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| Dear Friend,
Independence. That's the subject of this Monday's blog post, Your Independence Day. You can follow the link to read the post online, or just keep reading for the rest of the story.
July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain.
But July 4th wasn’t the day of actual separation: The separation came into effect on July 2nd, 1776, the date on which the Second Continental Congress approved a resolution declaring the “united States of America” as free and independent states.
In fact, historians believe that the Declaration of Independence wasn’t fully signed on July 4th. Some signatures were apparently obtained on July 2nd and there is a record of a signing ceremony in August 1776.
But the exact date doesn’t matter. It’s the construct that counts, the construct of independence.
Independence, and its antipode, dependence, are constructs equally applicable to your business, and to yourself.
Independence is a break, a fresh start. A fresh start in terms of leaving a prior arrangement or relationship and beginning one anew. A fresh start in terms of business strategy. A fresh start in terms of redoubling efforts. A fresh start at tackling problems or setting new goals. And so on.
Every year people around the world celebrate January 1, New Years Day, as a fresh start. For our country, July 4th celebrates its new start. But it easily could have been July 2nd or some date in August.
You, too, are free to choose your own independence day, or even a few of them, as a time to renew and reflect and restart.
Hot dogs, parades, and the red, white and blue are all a part of our nation’s Independence Day. You get to choose what’s a part of yours. |
| | | 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 version:
I want to talk to you about contracting -- in particular, about the mechanics of contracting and the mechanics of structuring an agreement.
Now you might say this is a lawyer’s job, but I have to tell you, I see more and more potential clients (and that’s generally how they remain), who have drafted contracts themselves.
They think, “Well shit, it’s easy – you just get yourself two or three examples, you download them or ask a friend, and then you make some changes and it's as good as any lawyer could do!”
Maybe it’s as good as some lawyers could do, but I guarantee you it ain’t good enough.
On a weekly basis, I see agreements in which terms are used – it could be “control”, or “material”, or “notice” -- but are not defined. What do they mean exactly? In the case of notice, what kind of notice? How is it given? In the case of control, as in change of control, what does that even mean?
Now some contract terms have long and established definitions that a court would almost certainly (but not certainly) plug in in the event of a dispute. For example, "breach" has a commonly understood legal meaning, but many terms don’t. In other words, they are terms that might be commonly used, but they have no commonly agreed, specific meaning.
The word "control," as in change of control, is but one example.
Contracts can both state new definitions and change generally established ones. Changing them might be in your favor. Leaving them amorphous might be in your favor. But did you make a conscious decision in connection with drafting? Have you decided to leave it amorphous or did you just forget?
All of these things seem minute, but the minutia can quickly turn into manure for you in the event of a dispute.
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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 - What You Need to Know About a Healthcare CEO Headed to Prison in Order to Avoid the Same Fate. - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
To paraphrase William Shakespeare, a rose by any other name might just be fraud.
Are marketing agreements legal? What about management or “administrative services” agreements? How about agreements for scheduling? Surely, those type of arrangements can’t send you to prison!
Indeed, they can if they’re just window dressing for underlying fraud.
And, in the case of Sam Sarkis Solakyan, the CEO California based Vital Imaging, Inc. and San Diego MRI Institute, they can send you to prison for 5 years.
An X-Ray View
As the aftermath of his conviction at trial in July, 2021, Solakyan and was sentenced on January 28, 2022, to five years in federal prison and ordered to pay $27,937,175 in restitution to victim insurance companies. The underlying scheme submitted more than $250 million in fraudulent claims, the vast majority for MRIs that weren’t medically necessary, through the California Workers Compensation system for medical services procured through bribes and kickbacks to physicians and others. He's also been barred from working in the healthcare and workers compensation industries during the three years of supervised release that's to follow his imprisonment.
Solakyan, through Vital Imaging, San Diego MRI Institute, and other companies, operated diagnostic imaging facilities from the Bay Area in the north to San Diego in the South.
Convicted of one count of conspiracy to commit honest services mail fraud and health care fraud, and 11 counts of honest services mail fraud, Solakyan conspired with physicians and others in a scheme in which the doctors were paid bribes and kickbacks in exchange for referral of Workers Compensation patients. Some of the illegal remuneration was in cash and some was in the form of a “cross referral” scheme in which the participants referred patients to one another.
So-called “recruiters” working for the Solakyan entities required physicians to refer a minimum number of patients to receive cross referrals.
And, getting back to the naïve questions at the top of this post, the participants in the conspiracy obscured the true nature of the financial relationships by entering into sham agreements for “marketing”, “administrative services”, and “scheduling”, when the arrangements were really for kickbacks and bribes.
In addition to Solakyan: Chiropractor Steven Rigler pleaded guilty to one count of conspiracy to commit mail fraud and was sentenced to a 6-month federal prison term. Fermin Iglesias, who was the CEO of various scheduling companies, pleaded guilty to conspiracy to commit mail fraud and health care fraud, and was sentenced to five years in federal prison. Co-conspirator Carlos Arguello was sentenced to four years in federal prison.
What You Really Need to Know
- Just because an arrangement looks on paper like it’s a management type agreement doesn’t effectively cover up an illegal scheme any more than a beach towel covers up an oil spill in the Gulf of Mexico.
- The underlying scheme, not the ink on the paper, governs legality versus illegality.
- Kickbacks and bribes don’t have to be in dollars. You scratch my back, I’ll scratch yours (cross referral schemes) are illegal remuneration, too.
- A state-law scheme (e.g., worker’s comp) quickly becomes a federal offense via the use of the mail or other means of interstate communication (e.g., a fax machine, a cell phone, a text message).
- Insurance companies have fraud department stacked to the rafters with former criminal investigators and they love to use the feds to pressure fraudsters and to do the collection work (restitution) for them.
- A rose by any other name would smell as sweet, but a papered-up scheme actually smells like fraud.
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| | | Listen to the podcast here, or just keep reading for the transcript.
I'm too busy right now.
There's too much going on.
Mañana.
Maybe next year.
Medical group leaders are busy focusing on day to day activities: Most are deeply involved in direct patient care. Some, yes, some, also devote some time to working on their business.
But there's a pressing need to engage in strategy. And you have to address the tough issues, like governance, succession planning, compliance, expansion of your business, and many more.
Yes, you're right, it's not the right time. In fact, it's never the right time.
So if there's never a right time but you have to take action anyway, then consider that it's always the right time.
Get started. Because one thing's for sure. The "unexpected" really isn't and it's better to be prepared.
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| | | 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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