan Mail Build in time for back & forth. In this episode, Captain Integrity Bob Wade breaks down how to deliver bad news with Mimi Bliss, Leadership Communications Consultant with Bliss Communications. Hear the power of the pause, how to use starter or transition phrases, why you should keep it short & simple, what to do if an executive keeps interrupting you, and the key phrases t...