This Week's Handpicked Articles

CMS proposes rule to prevent Medicaid payments from being diverted away from primary provider

New York health system pays $15.6M to settle billing fraud case

Becker's Hospital Review released a recent article discussing how N.Y.-based Health Quest Systems have agreed to pay more than $14.7 million to the federal government and an additional $895,427 to the state of New York to resolve False Claims Act allegations.

CMS proposes rule to prevent Medicaid payments from being diverted away from primary provider

In an article by Healthcare Finance, they talk about how the Centers for Medicare and Medicaid Services has proposed changing a regulation that currently allows states to divert Medicaid payments away from the primary provider.

Industry Insights

In our most recent blog, "Orange is Not Your Color: Recent Uptick of Stark Law Violations; tips to ensure you stay on the right side of the regulatory world" we covered three tips to help prevent you from wearing that orange jumpsuit.

Orange is Not Your Color_ Recent Uptick of Stark Law Violations; tips to ensure you stay on the right side of the regulatory world

Tip 1

First, find your physician arrangements. Do you know where they are? Who owns them? I assure you these first two questions will keep a whole staff busy for several weeks in order to wrap their arms around the paper deals floating between a hospital campus and its physician partners.

Tip 2

Does your physician partner KNOW they have an agreement with you? I know this sounds a bit “smart aleck-y” but at Ludi™, some of our clients have run into this problem – a few of their physician partners weren’t aware that a physician administrative role was part of their employment compensation and that they had specific duties that must be carried out to be paid as part of that agreement.

Tip 3

Audit – I hate this word with a passion, as it’s a downer and invokes chills, but if you are living and breathing compliance as a tenant of good business, you gotta audit your physician agreements.