KSM Healthcare Blog

President Obama just announced a nationwide initiative to find and eliminate fraud and abuse with respect to Medicare and Medicaid payments.  Numerous outlets have picked this item up. 

Here's a link to Politico's coverage.

This may open the floodgates for private recovery auditors to start investigating the various hospital-physician arrangements that exist in the marketplace. 

As relates to our clients, we would encourage everyone to take stock of their arrangements and make sure all compensation, especially physician compensation, is being paid at fair market value. 

Be advised that fair market value opinions are commonly issued with an "expiration date" and, generally, should not be relied upon for more than two years.  Therefore, just having a fair market value opinion on file may not be sufficient protection if it's based on old data and/or old methodologies.

Glad to see enforcement on the national radar?  Worried?  Think the enforcement will steer clear of the smaller markets?  We'd love to hear your thoughts in the comments section of our healthcare blog.