Stark Integrity

Latest Episodes:

Part 1 Physician Recruitment under the Stark Law/AKS: The Regs, Settlements, and Operational Challenges May 03, 2022

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Under the Stark Law, hospitals can financially induce physicians. In this episode, Captain Integrity Bob Wade starts his analysis on physician recruiting under the Stark Law. Hear how to study and apply the strict definitions, why physicians always have to sign the agreement, there’s no Fair Market Value or Commercial Reasonableness requirement specifically stated in the Physician Recruitment exception, how to negotiate a recruitment package, and the bucket analogy. Learn more at CaptainIntegrity.com

Life and Learnings from a CIA: A Discussion with Lucia Pizano-Urbina from Broward Health Apr 26, 2022

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How do you know? Where’s the proof? In this episode, Captain Integrity Bob Wade welcomes Lucia Pizano-Urbina of Broward Health to chat about life operating under a Corporate Integrity Agreement and the world of Compliance. Hear how to create a CIA Annual Report Subcommittee, always have a plan of correction for any item, be organized, learn the CIA (Corporate Integrity Agreement) inside and out, and check, check, check. Learn more at CaptainIntegrity.com

Group Practice Part 2: Stark Law's In-Office Ancillary Services Exception Apr 19, 2022

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If you believe you are a Group Practice, let’s do the Group Practice dance. In this episode, Captain Integrity Bob Wade continues the discussion on Group Practice under the Stark Law. Hear how to know what type of facility in which the services are provided, the difference between ancillary services and incident to services, why multimillion-dollar settlements have occurred in this area, what questions need to be answered, and a recap of Group Practice definitions and subdefinitions. Learn more at CaptainIntegrity.com

2021 CMS-Revised wRVUs and Impact on Physician Compensation: A Discussion with Bob Madden of SullivanCotter Apr 12, 2022

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Physician fee schedules change frequently. In this episode, Captain Integrity Bob Wade welcomes Bob Madden of SullivanCotter to break down the latest changes in wRVUs and their impact. Hear why you should be very careful when selecting a comparative group from the available benchmark data, keep key considerations in mind, prepare yourself for changes to come, why there were some anomalies in the 2021 survey data, and what your company’s key communication points should be. Learn more at CaptainIntegrity.com

Group Practices Part 1: The Mother of All Stark Law Definitions Apr 05, 2022

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The group practice definition under the Stark Law is the mother of all Stark Law definitions. In this episode, Captain Integrity Bob Wade shares the detailed definitions and subdefinitions of Group Practice under the Stark Law. Hear how to understand each subdefinition, how members of a group practice differ from physicians, what happens if you don’t meet all definitions, surrogate methods, and how much payouts for settlements can be. Learn more at CaptainIntegrity.com

Impact of COVID, 2021 wRVU Values, and 2022 Physician Fee Schedule on Fair Market Value and Stark Law Compliance Mar 29, 2022

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2020 and 2021 will have a long-term impact on Stark Law Compliance. In this episode, Captain Integrity Bob Wade details how the massive changes of the past couple years impact Fair Market Value and Stark Law Compliance. Hear the double whammy on physician compensation caused by COVID and the Physician Fee Schedule, why you need to be very careful in looking at total compensation, how to bill appropriately, insights from top surveys, and where there have been cash increases. Learn more at CaptainIntegrity.com

2021 Settlements Under the False Claims Act, Stark Law, and Anti-Kickback Statute - Lessons Learned Mar 23, 2022

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There are many lessons to learn from the 2021 False Claims Act settlements. In this episode, Captain Integrity Bob Wade recaps the major settlements under the False Claims Act in 2021 and what actionable insights we can pull from them. Hear why the qui tam weapon is still a large tool for the Department of Justice, healthcare is the largest source of false claims recovery for the government, personal liability continues to rise under the False Claims Act, how much was recovered in 2021, and the most game-changing settlements. Learn more at CaptainIntegrity.com

Business Valuations under AKS and Stark Law with Richard Romero from Coker Group Mar 16, 2022

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Value equals Benefit divided by Risk. In this episode, Captain Integrity Bob Wade welcomes Coker Group SVP Richard Romero to discuss the ins and outs of business valuations. Hear the 4 universal laws of valuation, how to make sure the standard of value applies to your situation, understand capacity constraints of your people and assets, when valuations come into play, and Richard’s favorite Fair Market Value definition. Learn more at CaptainIntegrity.com

Stark Law, Fair Market Value, and Approval Process Discussion with Parkview Health Attorney Alex Krouse Mar 08, 2022

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How does the Stark Law sausage get made? In this episode, Captain Integrity Bob Wade welcomes Parkview Health Associate General Counsel Alex Krouse to break down his experience and advice for Stark Law compliance. Hear how to develop teams and processes for provider compensation, consider several factors as you shape your organization, lean on the structure you set up, what the data tells you, and why a larger team is helpful. Learn more at CaptainIntegrity.com

Board Members Part 2: Compliance and Key Legal Requirements Including the Stark Law Mar 01, 2022

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As a Board member, you need to have effective oversight of the fraud and abuse statutes. In this episode, Captain Integrity Bob Wade continues the discussion on what you need to know as a Board member for Stark Law compliance. Hear the the 5 main statutes of fraud and abuse, how to ensure your organization has a regimented process to validate compliance, why you need to be comfortable with the high-risk arrangements being made, which statute is “The Granddaddy of Them All,” and a recap of the 7 components of an effective compliance program (and the unwritten 8th). Learn more at CaptainIntegrity.com and email Bob for his Board dashboard report tool

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