Wisdom. Applied.

Although no one is going to do time as a result of thinking that wet sidewalks cause rain, in the case of the federal Anti-Kickback Statute, confusion over correlation can put you in jail.

After having represented medical groups with a particular emphasis on hospital-based groups for 30 years, it has become strikingly clear that what distinguishes the most successful groups, from the great majority of the mediocre.

Medical group organizers generally confine their entity's business structure to a corporate or partnership type entity and then proceed to conduct business through it.

People are internally inconsistent. Many contracts in the healthcare sphere are inconsistent, too. The first causes grief, the second shifts power.

The volleys in this battle move slowly--think pendulum as opposed to ping-pong. And right now, despite the appeal, the pendulum is still on the side of “state law controls”.

Uncover the history of the whistleblower provisions in the False Claims Act and their significance in fighting fraud.

Fueled by the failure of large medical groups, the disappointments of hospital employment, and the ratcheting down of care by private equity, physicians are increasingly seeking alternatives to their current practice arrangements.

The “friendly physician.” Boy, is that’s a term of art or, perhaps better said, of artifice.

There is no such thing as static demand for services over a contract’s multi-year term, and it’s a fool’s bet, yet one many take, to believe that one can place a set value on total fair market value.

Cars go in reverse. So do ceiling fans and electric drills. But did you know that kickbacks go in reverse, too, and that there’s no safe harbor for that?

There’s a good chance that you can accomplish some or all of what a covenant not to compete addresses, even if the “law” says you can’t.

It’s no secret that hospital-based medical groups, particularly anesthesia and radiology groups, are experiencing significant trouble recruiting and retaining their professional staff due to increasing compensation demands combined with declining reimbursement.

Many people identify with the concept of “work-life balance,” and it’s valid for them.

Despite the fact that some states have strong prohibitions against the enforcement of non-competes, there are still ways to create agreements functioning as proxies for non-competes.

Certifying to Medicare that you’re here when you’re really there is a ticket to nowhere, or maybe to jail.

Health care fraud is far from harmless. Fraudulent activities drain billions from health care programs like Medicare and Medicaid, leading to higher taxes and less money for other important services.

Making The Bet Without Knowing The Odds by Mark F. Weiss

You’re signed in to the hospital’s electronic medical record system. What’s the harm in just typing in the name of a friend to see what pops up?

According to 2023 reports, by 2021, nearly 70% of physicians were employed by hospitals or investor-owned corporations.

No, I don’t have a crystal ball and I can’t predict the future. But that doesn’t mean that I’m blind and can’t see a cliff dropping off on the near horizon.

Telehealth can be used to vastly improve patients’ access to medical care. At the same time, it can be used to vastly improve criminals’ access to Medicare dollars. It shouldn’t be that difficult for physicians to assess the bona fides of their proposed participation in a telehealth “business model” when the ones doing the proposing are telemarketers.

If what the government alleged were true, it would be an emergency physician’s dream job: billing for services without ever treating or even speaking with the patient.

The financial impact was immediate and momentous: Neither new nor existing claims, nor payment for them, could be processed.

The financial impact was immediate and momentous: Neither new nor existing claims, nor payment for them, could be processed.

Many predicted that the financial behemoths run by the smartest guys in the room would swallow up every physician on the planet.