Physician Medical Practice “Misrepresentation” Risks

BUSINESS FRAUD RISKS

True Case Report

CMP logo

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

A Medical Practice Misrepresentation Case Model

Let’s say a physician decided to sell his practice and move to another state. The value of the sale was based, in part, on the yearly gross of the practice. The physician accepted installment payment terms from the buyer and moved to the new state. The buyer began to practice medicine at his new office. Although he was busy, his gross never approached the gross of the prior physician.

Eventually the buyer defaulted on the loan. The selling physician sued for the deficit. The defaulting physician and his forensic consultants then performed an in-depth evaluation of the seller’s practice. The buyer and his team noticed some discrepancies in the billing patterns and practices of the seller. Considering these discrepancies to constitute Medicare and insurance billing fraud, the seller counter-sued the buyer on the grounds of misrepresentation, alleging the gross receipts of the practice purchase price, was grossly inflated.

Citation: https://www.r2library.com/Resource/Title/0826102549

ASSESSMENT: Therefore, the buyer determined that the seller had fraudulently misrepresented the potential of the practice. He also notified state and federal authorities and filed complaints of insurance fraud against the seller.

The seller thought that he would move to the good life in the new state, but his old practice kept him in constant legal trouble.

YOUR THOUGHTS ARE APPRECIATED

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors : Best Practices from Leading Consultants and Certified Medical Planners™ book cover

Order Textbook: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

What is Health Insurance OUT OF NETWORK Medical Care?

By Staff Reporters

What does out of network [OON] really mean?

OON – This phrase usually refers to physicians, hospitals or other medical providers who do not participate in a health insurer’s provider network.

CITE: https://www.r2library.com/Resource/Title/0826102549

This means that the provider has not signed a contract agreeing to accept the insurer’s negotiated prices.

MORE: https://www.healthinsurance.org/glossary/out-of-network-out-of-plan/

YOUR COMMENTS ARE APPRECIATED.

Thank You

****

***

BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

***

****

WEALTH INCENTIVES: Temptation and Incentives

A WORKING WHITE PAPER

Orazio Attanasio

Agnes Kovacs

Patrick Moran

We propose a rich model of household behavior to study the effect of two important policies: mortgage interest tax deduction and mandatory mortgage amortization. These policies have attracted some controversy, first because they are conceived to increase overall saving, an objective that the literature does not agree they can achieve, and second because they incentivize illiquid savings and may thus increase the share of ‘wealthy hand-to-mouth’ households.

We build a life-cycle model where housing may act as a commitment device to counteract present biases arising from temptation. We show that the model matches several empirical facts, including the large share of wealthy hand-to-mouth households. We evaluate the effect of the two policies and find that they increase wealth accumulation by 7 and 10% respectively.

Our results demonstrate that these policies not only induce portfolio re-balancing, as emphasized by the previous literature, but also increase savings by making commitment more accessible.

See the source image

WHITE PAPER: https://www.nber.org/system/files/working_papers/w28938/w28938.pdf

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

***

***

PODCAST: What are DARK PATTERNS?

Physicians and All Web Surfers Beware!

By Staff Reporters

***

Dark Patterns are tricks used in websites and apps that make you do things that you didn’t mean to, like buying or signing up for something. The purpose of this site is to spread awareness and to shame companies that use them.

CITE: https://www.r2library.com/Resource/Title/0826102549

****

WTF is dark pattern design? | TechCrunch

***

PODCAST: https://www.darkpatterns.org/

YOUR COMMENTS ARE APPRECIATED.

***

RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

Thank You

***

***

%d bloggers like this: