Stark Integrity

2027 MPFS Proposed Rule: Why the Real Story Isn’t the Conversion Factor

Send us Fan Mail We’re not talking about conversion factors as they relate to the 2027 Medicare Physician Fee Schedule (MPFS) and proposed rules. In this episode, Captai

The Misunderstood Commercial Reasonableness Test Explained and Fire Stations

Send us Fan Mail There are 3 primary tests under the Stark Law: Fair Market Value (FMV), the Volume or Value standard, and Commercial Reasonableness (CR). In this episod

Is CMS Proposing That Physicians Cannot Perform a Procedure on Same Day as E&M Encounter in 2027?

Send us Fan Mail In the 2027 Physician Fee Schedule, CMS (Centers for Medicare & Medicaid Services) is proposing modifications for procedures and E&M services (Evaluatio

Implementing & Monitoring AI Responsibly: A Discussion with Arvita Tripati, Founder & Principal at Vahana Labs

Send us Fan Mail Having someone who is accountable is essential for AI governance. In this episode, Captain Integrity Bob Wade discusses implementing & monitoring AI res

Death by Committee? How to Run and Participate in a Compliance Committee Meeting That Actually Matters

Send us Fan Mail Compliance committees can either be a well-oiled engine in a Lamborghini, or an engine being held up by an engine hoist in need of repair. In this episo

Private Equity Meets the Stark Law: Navigating Physician Transactions, MSOs, Referral Risks…and Insects

Send us Fan Mail Why are private equity, physician groups, and the Stark Law like insects heading to a bug zapper? In this episode, Captain Integrity Bob Wade explains w

Stark Integrity Podcast: Is It a Podcast? Is It a Blog? Is it Both?

Send us Fan Mail You can now experience Stark Integrity in 2 ways: the podcast AND the blogs. In this episode, Captain Integrity Bob Wade introduces the Stark Integrity

Retraction

Send us Fan Mail In a recent episode of Stark Integrity, Captain Integrity Bob Wade made an incorrect statement regarding Erlanger Health and a Stark Law case. In this b

Using AI in Physician Contracting & Payment: A Discussion with Scott Lowry, Founder of StarkWatch

Send us Fan Mail Lean in wherever you have quick wins. In this episode, Captain Integrity Bob Wade talks using AI in physician contracting & payment as they relate to th

Part 3: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose

Send us Fan Mail Training goes a long way when it comes to informed consent. In Part 3 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decisio

Part 2: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose

Send us Fan Mail The more checks and balances an organization has along the way, the greater the protection for both the patients & the providers. In Part 2 of this 3-pa

Part 1: Informed Consent, Decision-Making Capacity, and Surrogates: A Discussion with Attorney Rachel Rose

Send us Fan Mail The patent’s right to autonomy is one of the core principles of the patient-provider relationship. In Part 1 of this 3-part episode, Captain Integrity B

Part 2: Holistic Audits: Synchronizing Professional & Facility Reviews: A Discussion with Kelly Loya & Bruce Truitt, Pinnacle Enterprise

Send us Fan Mail You should be able to duct tape your mouth & hands and give your documentation to the payer, and they should still be able to generally understand what

Part 1: Holistic Audits: Synchronizing Professional & Facility Reviews: A Discussion with Kelly Loya & Bruce Truitt, Pinnacle Enterprise

Send us Fan Mail You can’t audit the whole ocean. In Part 1 of this 2-part episode, Captain Integrity Bob Wade discusses holistic audits and synchronizing professional &

Effective Compliance Programs Return 2x-5x Return on Investment (ROI)

Send us Fan Mail There is indeed a return on investment (ROI) for an effective compliance program. In this episode, Captain Integrity Bob Wade quantifies that ROI as it

Anti-Kickback Compliance and Stark Exceptions: “I’ll Get You My Pretty and Your Little Dog Too”

Send us Fan Mail When analyzing a physician financial arrangement under the Stark Law, you also need to analyze it under the Anti-Kickback Statute (AKS). In this episode

“Entity” Definition Expansion (MCOs) and Exclusion (Anti-Markup): Is a House a Home?

Send us Fan Mail The definition of an “Entity” under the Stark Law includes Managed Care Organizations (MCOs) and the Anti-Markup Rule. In this episode, Captain Integrit

Global wRVUs and “Personally Performed Services”: Around the World in 80 Days

Send us Fan Mail When a physician doesn’t perform 100% of the services covered by a surgical period, you may have to consider splitting out the global wRVUs. In this epi

False Claims Act Settlements for 2025 (FCA)

Send us Fan Mail False Claims Act settlements (FCA): they just keep getting bigger. In this episode, Captain Integrity Bob Wade details the notable False Claims Act sett

Isolated Transaction Exception under the Stark Law: “All by Myself”

Send us Fan Mail There are some uses of the isolated transaction exception that are prohibited under the Stark Law. In this episode, Captain Integrity Bob Wade dives int