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Calvin Swartley, Director, Moss Adams

Keep Physician Compensation Contracts in Compliance to Avoid Stark Law Violations


By Calvin Swartley
Director
Moss Adams



Determining physician compensation requires a multifaceted approach and annual auditing to make sure hospitals and health systems don’t expose their organizations to fraud and abuse claims by potentially and inadvertently violating the Stark Law and anti-kickback statute.
Over the past decade, an increasing number of hospitals employed physicians to augment their networks and leverage negotiations with insurers.
Following the increased regulatory demands of the Affordable Care Act, and exacerbated by the shift from fee-for-service to value-based reimbursement models, independent physician organizations are overwhelmed with technological and regulatory burdens. Addressing these concerns can consume valuable practice time. Failing to do so has resulted in emerging penalties and settlements due to physician agreements or contracts violating Stark and anti-kickback regulations. Read article
Judge in robe striking a galvel

How to Spell Health Care Without R-E-F-O-R-M


By Craig B. Garner
Founder, Garner Health Law Corporation

On December 14, 2018, the Hon. Reed O'Connor issued a Memorandum Opinion and Order in Texas v. United States wherein Judge O'Connor declared the Individual Mandate "unconstitutional" on its own, "inseverable" from the rest of the ACA, and as a result the ACA itself "invalid."  Read article
Businessman in suit in handcuffs

New Criminal Penalties Included in Eliminating Kickbacks in Recovery Act of 2018 (EKRA)


By Richard S. Cooper, Esq.
Member, McDonald Hopkins LLC
On October 24, 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) was signed into law. It is a broad piece of bipartisan legislation intended to address the national opioid crisis. One of the bills included in the SUPPORT Act is the Eliminating Kickbacks in Recovery Act of 2018 (EKRA).  Read article
Emergency room at rural hospital

After Bitter Closure, Rural Texas Hospital Defies The Norm And Reopens


By Charlotte Huff
Kaiser Health News

Five months ago, the 6,500 residents of Crockett, Texas, witnessed a bit of a resurrection — at least in rural hospital terms. A little more than a year after the local hospital shut its doors, the 25-bed facility reopened its emergency department, inpatient beds and some related services, albeit on a smaller scale. Read article