Physician contract compliance matters, first and foremost, because breaking federal law comes with hefty fines. To give a recent example, a Montana hospital paid $24M to the federal government for violating the False Claims Act, Stark Law and the Anti-Kickback Statute. And it can get a lot worse than that. Settlements can reach hundreds of millions of dollars, and executives can be held personally responsible. But here’s the kicker: You can be under investigation and not even know it.
The government could be performing an audit on your organization’s physician compliance program without your knowledge. This is due to the False Claims Act, which enables people within your organization, known as “whistleblowers,” to inform the government of non-compliant practices. If there is a lawsuit, whistleblowers even get a share of the settlement.
If you’re performing regular internal audits of your physician agreements and have an organized physician contracting program in place, you will have a better grasp of what you’re spending. A solid understanding of your organization’s financials makes it easier to make informed decisions and ensure your physician agreements fall within federal regulations.
In a nutshell, this underscores the importance of running a tight compliance program. Learn more about how to implement a solid compliance program in which you define, determine and document FMV here.
If you have further questions about how to structure physician contracts and document compliance, we would love to talk to you. Email us at info@mdranger.com.
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