The Legal Environment of Physician Compensation

Krishnamurthy Surysekar, Miriam F. Weismann, Dana A. Forgione, Jimmy Carmenate

Abstract


We provide a review of the U.S. legal environment that impacts physician compensation plans. We also identify areas where the legal environment places a binding constraint on an organization’s ability to design compensation plans. We review current research on models used for physician compensation, and identify areas for future work.


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References


MedPAC. (2014). Report to the Congress: Medicare Payment Policy. Medicare Payment Advisory Commission, Retrieved Oct. 26, 2015 from www.medpac.gov/documents/reports/mar14_entirereport.pdf?sfvrsn=0.

Jackson Health Care. (2011). Physician Compensation Eight Percent of Healthcare Costs. Retrieved Oct. 26, 2015 from: www.jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs/.

Brook, R.H. “Physician Compensation, Cost, and Quality,” Journal of the American Medical Association, 304(7): 795–796 (2010).

Landon, B.E., O’Malley, A.J., McKellar, M.R., Reschovsky, J.D., and Hadley, J. “Physician Compensation Strategies and Quality of Care for Medicare Beneficiaries,” The American Journal of Managed Care, 20(10): 804–811 (2014).

MGMA. 2014. Physician Compensation and Production Survey: 2014 Report Based on 2013 Data—Key Findings Summary Report. Medical Group Management Association. Retrieved Oct. 26, 2015 from: www.mgma.com/Libraries/Assets/Key-Findings-PhysComp_FINAL-with-copyright.pdf.

Gosfield, A. “Quality Increasingly a Factor in Physician Compensation,” Medical Economics, (Aug. 10) 36–42 (2012).

Bunkers, B., Koch, M., McDonough, B., and Whited, B. “Aligning Physician Compensation with Strategic Goals,” Healthcare Financial Management, 68(7): 38–45 (2014).

Lee, T.H., Bothe, A., and Steele, G.D., “How Geisinger Structures its Physicians’ Compensation to Support Improvements in Quality, Efficiency, and Volume,” Health Affairs, 31(9): 2068–2073 (2012). Retrieved Oct. 26, 2015 from: http://content.healthaffairs.org/content/31/9/2068.long.

Johnson, J., and Higgins, A. “Evaluating the Fair Market Value of Pay for Performance.” Healthcare Financial Management, 68(4): 80–84 (2014).

42 C.F.R. § 411.351.

42 C.F.R. §411.357(p).

42 U.S.C. § 1395nn(e)(2).

66 Fed. Reg. 944-46. (Jan. 4, 2001).

See: 26 C.F.R. § 1.162-7(b) (3) (2004).

The Stark Law is codified at 42 U.S.C. 1395nn.

Wachler, A.B., and Dresevic, A. “Stark II Phase III—‘The Full Picture,’ The Health Lawyer, The American Bar Association Health Law Section, Special Edition, (Sept. 2007).

42 U.S.C. 1320a-7b.

See: 64 FR 63518 (Nov. 19, 1999).

31 U.S.C.§ 3729.

IRS, Internal Revenue Manual, 4.76.3.11.4.3 (Apr. 1, 2003). U.S. Internal Revenue Service. Retrieved Oct. 26, 2015 from: www.irs.gov/irm/part4/irm_04-076-003.html.

Ibid.

IRC§ 4958.


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