Implementing These Changes
Change is difficult and it takes time, especially when it will most likely impact the earnings of rheumatologists in a practice, some positively and some negatively. It is vital to get acceptance from the rheumatologists (both owners and employees) and to communicate that these changes are not being driven by the practice, but by much larger “forces”—namely third-party payers and a consolidating healthcare landscape. It is equally important to reinforce that maintaining the status quo may not allow the practice to remain financially viable and independent.
Additionally, the huge verdicts being handed down for improper compensation arrangements in violation of the Stark Law and the Federal Claims Act (e.g., Tuomey Healthcare for $357 million, Intermountain for $25.5 million, and St. Vincent and Holy Rosary for $3.95 million) and an increasingly aggressive enforcement climate focused on fair market value, commercial reasonableness, and not taking into account the value or volume of referrals, make it important that a healthcare attorney well versed in regulatory compliance matters, including Stark and related ancillary revenue-sharing issues, should also be involved in structuring any physician compensation package.
Steven M. Harris, Esq., is a nationally recognized healthcare attorney and a member of the law firm McDonald Hopkins, LLC. He may be reached at [email protected].
