Christine Hradsky No Comments

Tread Carefully When Renting Space

Medical fraud

Office spaces being rented between physicians and medical suppliers are getting more attention for potentially fraudulent activity and kickbacks.

As you know, medical practitioners are subject to a federal law that makes it a felony to influence the referral of federal health care business, including Medicare and Medicaid.

For example, if a physician refers a patient to a specialist and receives part of the specialist’s Medicare payment in exchange, the doctor has committed a felony under the Anti-Kickback Statute and could be subject to criminal and civil charges. The physician could also be excluded from Medicare and other federally funded health care programs. Read more

Christine Hradsky No Comments

A Buy-Sell Agreement Can Protect Your Practice and Minimize Disputes

Buy-Sell Agreements

When healthcare practices bring on new physicians, it’s important to make sure they sign buy-sell agreements to protect the practice from disputes.

In the wake of health care reform, you might find your practice inundated with new patients. With the extra workload, you might want to hire one or more physicians to help out.

If so, and if these physicians intend to take an ownership share of your practice, make sure each one signs a buy-sell agreement. Reason: It can safeguard your practice from disgruntled doctors and minimize disputes should they arise. Read more

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A Clear Policy Improves Billing Results

Billing

Medical practices are always looking to speed up third-party payments and keep patients’ accounts current. Here are some ways to make your practice’s billing procedures more efficient to improve cash flow.

You may have heard about the Vermont doctor who was fed up with the way medicine is practiced today and opened an office she calls “Simply Medicine.” The sole practitioner doesn’t accept insurance. Her fee is listed on a board in the waiting room: $2 a minute for labor, plus the cost of supplies. Read more

Christine Hradsky No Comments

Tips on the Medicare Appeals Process

Medicare Appeals

It’s frustrating to have Medicare claims denied — and it happens to almost all physicians from time to time. To successfully appeal claims that have been denied, you need to understand the process.

Nearly every physician has claims denied from time to time. Medicare, as a government program, has its own way of doing things. As you know, the process is different from insurance companies, which also have their own way of handling claims.  Read more

Christine Hradsky No Comments

Facing a HIPAA Audit: What to Know

HIPAA Audit

Since the Health Information Technology for Economic and Clinical Health Act (HITECH) was passed, the Department of Health and Human Services has been supplied with a range of tools to support enforcement.

Early in the history of the Health Insurance Portability and Accountability Act (HIPAA), violations typically involved receiving a warning letter from the Department of Health and Human Services (HHS). It was basically toothless and carried no penalties. In 2009, Congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH), which supplied the government with a range of tools to support enforcement. In short, HIPAA grew fangs. Read more

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What Tax Reform Means For Healthcare Entities: For-Profit & Non-Profit

HEALTHCARE EntitiesOn Dec. 22, 2017, President Trump signed sweeping tax reform, formerly known as the Tax Cuts and Jobs Act, into law, marking the largest change to U.S. tax policy in decades.

What changes are coming for healthcare companies?

To help organizations navigate the issues most impactful and urgent to the healthcare industry, we’ve prepared a summary of the major implications based on the signed legislation. Read more

Christine Hradsky No Comments

Legislative Alert: Congress Passes Budget Bill With Wins For Medical Groups

Overnight, Congress passed a sweeping two-year budget deal signed into law by President Trump today. The Bipartisan Budget Act of 2018 (H.R. 1892) is largely a win for physician practices. The law addresses top MGMA priorities, including reducing burden in the MIPS program, eliminating the unelected Medicare cost-cutting board known as the IPAB, and averting a flawed misvalued-code policy that would have resulted in drastic across-the-board payment cuts in 2019 and 2020.

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