Physician law : evolving trends and hot topics 2024 / Wes M. Cleveland.

Format:

Book

Author/Creator:

Cleveland, Wes, author.

Language:

English

Subjects (All):

Physicians.

Physical Description:

1 online resource (379 pages)

Edition:

First edition.

Place of Publication:

Chicago, Illinois : American Bar Association, [2024]

Summary:

This book provides a comprehensive overview of legal issues and compliance challenges in the healthcare industry, focusing on fraud and abuse risk areas associated with physician business relationships. It covers federal laws such as the Anti-Kickback Statute, False Claims Act, and the Stark Law, including recent changes and guidance from the Office of Inspector General (OIG). The text discusses various physician arrangements, including employment, joint ventures, and medical directorships, highlighting compliance concerns and recent settlements. It also explores telehealth regulatory issues, HIPAA compliance, and the structure and viability of Accountable Care Organizations (ACOs). The book is intended for healthcare professionals, legal practitioners, and policymakers seeking to understand the complexities of healthcare regulations and ensure lawful practice. Generated by AI.

Contents:

Cover

Title Page

Copyright

Contents

Foreword

Physicians Legal Issues Conference 2024 Planning Committee

Chapter 1—Entrepreneurial Medicine: Fraud and Abuse Risk Areas for Physician Business Relationships

I. Introduction

II. Federal Fraud and Abuse Laws

A. The Federal Anti-Kickback Statute

1. Exceptions and Safe Harbors to the Anti-Kickback Statute

a. Exceptions to the Anti-Kickback Statute

b. Safe Harbors to the Anti-Kickback Statute

2. OIG Special Fraud Alerts, Bulletins, and Other Guidance Involving Physicians

a. OIG General Compliance Program Guidance

b. OIG Special Fraud Alert: Practitioners to Exercise Caution When Entering Into Arrangements With Purported Telemedicine Companies

c. OIG Special Fraud Alert: Speaker Programs

d. OIG General Policy Statement Regarding Gifts of Nominal Value to Medicare and Medicaid Beneficiaries

e. 2015 OIG Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability

f. 2014 OIG Special Fraud Alert Regarding Laboratory Payments to Referring Physicians

3. Recent Changes to the Anti-Kickback Statute for Value-Based Arrangements and Other Areas

B. The False Claims Act

1. Whistleblower Actions Under the FCA

2. Examples of Potential False Claims for Items and Services

3. Penalties for Violation of the FCA

4. The 60-Day Overpayment Report and Refund Obligation

C. The Stark Law

1. Scope of the Stark Law Physician Self-Referral Prohibition

2. Examples of Physician Relationships Subject to the Stark Law

3. Penalties for Stark Law Violations Generated by AI.

Notes:

Description based on publisher supplied metadata and other sources.

Part of the metadata in this record was created by AI, based on the text of the resource.

Description based on print version record.

Includes bibliographical references.

ISBN:

9781639055197

1639055193

OCLC:

1492928725