Wisdom. Applied.

Was it a scam or an error? A settlement is just that and there’s been no determination of liability. Neither you nor I can know for sure what went on, but either way, there’s a lesson here about billing compliance.

Considering honey bees have been on earth for between 40 to 150 million years, it pays to consider their hive strategy for success, especially because it maps perfectly onto medical groups.

There’s huge danger in any arrangement in which you put your prescribing imprimatur on any script or order for any item, especially those reimbursed by Medicare.

In real life healthcare compliance, there's no get out of jail free card.

It’s imperative that you get started now and that you become willing to invest in your own future.

You Must Know the No. 1 Mistake in Exclusive Contract Negotiation by Mark F. Weiss

Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly turning to creative means to provide coverage and to improve collections.

There’s a reason why Medicare Advantage is fertile ground for fraud enforcement.

In healthcare, size used to signal strength. Bigger meant more services, more specialists, more veritas. But what if all that bulk is actually a liability?

As healthcare payers, tech platforms, and pricing vendors increasingly collaborate through sophisticated analytics, this case is a clear reminder: if you're coordinating decisions that competitors used to make...

Supervisory requirements aren’t just administrative niceties; they’re the difference between compliant practice and a lawsuit waiting to happen.

It’s not news to you that there’s a huge shortage of physicians in many medical specialties, such as in anesthesiology and radiology. With the overall aging of the physician population, shortages in other medical specialties, including those that are office-based, will intensify.

There are dumb crimes, and then there are crimes so dumb they come with a built-in paper trail leading straight to prison.

Even in the face of the provider shortage, during which you think that you have substantial negotiating leverage, when a significant chunk of your revenue comes from the hospital, you’re no longer just a contractor. You’re an appendage.

Over the past several weeks, I’ve seen multiple posts and comments on LinkedIn about the horrors of practicing as a cog in the wheel of Big Medicine, employment schemes facetiously referred to as “medical groups” by their health system or insurance company owners.

From insurance commissioner to healthcare fraudster to federal prison inmate.

According to Bain & Co, nearly one-quarter of physicians employed in health-system-led organizations are considering switching employers.

If you thought health care fraud required medical knowledge, think again.

Nudge Triggers a $17 Million False Claims Act Settlement by Mark F. Weiss

Buying a healthcare business, from a medical practice to a medicine manufacturer, is a lot like buying a house—you hope for the best, but sometimes, there’s wood rot hiding under that fresh paint.

The False Claims Act (“FCA”) is a powerful tool to fight fraud against the government, especially in healthcare. It contains a “qui tam” provision that lets regular people—called “relators” or whistleblowers—sue individuals and entities for fraud on behalf of the government.

There are, depending upon the particular arrangement, potential end runs around contractual pass-through billing prohibitions, but they are highly fact specific and technical.

Although any particular crisis can’t be predicted, classes of crisis are capable of prediction and, even if that is not true of a specific situation, the way in which your group or business will respond to a crisis can, should, and must be planned far in advance.

Are you sure those consultants are helping to improve your business? Or are they potentially sending you to jail?

Re-frame the issue for what it really is: Surprise physician services stealing. Now’s the time for the No Surprises Act, and each state counterpart, to go.