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Time out: Personal accountability in hospital-physician payments

Gail Peace ( is President and CEO of Ludi, Inc. in Nashville, TN.

Looking back in 2019, it seems every day there was a new headline highlighting bad behavior in healthcare, particularly around Stark Law and the Anti-Kickback Statute (AKS) violations. There were the blatant crime stories, but also multiple cases of personal behavior that somehow crossed a line. Reading these articles reminded me of how I felt in grade school, when as children, we all learned a few key lessons that, unfortunately, were somehow forgotten among many of those same kids who are now adults. Here are some of my favorites:

  • Respect and listen to your teachers.

  • Keep your hands to yourself.

  • Be nice to everyone and treat others as you want them to treat you.

But of course, nothing is ever as simple as it was in childhood, when our biggest worries seemed to be centered around who we were going to sit next to on the bus or if we felt prepared for a pop quiz in math class. In fact, the healthcare world today is quite a far reach from all of that uncomplicated bliss, especially when you factor in the fraudulent activities and crimes that occur. So, how did we get here?

In a nutshell, there are regulatory areas in the hospital industry in particular that fall into a proverbial gray zone, which, in turn, cause people to commit technical violations they never actually intended (e.g., miscalculating the amount of time a physician worked). But intent is not a good enough excuse when the Office of Inspector General (OIG) comes knocking. And given that there have already been millions of dollars spent in regulatory enforcements in 2019 alone (and we still have a few months to go!), these purposeful or non-purposeful violations are equally expensive. Now more than ever as we move into 2020, what is certain is that hospital executives—not just the hospital organization itself—must be willing to take personal accountability for anything that goes wrong. And the truth is, there is much that can and will go wrong in one specific area of hospital management: physician contracts.

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