May 2007

The California Department of Insurance and the Orange County District Attorney’s Office have arrested three doctors in what they are describing  as the largest medical fraud prosecution in the nation. Some stories are so abhorrent  they taint entire professions. In Orange County, three physicians and a group of ambulatory surgery center developers, some of whom have already

The Internal Revenue Service issued a directive on May 11, 2007 confirming that the provision of hardware and software components of electronic health records (EHR) will not constitute private inurement jeopardizing the tax exempt status of non-profit hospitals. This directive is another step forward in facilitating hospital subsidized EHR for private practice physicians.

The Centers for

Curtsinger v. HCA, Inc.

Dr. Curtsinger’s case illustrates one of the traps for the unwary in medical staff privileging cases. Dr. Curtsinger was summarily suspended, but was reinstated upon agreeing to a leave of absence to fulfill certain conditions for reinstatement. Upon completion of those conditions, Dr. Curtsinger requested return from his leave of absence; the hospital

The General Accounting Office (GAO) has issued a report recommending physician profiling, which they define as identifying efficient physicians. The entire report, i.e., GAO-07-307, is available at the following link: http://www.gao.gov/new.items/d07307.pdf

Following are key findings:

GAO estimates that physician account for 20% of the total health care expenditures, but influence 90% of total expenditures through referrals

The Internal Revenue Service issued a private letter ruling on April 20, 2007 concluding that captive professional corporations were beneficially owned by the hospital, but that the activities of the professional corporations were conducted on a larger scale then was reasonably necessary for the performance of the hospital’s exempt functions and that the professional corporations&rsquo