Online Continuing Education Courses

Understanding the Legalities of Fee Discounts, Particularly Time-of-Service Discounts and Hardship Discounts - 6 Hour

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one’s working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider’s practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.
• Verify how certain discount practices may be legally actionable as “improper inducements.”
• Evaluate federal Stark legislation and the discouragement of corruption in sound professional healthcare decision-making.
• Identify distinctions between federal anti-kickback and the federal Stark legislation.
• Critique state anti-kickback laws.
• Recognize the role the FTC played, and continues to play, in discouraging the fraudulent marketing of discount health care programs.
• Draw associations between co-pay requirements, consumer habits and federal healthcare expenditures.
• Assess how "professional courtesy" discounts may raise enforcers' concerns under the federal anti-kickback statute.
• Diagram how prepaid fee arrangements often resemble health insurance to unwitting patients.
• Illustrate pitfalls that advertising discounts visit on the practitioner.