Becker's Spine Review

24 PRACTICE MANAGEMENT Fewer indirect pay deals will be subject to Stark scrutiny in 2022: 3 details for surgeons to know By Patsy Newitt C MS reduced the number of indirect compensation agreements subject to Stark Law referral and billing prohi- bitions in its Nov. 2 clarification of indirect compensation arrangements, according to a JDSupra report by Matthew Westbrook, an attorney that specializes in healthcare regulatory compliance. CMS released the Modernizing and Clarify- ing the Physician Self-Referral Regulations Final Rule in January 2021, which made changes to Stark Law. Aer discovering is- sues with the indirect compensation arrange- ments guidance, it has clarified those over- sights. ree things to know about the new definition of indirect compensation: 1. Prior to the clarification, an indirect com- pensation arrangements only existed if: • ere's a chain of financial relationships between the referring physician, or im- mediate family member, and the entity providing the designated health service • e referring physician receives com- pensation that varies based on the vol- ume or value of referrals, and the com- pensation unit isn't fair market value • e entity ignores the fact that the re- ferring physician receives compensa- tion for referrals An indirect compensation agreement still must meet these three qualifications, but CMS' new rule clarified aspects of the exist- ing amendment. 2. CMS clarified an "individual unit" of phy- sician compensation as services performed by the physician, according to Mr. Westbrook. 3. e new rule also clarifies that an indirect compensation arrangement exists if a refer- ring physician receives compensation that varies with the volume or value of referrals and that unit of compensation either is not fair market value, could directly fluctuate as physician referrals fluctuate or is payment for the lease of office space or equipment. n Medical malpractice lawsuits: 5 stats for orthopedic surgeons to know By Carly Behm M ost orthopedic surgeons have been named in a medical mal- practice lawsuit, according to Medscape's Medical Malpractice Report 2021. Medscape surveyed 4,358 physicians across 29 specialties between May 21 and Aug. 28. Five stats orthopedic surgeons should know: 1. Eighty-one percent of orthopedic surgeons surveyed by Medscape have been named in a malpractice suit. Plastic surgeons and general sur- geons were at the top of the list, both with 83 percent of respondents saying they were named. 2. One-third of respondents who said they were sued said their lawsuits were settled. Two percent said cases went to trial and the judge or jury decided in favor of the plaintiff. 3. Thirty-two percent of primary care physicians and 47 percent of spe- cialists surveyed said they spend at least $10,000 a year on malpractice insurance premiums each year. 4. Thirty-five percent of respondents who said they were sued said they spend more than 40 hours preparing for their defense. The lawsuit pro- cess took one to two years for 40 percent of respondents who were sued, and 27 percent said it took less than a year. 5. The most common reason for malpractice lawsuits was failure to diagnose or a delay to diagnose (31 percent), followed by complications from treatment or surgery (29 percent) and poor outcomes or disease progression (26 percent). n OrthoLoneStar launches spine, orthopedic bundles in Texas By Carly Behm H ouston-based OrthoLoneStar has teamed up with Greenwich, Conn.- based Cedar Gate Technologies to bring a value-based care program for spine and orthopedic care in Texas. OrthoLoneStar will focus on reducing the cost of care through value-based care de- livery and a prospective bundled payment program, according to an Oct. 28 news release. Cedar Gate has more than three decades of experience creating and managing bundled payment agreements. In similar arrangements from Cedar Gate, patient outcomes and costs improved. "This new value-based care program opens up the opportunity for employers and payers to join us in our mission to de- liver exceptional care experiences to Texas patients," J. Bryan Williamson, MD, Ortho- LoneStar's medical director said in a news release. n

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