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Writing on healthcare compliance
A written post accompanies every weekly podcast episode. General information, not legal advice.
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- Stark Law
New Chapter, But Same Compass: Wade Health Law
A new chapter: Wade Health Law. But, the same compass. In this episode, Captain Integrity Bob Wade introduces his new law firm, Wade Health Law. Hear why he’s starting his own law firm, 4 stories that have shaped his personal life & professional career, the most important lessons he’s learned in life & healthcare law, why change is inevitable, and what to expect in future episodes of Stark Integrity. Learn more at WadeHealthLaw.com - Fair market value
The 2027 MPFS Proposed Rule: Why the Real Story Isn't the Conversion Factor
We’re not talking about conversion factors as they relate to the 2027 Medicare Physician Fee Schedule (MPFS) and proposed rules. In this episode, Captain Integrity Bob Wade focuses primarily on how the 2027 MPFS may impact physician compensation and Fair Market Value (FMV) in the future. Hear why the 2027 MPFS means a lot more with respect to physician compensation, how the Centers for Medicare & Medicaid Services (CMS) is beginning to challenge certain areas, why the 2027 MPFS is increasingly about why providers get paid, the most surprising aspects of the 2027 MPFS, and an analogy for Christmas morning. Learn more at WadeHealthLaw.com - Fair market value
The Misunderstood Commercial Reasonableness Test Explained and Fire Stations
There are 3 primary tests under the Stark Law: Fair Market Value (FMV), the Volume or Value standard, and Commercial Reasonableness (CR). In this episode, Captain Integrity Bob Wade dives deep into the Commercial Reasonableness standard. Hear why Commercial Reasonableness is fundamentally about a legitimate business purpose, the right questions to ask in terms of Commercial Reasonableness, why physician arrangements should be judged like a fire station, the biggest myth in healthcare compliance, and a David Letterman Top Ten List for Commercial Reasonableness. Learn more at WadeHealthLaw.com - Compliance
Is CMS Proposing That Physicians Cannot Perform a Procedure on the Same Day as E&M Encounter in 2027?
In the 2027 Physician Fee Schedule, CMS (Centers for Medicare & Medicaid Services) is proposing modifications for procedures and E&M services (Evaluation & Management) performed on the same day. In this episode, Captain Integrity Bob Wade describes what is being proposed as it relates to the Stark Law. Hear what is not going away, why the proposal is a payment methodology proposal, how there’s still time for advocacy to take place, several medical & non-medical examples, and Captain Integrity’s famous air quotes. Learn more at WadeHealthLaw.com - Compliance
Implementing & Monitoring AI Responsibly: A Discussion with Arvita Tripati, Founder and Principal of Vahana Labs
Having someone who is accountable is essential for AI governance. In this episode, Captain Integrity Bob Wade discusses implementing & monitoring AI responsibly as it relates to the Stark Law with Arvita Tripati, Founder & Principal at Vahana Labs. Hear why buying technology does not outsource the accountability, why you need to ask every vendor when the tool was last validated, why the goal is not zero AI risk, a Netflix analogy around AI governance, and “The Compliance Bot” poem from Captain Integrity. Learn more at WadeHealthLaw.com - Compliance
Death by Committee? How to Run and Participate in Committees Effectively
Compliance committees can either be a well-oiled engine in a Lamborghini, or an engine being held up by an engine hoist in need of repair. In this episode, Captain Integrity Bob Wade shares how to run and participate in a compliance committee meeting that actually matters. Hear why a compliance committee should ask questions, how to focus on the fire instead of the smoke, why every compliance committee meeting should end with ownership, a Stark Law example of a compliance committee meeting agenda, and a fitting David Letterman Top Ten List. Learn more at WadeHealthLaw.com - Compliance
Private Equity Meets the Stark Law: Navigating Physician Transactions, MSOs, and Referral Risks
Why are private equity, physician groups, and the Stark Law like insects heading to a bug zapper? In this episode, Captain Integrity Bob Wade explains why. Hear why ownership changes do not eliminate Stark Law risk, why compensation redesign deserves careful attention, why documentation is your best defense, the mother of all definitions, and the research behind insects being attracted to light bulbs. Learn more at WadeHealthLaw.com - Compliance
Is It a Podcast? Is It a Blog? Is It Both?
You can now experience Stark Integrity in 2 ways: the podcast AND the blogs. In this episode, Captain Integrity Bob Wade introduces the Stark Integrity Podcast Blogs, where you can enjoy each episode as 1 conversation, with 2 experiences. Hear what to expect with the new Stark Integrity website, how your favorite Stark Integrity topics & episodes are now searchable, the goal of Stark Integrity from the very beginning, how to use the new site as a research tool, and how your feedback helped shape the new site. Check out the new site at WadeHealthLaw.com - Compliance
Using AI in Physician Contracting & Payment: A Discussion with Scott Lowry, Founder of StarkWatch
Lean in wherever you have quick wins. In this episode, Captain Integrity Bob Wade talks using AI in physician contracting & payment as they relate to the Stark Law with Scott Lowry, Founder of StarkWatch. Hear how to quickly assess where your organization’s at with its Stark Law compliance program, how to aim for advancement instead of program perfection, why you should use inexpensive AI solutions to perform reviews & monitoring, some of the use cases for StarkWatch, and a bit of nostalgia for old school, offline resources. Learn more at CaptainIntegrity.com - Compliance
Part 3: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose
Training goes a long way when it comes to informed consent. In Part 3 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear why you need to document the decision-making capacity, how to make sure AI use is properly disclosed, why policies & procedures play a huge role, how AI is changing the healthcare world, and how surrogates work. Learn more at CaptainIntegrity.com - Compliance
Part 2: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose
The more checks and balances an organization has along the way, the greater the protection for both the patients & the providers. In Part 2 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear how decision-making capacity & inadequate informed consent lead to legal liability, considerations when it comes to anesthesia, personal anesthesia stories from Bob & Rachel, the best practices organizations can take to uphold patient autonomy, and notable high-profile cases involving sexual assault. Learn more at CaptainIntegrity.com - Compliance
Part 1: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose
The patent’s right to autonomy is one of the core principles of the patient-provider relationship. In Part 1 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear the recent cases where informed consent & decision-making capacity were relevant, the difference between decision-making capacity & informed consent, why having the piece of paper signed doesn’t necessarily mean informed consent, how providers & patients can protect themselves, and what you should think through as a patient before moving forward with anything. Learn more at CaptainIntegrity.com