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| Dear Friend,
Why commit just one healthcare felony when you can commit two?
Double your felony,
Double your sums.
Oops we got caught,
Now we’re jailhouse bums.
The second of the felonious, guilty-pleading “twins,” Semyon Narasov and Andrew Hillman, was sentenced on May 29, 2020, for his role in twin healthcare fraud schemes, one referred to as the Forest Park scheme after the now-defunct hospital group of that name, and the other the NextHealth scheme after the lab company “arrangement” controlled by the “twins.”
Narasov, who pleaded guilty in 2018 to conspiracy to commit money laundering in the NextHealth case and to conspiracy to pay and receive healthcare bribes and kickbacks in the Forest Park case, was sentenced on May 29 to 76 months in federal prison.
Narasov admitted that Forest Park paid the “twins” $190,000 to refer patients to Forest Park or to surgeons with privileges at the facility, and that they submitted phony invoices to conceal the bribes, which were funneled through a shell entity.
Narasov also admitted that while at NextHealth, he and his “twin brother” submitted fraudulent claims to private and government health insurance providers for prescriptions that were medically unnecessary, prescriptions for misbranded, non-FDA-approved drugs, and prescriptions prescribed by physicians who were receiving kickbacks, all while falsely claiming they had charged patients co-pays.
Hillman, too, pleaded guilty in 2018 and made similar admissions. Hillman was sentenced in December 2019 to 66 months in federal prison.
Hillman, formerly of Dallas, now resides at Federal Correctional Institute Texarkana. Where Narasov will serve time is, as of yet, not known.
In addition to the large slice of schadenfreude, you can take away more than a few valuable lessons from Narasov and Hillman at a cost far lower than 66 to 76 months of your life:
“Sharp” marketers and other scheme promoters, even hospital CEOs (how shocking!), will tell you that their lawyers have thoroughly vetted the arrangement. Don’t take their, or their lawyers’, word for it. They’ll be going to prison themselves for themselves, so they won’t be doing your prison time for you.
Over the years, I’ve kept clients out of what would surely have been the slammer in connection with schemes as diverse as:
- paying for “marketing” (marketing being a euphemism for kickbacks);
- paying (or receiving) “rent” for supply closets (“rent” being a euphemism for kickbacks);
- providing “employees” to ASCs (“employees” being a euphemism for kickbacks);
- receiving “fees” to prescribe pain medication over the phone to strangers (“fees” being a euphemism for kickbacks);
- and, well, other schemes that are so bizarre they don’t even pass the laugh test.
Do yourself a favor. Think for yourself and get competent legal advice for yourself. |
| | How to Deploy the Secret Sauce of Opportunistic Strategy - Webinar
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.
Join me for a live webinar event on June 25, 2020. Only by participating will you 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.
In order to respond to live and emailed questions, attendance is limited.
You'll receive a recording of the webinar if you can't attend live. |
| | | | 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.] |
| | Tuesday - PPE for Your Medical Group
Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript: |
| There’s been so much in the press, both the industry press and the popular press, over the last three months or so concerning PPE, all in the context, of course, of equipment for your group’s physicians and other providers.
But there’s been little to no mention, except on our blog, about groups doing much to protect themselves.
Have you used the months of downtime or slowdown to plan, to strategize about how to make your group more resilient, even anti-fragile, in the event of some later crisis, no matter whether it's a public health crisis, an economic crisis, or a political crisis? That's true "PPE" for your medical group.
Have you also used that time and opportunity to strategize for your growth?
Have you used the observation that most facilities and groups assume a fetal position in a crisis and that you can use the crisis, and their fear, to take their opportunities?
Think about both the PPE concept as well as the opportunistic possibilities for your group.
Either way, you’re protecting your group and protecting yourself.
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| | Wednesday - Free Stay Out of Jail Pass
Watch the video here, or just keep reading below for a slightly polished transcript:
As my gift to you, here's a free stay out of jail pass. But it does require a bit of effort on your part.
Instructions
Step 1: Read this short post.
Step 2: Print it out and trim off extra margins.
Step 3: Fold it so that it fits into your wallet.
Step 4: Pull it out and reread it once a week or, more often, if needed.
***
The chance to get a little something back, a vig, a taste, a cut.
It's a story nearly as old as time itself, but not normally the story one tells oneself. Then, it's usually a "business deal".
Perhaps that's the story that the surgeons who did business with Impartial Medical Experts, LLC (“IME”), told themselves.
The United States government is telling a different story, one that they are alleging in intervening in two whistleblower lawsuits in Massachusetts.
In that intervention, the government’s complaint centers around defendant Kingsley Chin, M.D., described as the founder and Chief Executive Officer of defendant SpineFrontier, a spine device manufacturer. The complaint alleges that Dr. Chin is also the founder and principal owner of defendants KIC Management Group Inc. and KICVentures LLC, which own and operate defendant SpineFrontier and defendant IME of which defendant Vanessa Dudley, Dr. Chin’s wife, was the sole employee.
According to the complaint, the defendants paid spine surgeons over $8 million in sham “consulting” payments ostensibly for product evaluations, when in fact the payments were for use of SpineFrontier devices.
The government claims that the “consulting” spine surgeons were generally paid $500 for a cervical procedure, and $1,000 for a lumbar procedure — but only if the surgeon used SpineFrontier devices — and that the spine surgeons often performed little or no work beyond implanting the devices, for which they were separately paid by carriers, including federal health care programs.
It’s also alleged that the defendants didn’t systematically collect or use feedback from the “consultants” and paid them even when they had provided no feedback at all. Surgeons allegedly could “consult” on SpineFrontier devices in this manner an unlimited number of times so long as they continued using the SpineFrontier product in surgery.
Although the complaint states the names of multiple spine surgeons, none are named as defendants in the action. It's likely that the government will pursue those physicians individually, perhaps criminally, as the story unfolds.
And that's the benefit of keeping this short but sad story in your wallet. Pull it out whenever anyone related to your practice offers to pay you for something. Yes, something as in anything.
Remind yourself that the federal Anti-Kickback Statute (“AKS”) prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, TRICARE, and other federally funded programs.
Remind yourself that the AKS doesn't simply support False Claims Act civil claims; it’s a criminal statute, the violation of which leads to actual jail time and large fines.
Remind yourself that, as you read this today and three weeks from today when you remember to pull it out again, that physicians like you are sitting in their cells today and that you don't want to join them.
Treat this clipping as a get out of jail free card and indeed it will be. Or, at least, for slightly more, contact me before you take those consulting fees or accept rent for that closet, or let your spouse take that part-time position as a manufacturer’s rep.
Put this in your wallet. Now. |
| | Thursday - This Is Why You Keep Screwing Yourself When Negotiating Deals |
| Listen to the podcast here, or just keep reading for the transcript.
Location: The center of the negotiation universe.
Date: Yesterday, today, and, one hopes, not tomorrow.
The lesson: One of psychology.
It happens time after time. You’re in the midst of negotiations for this deal or that.
You know that you should push for the points that are crucial. But then, you pull yourself back like a dog on a leash.
The problem, which can hardly ever be seen from inside the situational loop, is that you want, even need, to be liked. “Am I pushing too hard?” “What will they think?”
As a result, your inclination is to please when it should be to assert and advocate for your position. You give the other side more time when you know that time should be used as a tool against them. You give them the benefit of the doubt when they’ve never given it to you. You can’t do the deal for less than X but you do it anyway.
There are multiple “treatments” available for this condition but the fastest, easiest, and, yes, cheapest, is to remove yourself from the direct negotiating loop.
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| | Business Life in the Time of Coronavirus – Podcast Album
Be sure you’re armed with our best information, in an easy and transportable audio format.
You’ll be ready, wherever the road ahead takes you.
|
| | | 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 here.
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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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