The federal Anti-Kickback Statute (AKS) is a crucial law in the healthcare industry. It criminalizes the act of paying someone to refer patients or generate business when any form of state or federal healthcare program funds—such as Medicare, Medicaid, CHAMPUS, and TriCare—are involved. Many states have their own versions of this law. While it seems straightforward, many physicians and...
In the intricate world of behavioral healthcare, where reimbursement policies and insurance claims are critical to operational success, a new and concerning trend has emerged, potentially impacting how providers manage their financial operations. This silent contracting trend involves Florida Blue’s recent policy changes regarding laboratory service claims and their significant implications....
Unusual variations in the cellular protein factory can skew development, help cancer spread and more. But ribosome variety may also play biological roles, scientists say. In the 1940s, scientists at the recently established National Cancer Institute were trying to breed mice that could inform our understanding of cancer, either because they predictably developed certain cancers or were...
Negotiations to reduce drug prices can sometimes shift costs onto consumers. rudisill/iStock via Getty Images Plus ~~~~~ When it comes to drug pricing, the Trump and Biden-Harris administrations both have some very modest wins to tout. As director of the Health Outcomes, Policy, and Evidence Synthesis group at the University of Connecticut School of Pharmacy, I teach and study about the ethics...
When Jessica Staten’s kidney stones wouldn’t pass, she said, her doctor suggested a procedure to “blow ’em up.” She went to have it done last November at St. Joseph Medical Center in Bellingham, Washington, one of nine hospitals that the Catholic health system PeaceHealth operates in the Pacific Northwest and Alaska. “I was probably there a total of 3½ hours, and everything went well,” said...
Medical school equips physicians with the skills to care for patients but often leaves them unprepared for the business side of running a medical practice. Here are some crucial considerations for physicians before opening their own practice. Business Expectations Most healthcare professionals think if they’re amazingly good at what they do, patients will flock to them. Not true at all,...
