01Stark Law
The core of the practice. Bob analyzes financial relationships between hospitals and referring physicians against the Stark Law's exceptions, structures arrangements to fit them, and remediates the ones that do not.
Typical engagements
- Compensation arrangement review against applicable exceptions
- Group practice and in-office ancillary services analysis
- Transaction structuring for ownership and investment restrictions
- Remediation plans and look-back reviews
02Anti-Kickback Statute
Where the Stark Law is strict liability, the Anti-Kickback Statute turns on intent. Bob structures referral-source relationships to fit a safe harbor where one exists and documents the risk analysis where one does not.
Typical engagements
- Discount safe harbor structuring
- Value-based arrangements between hospitals and medical staff
- Marketing, joint venture and management arrangements
- Risk memoranda for arrangements outside a safe harbor
03False Claims Act
Stark and Anti-Kickback problems become False Claims Act problems. Bob represents providers responding to the Department of Justice and qui tam relators, from the first civil investigative demand through settlement.
Typical engagements
- Responses to DOJ civil investigative demands and subpoenas
- Internal investigations of fraud and abuse allegations
- Settlement negotiation with DOJ and qui tam litigants
- Representation of providers and consultants in depositions
04Fair market value & commercial reasonableness
An arrangement is only as safe as the file behind it. Bob evaluates whether compensation is fair market value and commercially reasonable, and builds the record a reviewer would need to agree.
Typical engagements
- FMV and commercial reasonableness defensibility opinions
- Network-wide compensation reviews
- Employment, directorship, call-coverage and lease arrangements
- Testifying and consulting work on compensation matters
05Self-disclosure & government investigations
Bob has led numerous Stark Law self-disclosures to CMS and self-reports under the OIG protocol, including one of the most closely watched Stark self-disclosures in recent years. He advises on whether, when and how to disclose.
Typical engagements
- CMS SRDP submissions and settlement negotiation
- OIG Self-Disclosure Protocol filings
- Overpayment analysis and 60-day rule compliance
- Payer billing and documentation review defense and appeals
06Compliance program oversight
Bob has served as independent compliance advisor to a hospital board under a five-year Corporate Integrity Agreement. He reviews programs for effectiveness and turns findings into recommendations a board can act on.
Typical engagements
- Compliance effectiveness reviews with enhancement recommendations
- Board-level compliance oversight under CIAs
- Reports to the Office of Inspector General
- Risk assessment cadence and audit design