AACE Learning Center Professional Resources-Business of Medicine

Video Transcription

Video Summary

In this video, attorney Robert Lyles presents a condensed version of his presentation on "The Business of Medicine." He highlights two primary areas of focus: payer issues and negotiating a first contract. Lyles emphasizes the importance of understanding payer audits, such as those conducted by Medicare Associated Contractors, Unified Program Integrity Contractors, Medicaid Fraud Control Units, and Special Investigative Units employed by private payers. He advises healthcare professionals to be aware of the different coverage and payment requirements imposed by different payers. Lyles also cautions that the government is increasingly holding individuals accountable for corporate wrongdoing, meaning healthcare providers should familiarize themselves with the laws and regulations governing medical practice, billing, and coding. Regarding contract considerations, Lyles recommends conducting due diligence on potential employers, assessing compensation schemes for compliance with anti-kickback and Stark laws, and seeking legal advice before entering into any contract. He further discusses issues like bonuses, liquidated damages, non-competes, confidentiality clauses, non-solicitation provisions, choice of law and venue, termination clauses, and transition considerations. Throughout the presentation, Lyles encourages healthcare professionals to consult with experts and consider the legal and regulatory implications of their decisions to ensure a smooth and successful professional practice.

Asset Subtitle

Robert Liles

Meta Tag

Concept Payer Audit

Concept Compliance

Concept Government Enforcement

Concept Enforcement Risk

Concept Medicare guidelines

Keywords

payer audits

contract considerations

government accountability

medical practice

legal advice

compensation schemes

Payer Audit

Compliance

Government Enforcement

Enforcement Risk

Medicare guidelines