Fremont, CA: OCT 14, 2016
NetZealous LLC, a professional trainings provider in the areas of regulatory compliance, human resources, healthcare and IT, offers trainings for healthcare providers and physicians on the ways of drafting a HIPAA physician agreement that meets the regulatory requirements set out by HIPAA and the Anti-Kickback statute. NetZealous LLC’s trainings also help these professionals take utmost care in ensuring that these provisions are thoroughly scrutinized to ensure full and proper implementation.
Physicians are covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. This means that they are bound by the provisions of HIPAA when they enter into agreements with a healthcare provider (hospital, clinic, etc.) with whom they work. Having clearly defined and written agreements between the parties is important, because they are both bound by the provisions of not only legislations such as HIPAA , bmt also others like the Anti-Kickback statute, which sets out its own conditions for the working arrangement between the parties.
Since a violation of the terms of HIPAA or the Anti-Kickback statute attracts heavy penalties –in the range of $ 50,000 and the possibility of the erring party landing in jail –it is critical to nail down all the components of a solid working relationship that is both beneficial and compliant with regulatory requirements.
Set out the nature of the relationship
The nature of the relationship between the healthcare provider and the physician has to be stated and finalized as a first step. HIPAA mandates that an employer-employee relationship cannot exist between the healthcare provider and the physician. The healthcare provider and the physician have to work out very crucial aspects such as ways by which a certain minimum guaranteed income for either party, the definition of the duties of the physician, what is considered a breach by the hospital and how to deal with it, and how to bring about and legally handle referrals by the physician to the hospital.
Adhere to the provisions of the Anti-Kickback statute
A very important part of the relationship is that there are a few requirements that need to be satisfied under the Anti-Kickback statute. The purpose of the Anti-Kickback statute is to prevent frauds from occurring in Medicare and Medicaid by medical professionals who offer their services and derive benefits from these programs in some or another way, either direct or indirect. It seeks to prevent diversion of money from pharmaceutical companies to physicians in order to influence medical decision-making. It prevents physicians from advertising or marketing a brand with which they are associated, as well as a number of other activities that benefit them.
At the same time, the Anti-Kickback statute also offers a few exceptions. This Act also has slight variations at the State level. The physician agreement under HIPAA has to ensure that the conditions, under which the physician and the healthcare provide work with each other state, understand and implement these provisions, including the exceptions, very clearly.
Agreement should also take confidentiality into consideration
The physician agreement has to have a clear definition of the meaning of classified information and what goes under this head. This usually consists of any part of the agreement that the parties have tagged as confidential, is discussed by both parties at the time of making the agreement, is generally understood to be confidential in the healthcare industry, and is within the ambit of what HIPAA classifies as confidential.
Other important provisions
These apart, there are other important aspects of the physician-healthcare provider agreement that need to be taken into consideration. These include:
Termination for Cause
Agreement for not competing
Promises made by the hospital to the physician
Trainings on how to frame physician-healthcare provider agreement
Since these processes for agreements are complex and require comprehensive knowledge of the nuts and bolts of HIPAA; it is essential for anyone bound by the provisions and entering into an agreement with a physician to be completely trained on the aspects of HIPAA agreements. They need to know what should go into the agreement, how it should be framed, what due diligence has to go into it, and a host of other areas.
A professional trainings provider like NetZealous LLC, based in Fremont, CA is the right sources for helping professionals in the healthcare industry frame the proper kind of physician agreements with which they stay compliant with the provisions set out in the various laws.
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Last updated on: 14/09/2016
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