As one partner at my firm puts it, “If it makes good business sense, in the health care business, it’s probably illegal.” As a practicing junior health care attorney it did not take long for me to learn this reality of the regulatory scheme I learned as a law student. As snarky as the sentiment may seem, the restrictions on profit-sharing, referrals, and reduced-cost or free goods and services imposed by Stark and Anti-Kickback laws (while well-intended) can stifle some creative thinking in health care delivery.
What is not always as salient in the daily grind of my practice focusing on transactions and system-level compliance issues, are the ways in which the regulatory scheme can limit a physician’s acts of generosity and kindness. Whether we think our regulations intended to align incentives with cost-effective and quality health care delivery are good, bad or otherwise, I found this article in the New York Times by Abigail Zuger to be a thought-provoking moment of pause to consider how the complex scheme plays out in the day-to-day delivery of primary care and the physician-patient relationship.
I too was struck by Abigail Zuger’s “When Healers Get Too Friendly” article from the NYT but I read it, and its back story, a bit differently. You may find my reflection on the Zuger article and response to your post at:
https://delong.typepad.com/annmariemarciarille/
in a post titled “Physician Boundary Crossing in the Face of Health Care System Failure.”