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Physician contract negotiations can be tricky, no matter how positive the relationship between the hospital and physician is. Start the process by doing your research.
In the event that you are audited, you will need to demonstrate that commercial reasonableness was carefully considered along with FMV.
MD Ranger has seen a steady increase in incentive components in hospital-based contracts.
Some of the growth in physician expenditures appears to be the result of continued growth in the number and scale of hospital-based programs and services.
Though rates at the individual service level remain relatively stable year over year, overall physician costs paid by hospitals have skyrocketed in the last decade.
At the individual contract level, several factors consistently correlate with higher contract rates
The two most important regulations to understand are the Stark Law and the Anti-Kickback Statute.
In cases of compliance infractions, courts consider all the relevant facts in including commercial reasonableness of an arrangement and whether or not an organization made a good faith effort to comply.
Each year, Dan Levinson provides HCCA’s attendees with a glimpse into what the OIG has occurred within the OIG recently and what they will be focusing on over the next year.
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