Limits on the Physician as a Good Samaritan

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.

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