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Physician Compensation Arrangements Hospitals

Warner Norcross + Judd

Federal Court Flags Stark and Anti-Kickback Risks in Physician Pay, Spotlights FCA Constitutional Questions on Appeal

On July 28, the federal district court in the Southern District of Ohio issued a pair of orders in related whistleblower cases under the False Claims Act (FCA): United States ex rel. Murphy v. TriHealth, Inc., et al., No....more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 188: Healthcare Valuation with Darcy Devine, Founder of...

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Joining Matthew and Heather this week is Darcy Devine, the founder of Buckhead FMV, which specializes in the valuation of healthcare businesses, services, and assets of all kinds. For over 20 years, Darcy has assisted...more

Blank Rome LLP

Structuring and Maintaining Value-based Care Arrangements

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Episode 5: Structuring and Maintaining Value-based Care Arrangements - In this episode of BRight Minds in Healthcare Delivery, Blank Rome partner Barak A. Bassman joins host Eric Tower to talk about how to legally and...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

Bass, Berry & Sims PLC

[Virtual Conference] Nashville Healthcare Fraud Conference - December 15th - 16th, 8:00 am - 1:00 pm CST

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Please join us for the 8th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Health Care Compliance Association (HCCA)

[Webinar] 10 Common Healthcare Compliance Concerns Related to Hospital/Physician Transactions - March 16th, 12:00 pm - 1:30 pm CST

Learning Objectives - This 90-minute webinar features the following topics: - Understand 10 common compliance concerns and challenges related to a variety of high risk hospital/physician transactions. - Develop risk...more

Steptoe & Johnson PLLC

What to Expect, Part II: New Stark Law Definitions for Physician Compensation

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The Centers for Medicare & Medicaid Services’ (“CMS”) new final rule amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), in part, defines fundamental terms, such as “fair market value” and...more

Health Care Compliance Association (HCCA)

Moving From Reactive to Proactive Compliance May Reduce Risks

Report on Medicare Compliance 29, no. 45 (December 21, 2020) - When an orthopedic surgeon demanded very generous compensation, the hospital weighed its clinical and business needs against the compliance risks. It had to...more

Nelson Mullins Riley & Scarborough LLP

Murky Waters – The Stark Controversy in Hospital-Physician Relationships

Since the completion of this article, CMS has announced that its final Stark law rule will be published in the Federal Register on December 2, 2020. I. Introduction - The Stark Law has been litigated for the past two...more

Holland & Hart - Health Law Blog

wRVU Compensation Formulas: Time to Review

Many hospitals, physician groups, or other providers compensate employed or contracted practitioners based on the work relative value units (“wRVUs”) they generate, e.g., a physician may be paid $x per wRVU performed....more

Health Care Compliance Association (HCCA)

Hospital Settles FCA Case for $50M; DOJ: CEO 'Disregarded' Concerns

Report on Medicare Compliance Volume 29, no. 32 (September 14, 2020) - Wheeling Hospital in West Virginia has agreed to pay $50 million to settle a False Claims Act (FCA) lawsuit over physician compensation, the Department...more

Bass, Berry & Sims PLC

Update: Third Circuit Allows Allegations of Improper Compensation under the Stark Law to Proceed, but Reverses Controversial...

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On December 20, 2019, the U.S. Court of Appeals for the Third Circuit granted in part a petition for rehearing filed by the University of Pittsburgh Medical Center (UPMC) in a False Claims Act (FCA) case that has generated...more

King & Spalding

New York Hospital Settles Overlapping Urology Surgery Allegations

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On November 8, 2019, the Department of Justice (DOJ) announced a settlement with a New York hospital for $12.3 million in connection with alleged improper overlapping and concurrent urology surgeries performed by one...more

Baker Donelson

Volume Value Take 2

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The CMS proposed regulation issued on October 17, 20191 provides much needed clarity on the question of when compensation is deemed to vary with the volume or value of referrals or other business generated between the...more

Bass, Berry & Sims PLC

Third Circuit Holds Allegations of Improper Compensation Methodologies under the Stark Law Survive Motion to Dismiss

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The U.S. Court of Appeals for the Third Circuit recently issued a False Claims Act (FCA) decision calling into question productivity-based physician compensation structures under the Stark Law, in reliance on a controversial...more

Bricker Graydon LLP

Recent Stark Act decision could have significant impact for employed physicians compensated based on personal productivity

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On September 17, 2019, the Third Circuit Court of Appeals issued a decision with potentially far-reaching consequences involving the Stark Act. The case, United States ex rel. Bookwalter v. UPMC, involves allegations that a...more

McDermott Will & Schulte

Third Circuit Perpetuates Tuomey’s Controversial Stark Law “Volume or Value” Standard

The US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law’s “volume or value” standard, known as the correlation theory and the practice “loss” theory in U.S. ex rel. J. William...more

Sheppard Mullin Richter & Hampton LLP

Food for Thought (and Health): Day 2 Notes from the JP Morgan Healthcare Conference

Addressing the Social Determinants of Health: Is the healthcare industry pushing a rock up a hill? We collectively are trying to provide healthcare with improved quality and reduced cost, but the structure of the nation’s...more

Tucker Arensberg, P.C.

Basic Contract Issues for New Physician Contracts

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When physicians have finally completed the medical education journey, many are confronted with a “physician employment contract,” usually from a hospital or medical practice, which could define the essential terms of their...more

King & Spalding

DOJ Reaches $3.28 Million Stark Settlement with San Diego Hospital

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Tri-City Medical Center will pay $3.28 million to settle alleged Stark Law violations that stemmed from financial arrangements with its former chief of staff and paperwork problems in more than 90 of its physician agreements....more

Carlton Fields

Avoiding the Bull’s-Eye

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The federal government collected over $200 million from three settlements based on health care fraud and abuse allegations this past September. This staggering amount excludes fees paid to attorneys, consultants and expert...more

Morgan Lewis

Stark Law Clarifications Bring Both Benefits and Potential Challenges - Hospital Industry Viewpoint

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The new clarifications suggest a more lenient CMS, but providers shouldn’t compromise their compliance standards. Throughout the halls of hospitals’ legal and compliance departments, people have been talking....more

McCarter & English, LLP

Don’t Mail That Overpayment Disclosure Just Yet: Implications of CMS’ Final Rule Expanding the Writing, Signature and Holdover...

The Centers for Medicare and Medicaid Services (CMS) on Nov. 16, 20151 published the calendar year 2016 physician fee schedule final rule, fundamentally reducing the burden on entities seeking to demonstrate compliance with...more

Poyner Spruill LLP

Final Curtain Call for Tuomey: Long-Running FCA/Stark Case Settled

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After 10 years of litigation, including two trials and appeals to the 4th Circuit Court of Appeals, the U.S. Department of Justice (DOJ) and Tuomey Healthcare System (Tuomey) have entered into a settlement of DOJ's action...more

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