Featured Articles

Obama Administration Turns Up Heat On Medicare Fraud

Todd Rodriguez
June 25, 2009 14:04

According to a statement by Secretary of HHS Catherine Sebelius in a June 24 HHS Press Release, "the Obama Administration is committed to turning up the heat on Medicare fraud..."  As evidence of this commitment, the Press Release announced the indictment of 53...

More Changes to the Stark Self-referral Regulations

Todd Rodriguez
September 30, 2008 14:04

For those of you who have not been watching your Stark radar screen closely, be aware that CMS recently made a number of substantial changes to the Stark self-referral regulations that may affect your practice arrangements. Some of these changes will not take effect until October 1, 2009, but...

Recent Articles

Feds Announce Largest Single Physician Medicare Fraud Bust

Todd Rodriguez
February 29, 2012 23:56

I have been speaking with physicians for years about the importance of developing effective fraud and abuse compliance programs in their practices and I often still get the same response:  The government is only interested in the big fish like pharmaceutical manufacturers and...

Fizzle But Not Much Bang: Medicare Fraud Prevention System Early Results Not Great

Todd Rodriguez
February 27, 2012 22:28

In June of 2011, I reported on this blog about a software program being launched by the federal Department of Health and Human Services to use a technology called predictive modeling to identify fraudulent and abusive billing practices on a prepayment basis.  The program, known as the Fraud...

Physicians Forewarned - The Impact of Medical Device Fraud on Physicians' Practices

February 03, 2012 19:03

A recent U.S. Department of Justice (DOJ) settlement with a medical device manufacturer highlights the need for physicians to pay close attention to their dealings with medical device companies. The settlement, announced in December, calls for the payment of $23.5 million to resolve allegations...

Mainstream Media Reports on Physicians Leaving Private Practice

Todd Rodriguez
January 31, 2012 16:44

Well, another interesting article this week regarding the exodus of physicians from private practice.  This time, it's the Philadelphia Inquirer reporting on "Why Heart Doctors are Leaving Private Practice"  Only time will tell if this a merely a fad or a real change in the way...

Physicians: Be Aware of the Pennsylvania Sales and Use Tax

Todd Rodriguez
January 30, 2012 15:58

Most medical practices in Pennsylvania are aware that Pennsylvania imposes a sales and use tax on various items and services purchased by medical practices.  However, physicians are not always clear on exactly the items and services to which the tax applies.  For example, the tax applies...

Selling Your Practice to a Hospital? Know Where You Want to End Up

Todd Rodriguez
January 25, 2012 21:16

There's an interesting piece in the Miami Herald today regarding hospitals once again acquiring physician practices. The article raises some good questions regarding the motivations underlying this growing (recurring) trend and suggests that it might be more about control than preparing for a...

Have Policies for Collecting Patient Balances

Todd Rodriguez
January 09, 2012 16:19

A recent article on CNNMoney discusses the not-so-new news story about the financial struggles of private medical practices. However, buried within the article is an important financial issue that many physicians overlook: collection of patient balances. According to one of the experts cited...

New Payment Models (Opportunities) Coming Sooner Than You Think

Todd Rodriguez
December 29, 2011 21:17

Many physicians I work with are talking about the possibility of new payment models such as bundled payments, episode-of-care payments and Accountable Care Organization (ACO) payment models. However, few medical practices have given much thought to how such payment models might actually work for...