The Stark Law


Book Description

Stark Law, Second Edition: A User's Guide to Achieving Compliance Penalties for violations can include $15,000 per claim--and you can be fined for even unintentional violations. Further consequences involve potential exclusion from participation in Medicare, Medicaid, and other federal health care programs.It's tough to simplify a complex rule. Here's help. You will be well equipped to protect your organization from the severe consequences of Stark Law violations with the practical analytical tools and explanations provided in "Stark Law: A User's Guide to Achieving Compliance, Second Edition. " This updated version of HCPro's Stark Law best seller, first published in 2005--and now co-authored by former CMS Stark Law regulator, Lisa Ohrin--helps health care providers, practitioners, suppliers, and other affected members of the health care industry understand the many recent changes in the Stark Law. It explains each provision of the rule and its practical effect for compliance professionals.There are no compliance shortcuts Since issuing its long-awaited Stark II, Phase III Regulations, CMS proposed and finalized a host of additional regulations, notices, and clarifications, including a major final rulemaking in August 2008. The number and speed of these changes add yet another layer to the already complex web of rules and regulations governing Stark Law compliance. Your copy of "Stark Law: A User's Guide to Achieving Compliance, Second Edition, " delivers: A thorough explanation of how the 2007 and 2008 regulations impact the Law as a whole, as well as your organization Access to a comprehensive outline of the entire Law in one location, from the initial proposed regulations through the most recent updates Scores of easy-to-understand case studies, which illustrate the application of the Law A searchable CD-ROM to help you find specific citations Take a look at the Table of Contents: Chapter 1: Background and Analytical Framework Chapter 2: Definitions Chapter 3: Designated Health Services Chapter 4: Referrals Chapter 5: Financial Relationships Chapter 6: All-Purpose Exceptions Chapter 7: Ownership Interest Exceptions Chapter 8: Direct Compensation Exception Chapter 9: Indirect Compensation Arrangements Exception Chapter 10: Exceptions for Physician Recruitment and Retention Payments in Underserved Areas Chapter 11: Period of Disallowance, Temporary Noncompliance, and Technical Noncompliance Chapter 12: Sanctions, Collateral Consequences, and Reporting Requirements Chapter 13: Advisory Opinions With such high stakes, your organization needs "Stark Law: A User's Guide to Achieving Compliance, Second Edition, " to remain on top of the recent amendments to the Law.




State and Federal Prohibitions on Physician Referrals


Book Description

Federal and state law restrictions on financial relationships between health care providers have undergone significant growth in the past decade. As the health care industry consolidates to form managed care systems and networks of providers, the financial relationship between providers becomes crucial in determining what referrals, marketing strategies, and billing practices are permissible. Defining the boundaries of permissible conduct under a myriad of statutes at both the federal and state level has become a difficult undertaking. This manual offers a variety of tools to assist attorneys and providers in understanding the complexities of the so-called Stark laws and regulations as well and presents a comprehensive state-by-state review of referral laws. Definitions, hypothetical case studies, full text of laws, regulations, and advisory opinions, corporate compliance polices relating to physician referrals, and checklists for determining the legality of specific financial arrangements make this an invaluable resource.




The Stark Law


Book Description




AHLA The Stark Law (Non-Members)


Book Description

More than a summary of the law, this new edition of an essential monograph offers in-depth critical analysis of this risky, complex area, as well as a wealth of practice pointers and advice for advising clients. Written by leading experts in the interpretation and application of Stark Law, the latest edition of The Stark Law: Comprehensive Analysis + Practical Guide offers up to date information on the following topics:The definition of entitySplit/shared evaluation and management servicesTimeshare agreementsValuing goodwill in physician practice acquisitionsJoint marketingFair market value assessments"Stand in The Shoes" when contracting with a groupWhen A collection of documents can constitute a written agreementDevelopments on the signature RequirementRevisiting fair market value over the course of a termLiability under The False Claims Act with respect to MedicaidBankruptcy trustees and Stark LawUpdates to the self-referral disclosure protocol




AHLA The Stark Law (AHLA Members)


Book Description

This completely updated, revised, and significantly expanded new edition of The Stark Law: Comprehensive Analysis and Practical Guide is not just a summary of the law. It remains an in-depth critical analysis of Stark Law authority, interpretation, and enforcement. Sharing a wealth of insight, the authors provide an analytic overview to assessing Stark Law compliance questions, before addressing the legal effect of the regulations and the regulatory process, and analyzing the implications of various federal cases and enforcement activity. Throughout the book, they include practical guidance for advising clients on complying with the current state of the law and regulations, as well as a look at what future direction the law might take. The authors highlight themes that emerge in the regulations, identify key definitions and interpretive changes, illuminate problem areas, and suggest guidance for navigating each of them.New developments on fundamental issues are addressed in this Seventh Edition, including commercial reasonableness, taking into account the volume or value of referrals or other business generated, and fair market value. The authors expand their analysis on recent areas of focus, including two new chapters on curing temporary noncompliance and new exceptions for value-based arrangements.Continuing areas of concern are also considered in detail, with the benefit of updated analysis. The authors address physician recruitment concerns and detail the evolution in CMS's view of the acceptability of percentage-based compensation, the continuing debate over specialty hospitals, and the viability of gainsharing and clinical co-management arrangements. Other coverage in this concise and comprehensive work includes models for Stark-compliant physician joint ventures, group practices and their applicable exceptions, developments in the area of self-disclosure, and more.




Physician Recruitment and Employment


Book Description

"The Second Edition of Physician Recruitment and Employment serves as a resource for physician recruitment offices within hospitals, medical groups, and health systems. Thoroughly updated, this edition offers comprehensive coverage of revisions made to the Stark self referral guidelines, general guiding principles, current legal environments, and recruitment policy development. In addition, it provides readers with the templates and tools necessary to optimize physician recruitment."--BOOK JACKET.




Understanding Compliance


Book Description

Design and operate a solid compliance program.




Healthcare Valuation, The Financial Appraisal of Enterprises, Assets, and Services


Book Description

A timely look at the healthcare valuation process in an era of dynamic healthcare reform, including theory, methodology, and professional standards In light of the dynamic nature of the healthcare industry sector, the analysis supporting business valuation engagements for healthcare enterprises, assets, and services must address the expected economic conditions and events resulting from the four pillars of the healthcare industry: Reimbursement, Regulation, Competition, and Technology. Healthcare Valuation presents specific attributes of each of these enterprises, assets, and services and how research needs and valuation processes differentiate depending on the subject of the appraisal, the environment the property interest exists, and the nature of the practices. Includes theory, methodology, and professional standards as well as requisite research, analytical, and reporting functions in delivering healthcare valuation services Provides useful process tools such as worksheets and checklists, relevant case studies, plus a website that will include comprehensive glossaries and topical bibliographies Read Healthcare Valuation for a comprehensive treatise of valuation issues in the healthcare field including trends of compensation and reimbursement, technology and intellectual property, and newly emerging healthcare entities.




Healthcare Valuation: The four pillars of healthcare value


Book Description

In light of the dynamic nature of the healthcare industry sector, the analysis supporting business valuation engagements for healthcare enterprises, assets, and services must address the expected economic conditions and events resulting from the four pillars of the healthcare industry: reimbursement, regulation, competition, and technology. This title presents specific attributes of each of these enterprises, assets, and services and how research needs and valuation processes differentiate depending on the subject of the appraisal, the environment the property interest exists, and the nature of the practices.