Contracts and Business Arrangements; Fraud and Abuse and the Stark Law.
Providing health services is a highly regulated industry. There are many ordinary commercial practices which, if used by a medical provider, can result in career-ending penalties, including fines, prison terms, loss of Medicare/Medicaid provider status and loss of medical licensure.
In order to do business with a medical provider, or in a medical business of any kind, you need an attorney who has experience in the formation and operation of medical business entities such as physician recruitment agreements, exclusive service contracts, joint ventures and employment agreements. If you are considering a business arrangement with a medical provider of any kind, or entering into a medical director agreement or other contract with a provider, you need an expert to structure the transaction. This is not an overstatement. There are many ordinary commercial practices which, if used by a medical provider, can result in career-ending penalties, including fines, prison terms, loss of Medicare provider status and loss of medical licensure
The anti-fraud and abuse laws and the Stark Law are complex and not readily summarized. However, in very general terms, they affect your business like this:
- The federal anti-fraud and abuse laws prohibit soliciting or receiving an incentive to refer patients for services reimbursed by Medicare or Medicaid
- The Florida law prohibits referrals for designated health services to an entity in which the provider is an investor, regardless of payor
- The Stark law prohibits a physician from making referrals for designated services to an entity with which he has an ownership or compensation arrangement, and prohibits the entity from presenting a claim for payment under of the federally funded healthcare programs
There are many other restrictions. Understanding how these principles apply to your contract, joint venture, merger or acquisition, medical director agreement or other business arrangement requires an expert.
Experienced legal services for healthcare providers
This firm has been advising health care entities and structuring their transactions for 28 years.
Get the personalized legal services you deserve. Call Christine C. Whitney today.
Christine C. Whitney, P.A. provides guidance to businesses that work with healthcare professionals throughout Florida and nationwide. To find out what the firm can do for you, call 904.356.4387 or contact the firm online.