Unit 5 Discussion - Medicare/Medicaid

Medicare/Medicaid

Instructions:

Please complete the following steps for your discussion post and response.

Select one of the following options to discuss.

Option A.

Read this article to help form your discussion: The Stark Truth About the Stark Law, https://www.aafp.org/fpm/2003/1100/p27.html:

You have been hired as a practice management consultant for a new practice start-up. The physician owners are asking you about additional revenue opportunities, but want to remain in compliance with accepting Medicare and Medicaid patients.

Explain one possible situation that would benefit the practice while still remaining in compliance with Stark and Anti-Kickback laws.

Option B.

You have been hired to manage a new group practice, which is currently being formed. At one of your planning meetings, the business consultant suggests the practice should include an in-house laboratory.

If an in-house lab is included in the group practice, can the physician-owners refer Medicare/Medicaid patients to it? Explain your answer using a supporting source.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Peer response

Medicare/Medicaid

Instructions:

Please post 2 peer responses.

In the response post, include the following, depending on the option you chose for the initial post:

Option A.

Assume the role of a CMS Compliance Specialist. Review the scenario your classmate has proposed.

Is this compliant to receive reimbursement for Medicare/Medicaid patients?

What compliance advice would you provide this consultant with as they move forward in their business plan?

Option B.

Did your classmate accurately determine the legality of a physician-owned in-house lab? Provide feedback to either support or contrast their position. Remember to use scholarly sources to support your feedback.