RISK 120

Course overview

*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.