Wisdom. Applied.

As always in these types of cases, which are civil actions, the settlement does not involve any admission that the allegations were true.

Maybe those excuses worked in fourth grade, and maybe Samirkumar J. Shah, M.D. should have tried them, but the one he went with, “I can’t show up at my sentencing for health care fraud because my doctor says I need to rest at home following a Covid vaccine reaction,” didn’t impress United States District Judge David S. Cercone.

You don’t have to have read any Hemingway or have had an uncle with a taxidermied marlin on the wall of his den to know about fishing for big ones.

A CMS advisory opinion [Advisory Opinion No. CMS-AO-2021-01] issued in June 2021 provides guidance that a parent-subsidiary medical practice entity structure in which the subsidiaries themselves don’t qualify as “group practices” under Stark can, in total, qualify as a “group”.

running a restaurant instead of a medical group. Let’s say you decide to measure and reward on the basis of the time a waiter or waitress takes to picks up food in the kitchen and deliver it to the table. Soon, waiters would be jogging through the joint, tossing plates onto the tables...

One thing is for certain, it will be no more walk in the park for the seven defendants convicted for their roles in a bribe and kickback scheme related to referring patients to Forest Park Hospital, a now defunct chain of Texas facilities.

With the tip of the hat to T.S. Eliot, the world for Community Regional Anesthesia Medical Group (CRAMG) ended on June 16, 2021, not with a bang but a whimper.

Quoting from his speech on August 28, 1963, King stated, "I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character. I have a dream today!”

What if you were running a restaurant instead of a medical group? Let’s say you decide to measure and reward on the basis of the time a waiter or waitress takes to picks up food in the kitchen and deliver it to the table…

How prepared are you if, despite the prophylactic precautions taken by your in-house team, taken by your outside coding and billing provider, and by your EHR vendor, your defenses are breached?

In my experience, most kickback schemes are not as brazen as this. They involve fewer numbers of people and, sometimes, behavior that is more easily rationalized by the participants as “sort of legal”.

Was the Cure Worse Than the Disease? Surprise Medical Billing and U.S. Anesthesia Partners v. UnitedHealthcare

Need a marketing consultant to help grow your ASC? You might want to check with your carriers first.

Laugh about it or cry about it, the bottom line is the same: they are cutting costs by moving all cases that can be moved out of the hospital out of the hospital. Where does that leave you?

Chalk up a victory for less care at higher prices. Hey, aren't those two of the Anti-Triple Aim?

Well the story as told by the Government is a familiar one: They allege that the events were payments to benefit Dr. Asfora and induce him to use Medtronic's SynchroMed ll intrathecal infusion pumps.

It was perhaps the funniest healthcare headline ever: “Zimmer Biomet to combine spine, dental businesses to form company called NewCo.”

The healthcare world was supposedly abuzz last week when the New England Journal of Medicine published (on Jan 2, 2020) the report of a study that shows that consolidation in the hospital industry doesn’t lead to higher patient satisfaction or to higher quality.

Strategic advantage is gained by being able to process information and take action faster than one's opponent.

How would your reorganize your medical practice, healthcare business, and relationships if you were paid only for successful outcomes, no matter how they are measured?

What is your favorite dessert, something that goes well with barbecue? Whether it's pie or vanilla ice cream (or both!), it's probably not 10 years in federal prison.

Here, courtesy of Tenet Healthcare and two terminated cardiologists is a lesson about firing physicians . . . and, when not to.

Over the years, I have dealt with many hospital CEOs that I thought were criminals. In fact, I have dealt with some who were indicted, and, in at least one case, a CEO who later became a long-term “guest” in the Gray Bar Hotel.

Big data and business decision-making, especially in your practice, are two very different things.

Let’s say you are the leader of a medical group. It could be a small group of a handful of physicians. Or, you could be the President and CEO of a 600 or 6,000 provider group. It does not make any difference.