|Perfect Number of Pages to Order||5-10 Pages|
Reverse Referral Fees Assignment HA4070D
Reverse Referral Fees (Assignment 11)
Submission is required to complete this assignment.
Complete the “Reverse Referral Fees” problem on page 573 as a two- to three-page paper. The Marcus Welby Hospital’s general description can be found here.
You’re an outside attorney for Marcus Welby Healthcare Corporation (MWHC), which is concerned that spending in some of its ancillary departments are causing it to lose money under Medicare and HMO insurance. It wants to start charging some of the costs of running its hospital-based physicians’ departments. Its current arrangement with these physicians is that they have exclusive contracts to work in these areas, but no money is exchanged. The hospital is in control of billing, personnel, and overhead, but it invoices separately for facility charges and professional fees, and the physicians keep all professional fees collected on their behalf by the hospital. In the industry, this is standard procedure. MWHC proposes the following changes to this arrangement:
Have the radiology group pay for the hospital’s services, supplies, personnel, utilities, maintenance, and billing. This package would generally cost $100,000 to $150,000 per year in a non-hospital, office-based scenario. The hospital will initially charge the radiology group only $25,000, but over the next four years, the expenses will rise to $100,000. Payments are required only if the hospital’s gross income from radiology services in the preceding year exceeded $1,000,000.
When a physician on the MWHC medical staff orders a test from the clinical lab, the hospital’s clinical laboratory, under the guidance of the pathology section, would pay the hospital a 20% charge for “specimen collecting and handling services.”
What advice would you provide to someone in this situation?