Stark Integrity

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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

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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

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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

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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

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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