This is a criminal law that subjects violators to fines and imprisonment. Since criminal prosecutions are not covered by malpractice or general indemnification insurance, physicians must pay attorneys' fees for contesting charges brought against them. These fees can easily exceed $100,000. Physicians convicted under the law can also lose their license to practice medicine.Given the clarity of the law and the severity of the penalties, it would seem that physicians and their attorneys would be scrupulous in adhering to the requirements of the law. This is not the case:
The "it" in that observation by a Washington health care attorney refers to financial considerations built into business relationships between clinical labs and physician/hospital referral sources.To be more specific, the "it" is a renumeration prohibited under the Medicare fraud and abuse law. A substantial percentage of medical businesses engage in prohibited practices, and most of these prohibited practices occur in business arrangements structured and approved by lawyers. The interesting question is not that physicians might unknowingly violate the provisions of a given law but that their attorneys would counsel them to violate the law. Column: Caution advised in relations with laboratory referral sources. Med Lab Observer 1986 Jul; 18:23.
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