Medical Journal - Houston April 2013

Financial Perspectives : Exceptional customer service : How to do it , see page 3

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INSIDE

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Huntsville Memorial Hospital Opens New Emergency and Imaging Center

see page 10

INDEX

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Financial Perspectives ....... 3 THA ............................... 4 Technology ....................... 6 Special Feature .................. 8 Breaking Ground ............ 10 Integrative Medicine ........ 12

SuperFoods Rx For Pregnancy see page 12

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PRSRT STD US POSTAGE PAID HOUSTON TX PERMIT NO 13187

The Leading Source for Healthcare Business News

BY Mary M . Bearden and Allison Shelton , Brown & Fortunato , P . C .

On March 26 , 2013 , the Office of Inspector General ( OIG ) issued a Special Fraud Alert regarding physicianowned entities . The Fraud Alert highlights the potential for abuse when a physician has an opportunity to earn a profit through an investment in an entity for which the physician can generate business . In the Fraud Alert , the OIG ( 1 ) outlines suspect features of physician-owned entities ; ( 2 ) discusses policy concerns associated with such entities ; ( 3 ) indicates that , under certain circumstances , hospitals that enter arrangements with physician-owned entities may violate the Medicare / Medicaid antikickback statute ( AKS ); and ( 4 ) highlights the risks associated with physician-owned distributorships .

Repeatedly throughout the Fraud Alert , the

By Peter Andrew Sacco Ph . D ., Author , Right Now Enough Is Enough

When individuals engage in substance abuse ( alcohol , drugs , etc .) and they are unable to quit usage on their own even though they have tried repeatedly , but succumb to using again , they might be said to possess an addiction . Addictions are multi-faceted whereby they affect individuals in one or more ways ; biologically , psychologically or socially . When the body develops withdrawal symptoms after the individual

OIG emphasizes that : “ Longstanding OIG guidance makes clear that the opportunity for a referring physician to earn a profit , including through an investment in an entity for which he or she generates business , could constitute illegal remuneration under the anti-kickback statute .” According to the OIG ’ s interpretation of the AKS , if only one purpose of remuneration is to induce referrals , then the arrangement violates the AKS . To determine whether one purpose of an arrangement with a

discontinues use , they are said to possess a physical tolerance ( body needs it ). The substance is in their blood stream and they need it to physically function in order to remove the sideeffects of withdrawal . Conversely , when an individual craves a substance that leads them to suffer emotionally and / or impedes their rational functioning without it , they are said to possess a psychological addiction . When prescribing drugs to patients it is important to understand that certain individuals possess addictive personalities , that have the

April 2013 • Volume 10 , Issue 1 • $ 3.50

Physician-owned distributorships remain on the Fed ’ s radar

physician-owned entity is to generate illegal referrals , the OIG will look at the totality of the facts and circumstances , including operational safeguards , the details of an entity ’ s legal structure , and the conduct of all investors and other parties involved in the arrangement .

With all physician-owned entities , the OIG has four general concerns . First , the physician ’ s ability to maximize a profit

Please see LEGAL AFFAIRS page 13

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potential to get addicted to certain types of drugs !

A d d i c t i o n and substance dependence is a slow , insidious process which develops over time through repeated use and eventual abuse of the drug of choice . When most addicts began using their substance of choice and using moderately , they were in control . When prescribed by a physician , they believe that the physician has their best intentions in mind . Since physicians practice “ beneficence ”, doing what is best for the patient , most patients

Please see ADDICTION page 14