Gosfield and Shay on Health Law

Gosfield & Shay on Health Law is a podcast dedicated to unpacking the complexities of health care compliance, physician group structuring, and federal regulatory policy. Presented by Alice Gosfield & Daniel Shay , one of the nation’s leading health care attorneys, the show helps physicians, practice managers, and hospitals navigate the legal landscape with clarity, strategy, and confidence.

Gosfield and Shay on Health Law is a business podcast hosted by gosfieldshay, with 10 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.

gosfieldshay hosts Gosfield and Shay on Health Law, a business show with 10 episodes published.

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  Episode #10

  Stark Law and Physician Compensation: Productivity Pay and Profit Sharing Explained

  Jul 31, 202618 min

  Episode Summary: In this episode of Gosfield and Shay on Health Law, Alice Gosfield, a renowned healthcare attorney, dives deep into the complexities of Stark Law and its implications for physician compensation. Joined by host LeAnn Lyon, Alice unpacks the intricacies of productivity formulas, profit sharing, and the common pitfalls physician groups encounter. She explains how Stark Law regulates internal compensation decisions, emphasizing the importance of understanding designated health services and the impact of referrals. Alice also distinguishes between Stark and the anti-kickback statute, providing clarity on compliance and legal obligations. The episode offers valuable insights into structuring compensation formulas that align with Stark's regulations while addressing the evolving landscape of value-based care. Listeners gain a comprehensive understanding of how to navigate these legal frameworks to ensure compliance and optimize compensation strategies. Key Timestamps: 00:01 – Introduction 0:53 – Understanding Stark Law's Impact on Compensation 1:24 – Key Provisions of Stark Law 2:04 – Group Practice Regulations and Profit Sharing 3:04 – Designated Health Services Explained 4:32 – Technical Component Revenue Allocation 5:06 – Historical Context and First Settlements 6:01 – Incident to Billing and Its Implications 7:20 – Importance of Referral Distinctions 8:33 – Productivity Compensation vs. Profit Sharing 9:43 – Stark vs. Anti-Kickback Statute 12:32 – Value-Based Care and Stark Regulations 14:56 – Designing Practical and Defensible Compensation Formulas 15:24 – Documenting Compensation Formulas About the Show: Gosfield and Shay on Health Law is a podcast dedicated to providing healthcare professionals with in-depth analysis and insights into the legal and regulatory challenges facing the industry. Hosted by Alice Gosfield, a leading healthcare attorney, and LeAnn Lyon, the show covers a wide range of topics including Medicare compliance, physician compensation, and healthcare regulatory strategy. With a focus on clarity and strategic guidance, the podcast aims to empower listeners with the knowledge needed to navigate the complex landscape of healthcare law effectively.

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  Episode #9

  Why Prior Authorization Has Become a Breaking Point in Health Care

  Jul 3, 202612 min

  Episode Summary: In this episode of Gosfield and Shay on Health Law, Alice Gosfield, a renowned healthcare attorney, joins host LeAnn Lyon to delve into the complexities of prior authorizations in the healthcare system. They explore the historical context and recent scrutiny of prior authorizations, revealing how these processes have become a significant burden for physicians and patients alike. Alice discusses the role of pharmacy benefit managers and the controversies surrounding their practices, as well as the challenges posed by predictive algorithms and artificial intelligence in decision-making. The episode also covers Medicare Advantage's role in the prior authorization debate and the implications of new CMS rules aimed at increasing transparency and efficiency. Listeners will gain insights into the ongoing reforms and the potential for meaningful change in the healthcare landscape. Key Timestamps: 00:01 – Introduction 00:54 – The Rise of Prior Authorizations 01:09 – Burden on Physician Practices 02:22 – Role of Pharmacy Benefit Managers 03:36 – Industry's Response to Criticism 04:31 – Administrative Burden on Physicians 05:41 – Impact of Predictive Algorithms 06:42 – Medicare Advantage and Prior Authorization 08:11 – New CMS Rules and Their Impact 09:46 – State Regulations and Physician Rights 10:14 – Future of Prior Authorization Reforms About the Show: Gosfield and Shay on Health Law is a podcast dedicated to exploring the intricate world of healthcare law and policy. Hosted by healthcare attorney Alice Gosfield and LeAnn Lyon, the show offers insightful discussions on topics like Medicare, fraud and abuse, and healthcare regulations. With a focus on strategic clarity and practical guidance, the podcast aims to inform and empower physicians, healthcare professionals, and policymakers navigating the complex legal landscape of healthcare. Whether you're a seasoned professional or new to the field, this series provides valuable perspectives on the ever-evolving world of health law.

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  Episode #8

  Physician Employment Agreements: Perspectives and Pitfalls from Both Sides

  Jun 5, 202625 minS0

  <p>Episode Summary: </p> <p>In this episode of Gosfield and Shay on Health Law, healthcare attorney Daniel Shay discusses the intricacies of physician employment agreements. Daniel delves into the evolution of compensation structures over the past decade, highlighting the shift from fixed salaries to productivity-driven models. The conversation covers the impact of industry consolidation, the role of private equity, and the pressures on employers to maximize productivity. Daniel also examines the challenges physicians face with non-compete clauses, termination provisions, and tail coverage obligations. By understanding these elements, physicians can better navigate their contracts and protect their interests. This episode p...

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  Episode #7

  Why Medicare Enrollment Is Like Home Ownership (Because It Requires Constant Maintenance)

  May 8, 202613 minS0

  <p>Episode Summary: <br> In this episode of Gosfield and Shay on Health Law, healthcare attorney Daniel Shay delves into the intricacies of Medicare enrollment, likening it to the ongoing responsibilities of homeownership. He highlights the necessity for constant updates and vigilance to maintain compliance, emphasizing the importance of responding to revalidation requests and updating application information within specified timelines. Daniel Shay discusses the consequences of failing to comply, such as deactivation and revocation of billing privileges, and provides real-world examples of how outdated information can lead to serious issues. He offers practical advice for healthcare practices to manage their e...

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  Episode #6

  Non Face-to-Face Services in Medicare: Risks and Rewards

  Apr 10, 202611 minS0

  <p>Episode Summary:<br> In this episode of *Gosfield and Shay on Health Law* attorney Alice Gosfield delves into the complexities and potential pitfalls of billing for non-face-to-face services under Medicare. She discusses the shift in Medicare payment policies, specific documentation requirements, red flags for federal auditors, and the challenges posed by remote physiologic monitoring. Alice also explores rules for split shared visits and the implications for physician compensation models, offering valuable insights for healthcare providers navigating Medicare reimbursement.</p> <p>Key Timestamps:<br> 00:00 – Introduction<br> 03:22 – Shift in Medicare payment policies<br> 07:15 – Documentation requirements for non-face-to-face services<br> 11:45 – Red flags for fede...

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