Nov 16

Get Sure That You’re Insured – Podcast

What if you’re sued for an event that one of your own members didn’t cause? To your dismay, you find out that you’re not covered for that.

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Mark F. Weiss

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Nov 15

A Naive Anti-Kickback Question Answered – Medical Group Minute Series

There’s an expression in carpentry, “measure twice, cut once.” We should have the same expression in terms of healthcare deals…

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Mark F. Weiss

Nov 14

History Rhymes in Healthcare Just as it Does in Home Delivery Services: Ride the Trend – Success In Motion Series

Ride along with Mark as he discusses the fact that trends, even those that seem modern, such as home delivery of fully prepared meals, are simply history repeating itself or, at least, rhyming. Understanding this facilitates your exploitation of trends in healthcare.

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Mark F. Weiss

Nov 13

Healthcare Freedom of Choice: Doughnuts and Doing Time


In a Wall Street Journal piece published in last weekend’s Saturday/Sunday Nov. 11-12, 2017, edition, Ezekial Emanuel, M.D. of the University of Pennsylvania and other pursuits, wrote of the “hype of virtual medicine.”

In particular, he cited studies that show that virtual medicine and high-tech health gadgets such as Fitbits accomplish nothing in regard to increasing patient compliance with doctors’ orders or to actually live healthier lifestyles. The same compliance problems that exist with regard to traditional medical encounters exist with regard to technological encounters.

The bigger issue is why he’s surprised at all.

People are free to do with their health what they want to do, and the simple fact of the matter is that many people don’t feel like complying with physicians’ “orders” any more than many physicians feel like complying with “compliance” laws.

It’s simply a fact of free choice.

Just as I wasn’t surprised when, several years ago, a corpulent physician suggested that I eat a second lunch in the physician’s dining room at the hospital “because the food is free,” I’m not that surprised when a group of hospital administrators thinks that an obviously defective and illegal kickback scheme is a perfectly valid business model.

Free choice in structuring healthcare deals, just as free choice in having that fifth doughnut, falls on a risk-reward-punishment continuum.

What’s Sally’s (the wife and mother) health risk when faced with the question of second glazed or fourth jelly? What’s Sally’s (now at her desk as hospital CEO) risk when faced with the question of entering into an undocumented financial arrangement with a referring physician, thus implicating Stark and the Anti-Kickback Statute? What’s Sally’s sister Sarah’s risk when faced with the question of entering her medical group into a deal with pharmacy owners and investors to telephonically prescribe pain creams to patients on a one-off, transactional basis?

Pleasure/money now, with some risk of diabetes/debarrment/detainment far off in the future. Or, maybe not so far off.

The issue of risk isn’t just the cold calculation of the chance of getting caught. It’s that chance times the intensity of the punishment. A 5% chance of 10 years in prison is riskier than a 60% chance of a $50,000 civil monetary penalty and being forced into a Corporate Integrity Agreement.

Of course, the scale that we use to measure risk isn’t fixed either, and some put an extra finger or even two on the side of the scale marked “it won’t happen to me.” But, then again, we’re also free to fool ourselves.

How else can you explain deals gone awry such as these:

Sweet Dreams Nurse Anesthesia agreed to pay $1,034,416 to the U.S. government and $12,078.79 to the the State of Georgia to resolve allegations that it violated (due to underling AKS violations) the False Claims Act and the Georgia False Medicaid Claims Act.

Specifically, they were alleged to have entered into arrangements with ASCs to provide the facilities with free anesthesia drugs in exchange for exclusive anesthesia agreements. They were also alleged to have agreed, through an affiliate, to fund the construction of an ASC in exchange for contracts as the exclusive anesthesia provider at that and a number of other ASCs.

MediSys Health Network Inc., the owner of Jamaica Hospital Medical Center and Flushing Hospital and Medical Center, both in Queens, New York, agreed to pay $4 million to the U.S. government to settle allegations that it violated (due to underlying Stark Law violations) the False Claims Act by engaging in improper financial relationships with referring physicians.

Specifically they were alleged to have have submitted false claims to the Medicare program for services rendered to patients referred by physicians with whom the defendants had improper compensation and office lease arrangements.

So, strap on that Fitbit and have the glazed, or give free drugs to the ASC, or provide free office space to the cardiac surgery group.

Hey, it’s a free country. Just remember that you’re free to suffer the consequences, too.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

Nov 09

You Are Not A Service – Podcast

Running a hospital based group as “service” for the hospital, functioning as a sort of clearinghouse for income and expenses, severely limits your group’s future.

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Mark F. Weiss

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Nov 08

Hundred Year Floods, “Worst Storm Ever,” and Protecting Your Business From the Future – Medical Group Minute Series

What is your medical group or business doing to prepare for a worse than “worse” case scenario? What are you doing to hedge against it? What are you doing to benefit from it?

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Mark F. Weiss

Nov 07

It’s Fall for Some Hospitals. Opportunity Abounds. – Success In Motion Series

Ride along with Mark as he discusses the fact that, unlike deciduous trees, some hospitals won’t be springing back to life next year. As a result, opportunities abound.

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Mark F. Weiss

Nov 06

Cooking Time = Negotiating Time

 

Yesterday, as my wife and I were in the kitchen, she quipped, peering into the oven, that she forgot to set the timer for the final step of the recipe.

I asked what she should have set the timer for, and she said 8 minutes, but that that was just cooking time, not actual time.

Hmm. Was time different inside the oven? Was a minute not a minute?

Okay, I’m not an idiot. I know that “cooking time” just means “estimated time.” Or does it? Think about it for a moment. Is time always the same?

I’m not trying to go all Einstein on you. [Einstein is said to have said, but probably didn’t himself say, in explaining relativity, something to the effect of, “when you sit with a nice girl for two hours you think it’s only a minute, but when you sit on a hot stove for a minute you think it’s two hours. That’s relativity.”]

Or, maybe I am, because “cooking time” as a different sort of time, a distorted time, a malleable time, is a perfect concept for use in negotiation.

Each negotiation has its own timing, not one set by a standard recipe or by a clock on the wall or on the calendar, but one that can be, and should be, set by you.

The object is not to get the deal done quickly, but to get the deal done – meaning on terms acceptable to you. Accomplishing that rarely means quickly and it always means deliberately.

Sometimes it means changing the clock to slow things down or to speed it up. Always it means deciding when to bring up issues, adding ingredients to the deal, if you will.

Other times it means imposing deadlines, real or imagined. Almost always it means ignoring deadlines.

Time in negotiation is not real time.

Instead, it’s a tool in the kitchen drawer of negotiation. A very useful tool.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

Nov 02

Why You’re Actually In Sales – Podcast

You keep your medical skills up. It’s time that you focus on your sales skills as well.

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Mark F. Weiss

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Nov 01

What A Marshmallow Says About Your Medial Group’s Future – Medical Group Minute

Would you rather have one marshmallow now, or two tomorrow?

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Mark F. Weiss

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