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Category Archives: Physicians and Group Practices

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Effective Compliance Plans: Have they ever been more important to your organizations?

Posted in Hospitals, Physicians and Group Practices, Regulations

Last month, the Department of Justice (DOJ) announced that it had entered into a $25.5 million settlement with Intermountain Health Care, Inc. (Intermountain), Utah’s largest health system with 22 hospitals and more than 4,500 physicians, to resolve self-reported violations of the Stark Law and the False Claims Act. The claims at issue primarily involved compensation… Continue Reading

HIPAA Final Omnibus Rule Brings “Sweeping Changes” to the Health Care Industry

Posted in Hospitals, Physicians and Group Practices, Regulations

The long wait for the HIPAA Final Omnibus Rule is finally over, and it covers a broad range of HIPAA issues, including: The Breach Notification Rule; The HIPAA Enforcement Rule, implementing changes mandated by the HITECH Act; The Privacy and Security Rules, implementing changes mandated by the HITECH Act, as well as other changes to… Continue Reading

Physician-Hospital Integration: “Same Doctor Visit, Double the Cost”

Posted in Accountable Care Act, Hospitals, Medicaid, Physicians and Group Practices

“Same Doctor Visit, Double the Cost” – this is the title of a recent Wall Street Journal article written by Anna Wilde Mathews, which provides a view on the hospital-physician integration phenomenon.  The article describes the higher fees charged by hospitals that result when physicians become employed by hospitals.    It is our experience that… Continue Reading

CMS Launches New Tools to Fight Health Care Fraud

Posted in Hospitals, Medicaid, Physicians and Group Practices

The federal government’s war on healthcare fraud is going high-tech with the opening of a $3.6 million command center.  The Centers for Medicare and Medicaid Services (CMS) pays $750 billion each year to more than 1.5 million healthcare providers, and healthcare fraud is estimated to cost taxpayers more than $60 billion annually (see Health Law… Continue Reading

Linking Patients and Doctors Through a Smart Phone App

Posted in Hospitals, Physicians and Group Practices

Forward-thinking hospital systems are taking advantage of new technology to facilitate patient-doctor interaction.  Providence Health Ministry in Mobile, Alabama  recently announced the launch of a new smart phone app to connect patients with the doctors and physician groups practicing at Providence Hospital.   The features of the app enable patients to:  search lists of available doctors… Continue Reading

CMS Releases Three-Day Payment Window FAQs

Posted in Administration, Hospitals, Physicians and Group Practices, Regulations

On July 9, 2012, the Centers for Medicare and Medicaid Services (“CMS”) posted 43 frequently asked questions (“FAQs”) addressing various issues concerning the 3-day Payment Window Rule (the “Rule”).  As background, the Rule applies to outpatient services furnished (1) by a hospital or (2) by another Part B supplier (referred to herein as a “Physician… Continue Reading

Smart Things Hospitals Do To Build Physician Relationships

Posted in Administration, Hospitals, Physicians and Group Practices, Relationships

Regardless of the brilliant strategy or the fantastic business plan – if the people in a business deal “don’t work”, then the deal won’t work.  Savvy hospitals and physician groups understand this phenomenon as they approach negotiation.  Their conduct facilitates a good outcome and an environment in which the new relationship can create value in… Continue Reading

The Physician As Negotiator

Posted in Administration, Hospitals, Leadership, Negotiation, Physicians and Group Practices

One of the questions I am routinely asked in an early meeting with a physician group is: who should we have as our physician-negotiators? There are three keys to arriving at an answer. Key #1. Do you have shareholders with business skills? Psychologists tell us that the popular elementary-age children are often those with the… Continue Reading

The Administrator’s Role in Hospital Negotiations

Posted in Administration, Hospitals, Negotiation, Physicians and Group Practices

Having been a cardiology administrator for three years, I know the tensions that physician group administrators (by this term, I mean to refer to a group’s chief administrative officer by whatever title) handle every day. They manage physicians who in some contexts are the practice’s owners and the production units in others. They must serve… Continue Reading