toomer2244
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- Sep 1, 2018
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I joined a private practice group and maybe having some second thoughts but want to get some opinions first. I am not a lawyer.... there is pressure to produce... which is fine....if you do there are financial benefits... but I want to be ethical and feel I am doing the right thing...
One physician is the sole owner of both the UDS in-house lab (both screening and confirmation) and an MRI machine. He gives bonuses to the employed doctors for both each month. The bonus is based on a % after overhead. There is obvious pressure to send for MRIs. UDS is out of the doctors hands as the risk is already assigned without input. However the order goes under the physician seeing the patient.... sketchy? Especially if you don't agree if a UDS is needed?
Of note the owner (or his delegate) is the only person that can "risk" stratify a patient for the UDS. Most patients are considered high risk and every new patient gets a UDS (even if they do not want narcotics and are referred for an injection).
Does this set up go against stark laws? He is the sole owner and no one owns shares.
He also gives bonuses for DME (back braces... TENs...) to both the employed docs and numerous mid-levels. Does the stark law include these type of referrals? Back braces are also dispensed when patients are sedated for a procedure.... not by me.... (versed).
Research is also done at this site and patients are pressured to participate.... basically the staff (MAs) are incentivized with send patients to research studies.....
The job is in a great city and location. Could pay very well.... however there are many issues and no real input..... I think the answer is obvious but am concerned about the potential stark law issues and wanted to see if I could get some opinions.
One physician is the sole owner of both the UDS in-house lab (both screening and confirmation) and an MRI machine. He gives bonuses to the employed doctors for both each month. The bonus is based on a % after overhead. There is obvious pressure to send for MRIs. UDS is out of the doctors hands as the risk is already assigned without input. However the order goes under the physician seeing the patient.... sketchy? Especially if you don't agree if a UDS is needed?
Of note the owner (or his delegate) is the only person that can "risk" stratify a patient for the UDS. Most patients are considered high risk and every new patient gets a UDS (even if they do not want narcotics and are referred for an injection).
Does this set up go against stark laws? He is the sole owner and no one owns shares.
He also gives bonuses for DME (back braces... TENs...) to both the employed docs and numerous mid-levels. Does the stark law include these type of referrals? Back braces are also dispensed when patients are sedated for a procedure.... not by me.... (versed).
Research is also done at this site and patients are pressured to participate.... basically the staff (MAs) are incentivized with send patients to research studies.....
The job is in a great city and location. Could pay very well.... however there are many issues and no real input..... I think the answer is obvious but am concerned about the potential stark law issues and wanted to see if I could get some opinions.
