Healthcare fraud happens all the time but the most classic case of fraud is charging for something and not performing the service. Let’s look at the at the recent arraignment of Primera healthcare executives in Atlanta Georgia. Tim Darnell from the ATL based paper patch writes in his article, “Primera Medical Group Execs Charged With…

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As a physician you have taken an oath to serve your patients to the best of your ability. In the environment of healthcare it is very easy to commit fraud, whether it be intentional or unintentional, it happens. One way to make sure that you land on the radar for an audit is to just…

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Let’s delve into Stark law and how it impacts the delivery of healthcare. Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity providing designated health services (“DHS”) if the physician (or an immediate family member) has a financial relationship with that entity. This weeks article…

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MFN

What is a most favored nations clause and why is it relevant to healthcare? Put simply it means that the insurer is getting the best price that the doctor is willing to give. How do many people violate this? Cash discounts. Lets look into the details straight from Evan Sznol’s Issue Brief: Most Favored Nation…

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