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| Dear Friend,
Labor, as in work.
That's the subject of this past Monday's blog post, Laboring on [About] Labor Day. Follow that link to the blog, or keep reading for the entire post.
The post, an annual classic, was originally written and published on September 5, 2016, Labor Day in the U.S.
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Originally proposed by union leaders, Labor Day commemorates American workers. Just as unions have mostly outlived their usefulness to all but union leaders, Labor Day has become a day for barbecues, family gatherings, and just plain old fun.
Some claim that there is a thing called “work-life balance.” My opinion is that we have only one life (I’m not betting on reincarnation) and that work is an essential part of it. It’s a main driver in why we’re here. Work gives us a purpose in life.
I’ve often heard people say things akin to “I have four years left,” in reference to the time until they “retire.” I shake my head in wonder, both because it seems to me as if they’re talking about a prison sentence (i.e., four years until parole) and because it seems as if they believe that work is getting in the way of some idealistic “life” that hasn’t yet begun.
I’m certainly not advocating that you work, work, work and have no fun, for what is life without fun. I believe that we should approach work and non-work as building blocks for your day. You not only have to work smarter (do the right thing) but there’s no getting around the fact that you also have to work harder.
I can almost guaranty that your competitors are not just sitting around the pool today, they’re also doing some thinking about how they can snatch away your opportunities. Even if I’m wrong and they’re all floating around on inner tubes, it’s even more of a reason for you to outwork them into the ground.
I took some time off this morning. Now I’m about to get back to work preparing for a meeting. After all, it’s Labor Day |
| | | Business Life in the Time of Coronavirus Mini-Series
The coronavirus crisis caused a short term economic crisis for many medical groups. Our mini-series shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
[If you haven't already seen them, follow this link to watch our entire series.] |
| | Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript:
I often deal with clients who have problems with employees, and, occasionally, with disruptive employees. I’m also often asked what's the best way to deal with these disruptive individuals.
The answer is always the same; don’t hire the jerk to begin with!
Ok it sounds simplistic, but I bet if you really think back, you knew that guy, or that gal, was trouble before you hired him/her. If you have even a modicum of emotional intelligence you probably picked up on the fact. But you needed someone, so you hired them, even though there was a lingering funny feeling in your gut.
Hiring right is the secret to not dealing with disruptive people.
“Okay," you say, “but now what do I do with the disruptive person working for me?”
Give them a warning. Tell them what they must do to improve.
If they don’t do what you’ve told them must be done – no second warning, no second chance, just get rid of them.
There’s the saying about a fish rotting from the head down. A business rots from the disruptive employee down. Don’t poison the rest of your business.
Hire right! But if you’ve made a mistake, and you can’t correct it, then fire right - which is fire fast.
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| | How to Deploy the Secret Sauce of Opportunistic Strategy
Webinar On Demand
They say that COVID-19 has changed the world, creating the "new normal." Many of your colleagues and many hospital administrators are running scared.
Others, leaders like you, know that crisis means opportunity.
Let me provide you with the strategic tools and insights that you need in order to seize opportunities, whether they’re in the context of your current business relationships, the expansion of your business activities, or the creation of new ventures.
You will learn:
•Defense as a defective default: It’s necessary, but not sufficient.
•Exploiting weakness: Drop the guilt and identify opportunity.
•Flat line negotiation is fatal: Understand its myths and limitations.
•Negotiation reality: Learn to identify and deploy on multiple planes to affect the outcome.
•Maneuver: Harness the power of maneuver, both in overall strategy and in specific negotiation strategy.
Others see a crisis and freeze in fear. Learn how to see the opportunities and obtain the tools to increase your odds of obtaining them.
The price to attend is $479. The cost of not attending is astronomical. |
| | | Wednesday - Are You Sure You're Insured Against A Cyber-attack - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
Cyber-attacks. The news has been filled with reports of them.
Oil pipelines.
Meat processing plants.
And, closer to home, to the healthcare industry, that is, Scripps Health and, as learned the first week of June 2021, the UF Health Central Florida cyber-attack.
How prepared are you if, despite the prophylactic precautions taken by your in-house team, taken by your outside coding and billing provider, and by your EHR vendor, your defenses are breached?
In particular, how sure are you that you’re insured, as in cyber insured, in regard to the damages caused by the attack?
In general terms, cyber insurance covers costs associated with cyber-attacks and data breaches.
As you might expect, though, the devil’s in the details when it comes to insurance coverage in general, and nowhere is this more true than in connection with cyber coverage.
Varying policies and modifications to them by way of endorsement, at varying premium levels, can be had to address cyber-attack damages. To name but a few: notification of patients/customers, regulatory defense expenses, the payment of fines, the cost of repairing computer systems and of recovering lost data, crisis management expenses, the cost of forensic investigations, and even business interruption.
It’s essential you understand that, unfortunately, relying on your insurance broker alone won’t always solve your cyber insurance preparedness. Cyber insurance dovetails with your other coverages; particular policy language, both in proposed cyber insurance policies and in your existing coverages are often interdependent. No two policies are the same and price shopping is an ineffective strategy.
Whether you’re just starting to consider coverage or want to assess what you actually have, we should talk. |
| | | | | Listen to the podcast here, or just keep reading for the transcript.
Forest Park was a Texas chain of beautifully constructed hospitals. Operative word: was.
Beneath the veneer of great architecture and beautiful interior design was, so federal prosecutors alleged, a decrepit scheme involving questionable marketing agreements and multiple types of fake arrangements from “consulting contracts” to “leases” and even fake companies.
The alleged aim? Referrals of well-insured patients to the out-of-network hospitals.
A slew of defendants, including physicians, were sentenced to terms in federal prison.
Some Background
In April 2019, the jury in the second round of Forest Park bribery and kickback trials in federal court in Dallas found seven of nine defendants guilty.
- Spine surgeon Shawn Henry, D.O.
- Spine surgeon Michael Rimlawi, D.O.
- Pain management physician Mike Shah, M.D.
- Spine surgeon Douglas Won, M.D.
- Nurse and workers’ compensation insurance consultant, Iris Forrest
- Forest Park’s co-administrator Mac Burt
- The owner of companies through which Forest Park channeled payments to physicians, Jackson Jacob.
Others had been found guilty at earlier trials or had pleaded guilty.
At issue were multiple charges, from violation of the federal Anti-Kickback Statute to money laundering. The government contended that Forest Park took in $200 million and paid out $40 million in kickbacks and bribes before finally shutting down all business operations. Central to the fact pattern concerning the convicted physicians was the “co-marketing agreement” concept: The physicians were given “marketing money” to boost their practices and, ultimately, the hospitals’ business.
The defendants argued that the so-called “marketing money” was not tied to referrals, an argument that the prosecution dismissed. At least one of the participants in the scheme admitted that marketing money was doled out as a percentage of referred cases.
The Sentencings
- Shawn Henry, D.O. – 7 ½ years
- Michael Rimlawi, D.O. – 7 ½ years
- Mike Shah, M.D. – 48 months
- Douglas Won, M.D. – 5 years
- Iris Forrest – 3 years
- Mac Burt – 12 ½ years
- Jackson Jacob – 8 years
In addition to those seven defendants, the following individuals were also sentenced:
Hospital manager Alan Andrew Beauchamp, who pleaded guilty, was sentenced to 5 years, 3 months.
Wade Neal Barker, M.D., a Forest Park co-founder, who pleaded guilty, was sentenced to 5 years.
Chiropractor Frank Gonzalez who referred patients to Forest Park for bribes and who pleaded guilty, was sentenced to 21 months.
Israel Ortiz, who pleaded guilty and whose company filled out pre-authorizations for worker’s comp patients received a 1 year sentence..
But wait, there are more:
The other Forest Park co-founder, Dr. Richard Toussaint Jr., who pleaded guilty, was previously sentenced to 5 years in prison to run concurrently with another sentence he was previously serving.
Andrew Jonathan Hillman, a healthcare company owner, was sentenced in December 2019 to five years in prison after pleading guilty.
Semyon Narosov, Hillman’s business associate, was sentenced in July 2020 to 4 years 3 months in prison after pleading guilty.
Carli Adel Hempel was sentenced in October 2020 to three years’ probation. She pleaded guilty.
And, Kelly Wade Loter and Andrea Kay Smith, both of whom pleaded guilty, were given probation in January 2020.
The Moral
The easiest (and most gratuitous) takeaway is that kickbacks are illegal. But, you already knew that.
What is far more important to note is the need for caution, extreme caution, whenever entering into any sort of financial relationship with someone or some entity with whom you share a referral relationship, no matter which way the referrals flow.
For example, some of the allegations in the Forest Park case centered around the payment of “marketing money” from the facility to physicians. Some naïvely believe that marketing money from a hospital to physicians is not something that should involve significant anti-kickback scrutiny. Wrong.
Additionally, Forest Park shows that even convoluted payments through “money drop” entities, even ones that look like a game of Chutes and Ladders, can be un-woven. And, as a double take away for you, they can be un-woven by other participants in a scheme such as the former Forest Park Chief Operating Officer and a physician/investor/founder who both previously pleaded out early and cooperated with the authorities in convicting their fellow schemers.
One can assume that all or nearly all of the now convicted men and women had counsel advise them on the propriety of their arrangements. In fact, the Dallas Morning News reported that the sentenced physicians had the marketing money deal “approved” by their so-called “health care lawyers”.
When someone tells you the deal is okay because their attorney vetted it, don’t be so sure. Get your own counsel.
And, make sure that the person advising you not only has knowledge, but also a good dose of common sense, which, apparently, is not that common. |
| | | Calibrate Your Compass
Read our exclusive RedPaper to guide you through this evolving situation.
The coronavirus crisis caused a short-term economic crisis for many medical groups. Our RedPaper shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
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| | Help Us Help You With Helpful Content
What tailored content would you most like to see during this
time? How can we focus on solutions to your most pressing strategic concerns?
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| | | | We all hear, and most of us say, that the pace of change in healthcare is quickening. That means that the pace of required decision-making is increasing, too. Unless, that is, you want to take the “default” route. That’s the one is which you let someone else make the decisions that impact you; you’re just along for the ride. Of course, playing a bit part in scripting your own future isn’t the smart route to stardom. But despite your own best intentions, perhaps it’s your medical group’s governance structure that’s holding you back.
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| In fact, it’s very likely that the problem is systemic. The Medical Group Governance Matrix introduces a simple four-quadrant diagnostic tool to help you find out. It then shows you how to use that tool to build your better, more profitable future. Get your free copy Free.
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| | | | Whenever you're ready, here are 4 ways I can help you and your business:
1. Download a copy of The Success Prescription. My book, The Success Prescription provides you with a framework for thinking about your success. Download a copy of The Success Prescription here.
2. Be a guest on “Wisdom. Applied. Podcast.” Although most of my podcasts involve me addressing an important point for your success, I’m always looking for guests who’d like to be interviewed about their personal and professional achievements and the lessons learned. Email me if you’re interested in participating.
3. Book me to speak to your group or organization. I’ve spoken at dozens of medical group, healthcare organization, university-sponsored, and private events on many topics such as The Impending Death of Hospitals, the strategic use of OIG Advisory Opinions, medical group governance, and succeeding at negotiations. For more information about a custom presentation for you, drop us a line.
4. If You’re Not Yet a Client, Engage Me to Represent You. If you’re interested in increasing your profit and managing your risk of loss, email me to connect directly. |
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