Wisdom. Applied.
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Wisdom. Applied.
Podcast by Mark F. Weiss
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Non-Competes After the FTC’s Pivot: A Balancing Act for Medical Group Leaders
Non-Competes After the FTC’s Pivot: A Balancing Act for Medical Group Leaders by Mark F. Weiss
The FTC Buries Its Ban on Non-Competes, But Sharpens its Aim on Violations
FTC ditches a full non-compete ban, but healthcare employers still face targeted crackdowns. Physician groups, take note.
From Kings to Contracts: No Love Lost
Even the strongest physician-hospital relationships are transactional. Survival depends on diversification, not loyalty myths.
The Anti-RFP: Forward and Reverse Auctions for Physician Services
Several years ago, it would’ve been difficult to write too much about the strategy of responding to an RFP, i.e., a request for proposal, for physicia...
$500 Million in Alleged Phony Charges and the Dangers of Medical Directorship
$500 Million in Alleged Phony Charges and the Dangers of Medical Directorship by Mark F. Weiss
The Prevailing Healthcare Business Model is Upside Down
Some models were once useful, but no longer are. How’s the “reliant on Medicare”, or even the “reliant on commercial payors”, model working out for yo...
Will Your Business Walk Back in in the Morning?
Your business exists and interfaces on multiple planes and, therefore, the far smarter approach is to explore and adopt protection on each.
Double Trouble: Prosecuted and Sued for the Same Scam
Out of state and still billing for in-person care? A physician submitted claims while vacationing in Hawaii—and now faces criminal sentencing and a $5...
You Can't Lipstick That Pig: Why Physicians Must Carefully Vet Deals
Deals involving management services agreements, consulting contracts, or similar structures can appear completely legal at first glance. But dig deepe...
Healthcare Fraud and the Physician as Victim
The majority of healthcare fraud schemes center on fraud perpetrated by physicians, but what about schemes orchestrated to victimize physicians?
The Nation’s Largest Health Care Fraud Bust, Plus Bureaucratic Negligence
It’s been said that people read published lists of disciplined fellow professionals out of a sense of schadenfreude, the pleasure derived from another...
Why Fail at Optionality?
Although dollars are a lubricant, the real issue is freedom or optionality.
Speak Truth to Numbers
Bureaucratic sorts are drawn to numbers because numbers can be gathered and processed and manipulated, all with the goal of lifetime employment for th...
A Ban on PE in Medical Practice and a Gutting of Practice Value
Certainly, Oregon is a small state in terms of medical practice, but what’s happened in Oregon could, and some say will, spread across the country.
Pain Doc Likely in Pain After Settling Allegations That Billed Procedures Weren’t Performed
Was it a scam or an error? A settlement is just that and there’s been no determination of liability.
Neither you nor I can know for sure...
Why Hospital-Based Medical Groups Must Exploit Honey Bee Strategy
Considering honey bees have been on earth for between 40 to 150 million years, it pays to consider their hive strategy for success, especially because...
14 Month Prison Term in “Doctor Chasing” Scam
There’s huge danger in any arrangement in which you put your prescribing imprimatur on any script or order for any item, especially those reimbursed b...
DOJ to Focus on Criminal Healthcare Fraud and Prosecuting the Individuals Involved
In real life healthcare compliance, there's no get out of jail free card.
Avoid the Second Biggest Mistake Medical Group Leaders Make
It’s imperative that you get started now and that you become willing to invest in your own future.
You Must Know the No. 1 Mistake in Exclusive Contract Negotiation
You Must Know the No. 1 Mistake in Exclusive Contract Negotiation by Mark F. Weiss
How Medical Group Collaboration Creeps into Fraud—Pass-Through Billing
Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly turning to creative means to provide coverage and to impr...
Did They Sell Their Seoul? The $62+ Million Settlement
There’s a reason why Medicare Advantage is fertile ground for fraud enforcement.
Why Bigger Hospitals May Actually Be More Fragile
In healthcare, size used to signal strength. Bigger meant more services, more specialists, more veritas. But what if all that bulk is actually a liabi...
An Algorithmic Conspiracy? DOJ Weighs In on MultiPlan Case
As healthcare payers, tech platforms, and pricing vendors increasingly collaborate through sophisticated analytics, this case is a clear reminder: if...
Advanced Practice Providers Aren’t Necessarily the Grout For the Physician Gap
Supervisory requirements aren’t just administrative niceties; they’re the difference between compliant practice and a lawsuit waiting to happen.
Medical Group Growth Without Recruiting
It’s not news to you that there’s a huge shortage of physicians in many medical specialties, such as in anesthesiology and radiology. With the overall...
The $4 Million Pee Test Scam: How One Lab Owner Flushed His Future
There are dumb crimes, and then there are crimes so dumb they come with a built-in paper trail leading straight to prison.
Have You Mistakenly Sold Out Your Future for Stipend Support?
Even in the face of the provider shortage, during which you think that you have substantial negotiating leverage, when a significant chunk of your rev...
On Strike. Physician Unionization and the Further Commoditization of Medical Practice.
Over the past several weeks, I’ve seen multiple posts and comments on LinkedIn about the horrors of practicing as a cog in the wheel of Big Medicine,...
From Insurance Watchdog to Prisoner: A Cautionary Tale for Healthcare Professionals
From insurance commissioner to healthcare fraudster to federal prison inmate.
First, Let’s Kill All the Healthcare Systems.
According to Bain & Co, nearly one-quarter of physicians employed in health-system-led organizations are considering switching employers.
How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud
If you thought health care fraud required medical knowledge, think again.
Nudge Triggers a $17 Million False Claims Act Settlement
Nudge Triggers a $17 Million False Claims Act Settlement by Mark F. Weiss
What’s Lurking in Your Business Acquisition? Nearly $60 Million in Lessons from Pfizer and Biohaven
Buying a healthcare business, from a medical practice to a medicine manufacturer, is a lot like buying a house—you hope for the best, but sometimes, t...
Will the Whistleblower Law Be Whistled Out?
The False Claims Act (“FCA”) is a powerful tool to fight fraud against the government, especially in healthcare. It contains a “qui tam” provision tha...
Aetna Health v. Radiology Partners and the Danger of Pass-Through Billing
There are, depending upon the particular arrangement, potential end runs around contractual pass-through billing prohibitions, but they are highly fac...
The Crisis Caused By the Lack of Crisis Planning.
Although any particular crisis can’t be predicted, classes of crisis are capable of prediction and, even if that is not true of a specific situation,...
Lesson from McKinsey - Avoiding Consultants from Hell
Are you sure those consultants are helping to improve your business? Or are they potentially sending you to jail?
Now’s The Time to Overturn the No Surprises Act
Re-frame the issue for what it really is: Surprise physician services stealing. Now’s the time for the No Surprises Act, and each state counterpart, t...
Probably the Most Valuable Anti-Kickback Lesson of All Time
Although no one is going to do time as a result of thinking that wet sidewalks cause rain, in the case of the federal Anti-Kickback Statute, confusion...