Kaiser News: Hospital Kickbacks to Pain Physicians

[drusso]

Hospitals Accused Of Paying Doctors Large Kickbacks In Quest For Patients - KFF Health News

Hospitals are eager to get particular specialists on staff because they bring in business that can be highly profitable. But those efforts, if they involve unusually high salaries or other enticements, can violate federal anti-kickback laws.

khn.org

"To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians across the nation, the federal government charged in a lawsuit filed this spring."

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[thecentral09]

So what is the 90th percentile?

 

[lobelsteve]

So what is the 90th percentile?

More than I make.

 

[callmeanesthesia]

Hospitals Accused Of Paying Doctors Large Kickbacks In Quest For Patients - KFF Health News

Hospitals are eager to get particular specialists on staff because they bring in business that can be highly profitable. But those efforts, if they involve unusually high salaries or other enticements, can violate federal anti-kickback laws.

khn.org

"To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians across the nation, the federal government charged in a lawsuit filed this spring."

So basically the problem here isn’t the requirement to keep referrals and services in-house - plenty of hospitals have those requirements without coming under this scrutiny. The problem is that physicians are being paid according to the actual value to the organization rather than keeping their salaries “average” (a continually falling number).

 

[drusso]

So basically the problem here isn’t the requirement to keep referrals and services in-house - plenty of hospitals have those requirements without coming under this scrutiny. The problem is that physicians are being paid according to the actual value to the organization rather than keeping their salaries “average” (a continually falling number).

Keeping referrals in-house is bad for patient choice and undermines the entrepreneurial foundation of independent medical practice.

 

[Orin]

And sometimes it's bad for patients?

https://www.usnews.com/news/health-news/articles/2019-05-30/unc-cardiologists-concerns-over-pediatric-surgery-reflect-broader-problem

 

[Ligament]

Moral of the story to the layperson; doctors evil. Doctors make too much money. All doctor's fault.

 

[paindoc007]

“federal laws mandating that hospitals pay doctors fair market value for their services without regard to how much additional business they bring through referrals”

What exactly is fair market value? What if someone is making 60th national percentile for $/wrvu. Is that fair? What about 70 or 75? What point is it not fair compensation anymore

 

[Orin]

So basically the problem here isn’t the requirement to keep referrals and services in-house - plenty of hospitals have those requirements without coming under this scrutiny. The problem is that physicians are being paid according to the actual value to the organization rather than keeping their salaries “average” (a continually falling number).

This is more than that, because they're arguing that the physician's enterprise value cannot be used to determine salary OR support.

"Last August, William Beaumont Hospital, part of Michigan’s largest health system and located outside Detroit, paid $85 million to settle government allegations that it gave physicians free or discounted offices and subsidized the cost of assistants in exchange for patient referrals. "

That's seems like a very broad interpretation of the Anti-Kickback Statute and the Physician Self-Referral/Stark law)