Stark Law Terms Often Misunderstood by Physicians

October 13, 2011 by · Leave a Comment 

By Adil Daudi, Esq.

Stark-GraphWith the government beginning to scrutinize a physician’s practice now more than ever, many physicians are starting to take a proactive role in understanding certain rules that have been implemented against them.

In January of 1992, Congress imposed and substantially changed the health care industry by introducing what is commonly referred to as the Stark law. Specifically, Stark law is comprised of Sections 1877 (42 U.S.C. §1395nn, applicable to Medicare) and 1903 (42 U.S.C. §1396b, applicable to Medicaid) of the Social Security Act.

Stark law governs physician self-referral for Medicare and Medicaid patients, and prohibits physicians from referring designated health services (DHS) to Medicare or Medicaid qualified patients to an entity where the physician, or an immediate family member of the physician, has a vested financial relationship.

Despite the unambiguous definitions, many physicians/hospitals have fallen prey to this law and have found themselves in substantial legal issues. For any physician, it is imperative for them to know and understand the basics of this law and what certain definitions mean; as the understanding of the simplest terms can help avoid potential litigation.

The following are the top three (3) definitions that many physicians often misunderstand: Please note, these definitions are not exclusive, and it is always strongly advised to consult with your attorney prior to any potential referrals that may fall under this rule.

1.  Financial Relationship: An ownership or investment interest (through equity, debt or other means) in an entity; or a compensation arrangement between a physician, or immediate family member of a physician, and an entity.

2. DHS: The following are the type of services that are restricted under Stark: (i) clinical laboratory services, (ii) physical therapy, occupational therapy, and speech-language pathology services, (iii) radiology and certain other imaging services, (iv) radiation therapy services and supplies, (v) durable medical equipment and supplies, (vi) parenteral and enteral nutrients, equipment and supplies, (vii) prosthetics, orthotics, and prosthetic devices and supplies, (viii) home health services, (ix) outpatient prescription drugs, and (x) inpatient and outpatient hospital services.

3. Referral:  Generally, a referral is considered a request by a physician for, or ordering of any DHS for which payment may can be made under Medicare Part B; in addition, it is a request by a physician to perform any DHS for which payment may be made under Medicare.

Despite these general terms, Stark law is a very complex rule that many physicians fail to take the interest in understanding. A physician who violates this rule is subject to the following penalties: denial of payment; required person would be required to refund amounts collected that were billed; and civil money penalty and being excluded from Medicare, Medicaid and other possible federal programs.

The above is simply an informative piece designed to help simplify certain terms under Stark law. Please consult with your own attorney to provide you with additional information that may be more specific to your situation and needs. Although the rule was implemented more than twenty-years ago, the government has recently begun to scrutinize the application of this rule.

Adil Daudi is an Attorney at Joseph, Kroll & Yagalla, P.C., focusing primarily on Asset Protection for Physicians, Physician Contracts, Estate Planning, Business Litigation, Corporate Formations, and Family Law. He can be contacted for any questions related to this article or other areas of law at adil@josephlaw.net or (517) 381-2663.

13-42

Drafting a Land Contract 101

June 30, 2011 by · Leave a Comment 

By Adil Daudi, Esq.

As the banking industry continues to monitor with great strictness on who is a prime candidate for a mortgage, more and more people are turning towards an alternative method when it comes to purchasing real estate – a land contract.

A land contract is an agreement between the buyer and seller, whereby the seller provides financing to the buyer for the buyer to purchase the property on an agreed upon purchase price. Typically, once such an agreement is drafted, the buyer puts a minimal down-payment, and subsequently agrees to make monthly installments to the seller that goes towards the total purchase price; and after a certain period, the buyer is to make a balloon payment for the balance remaining. Under such an agreement, the seller continues to hold legal title to the property; however the buyer is entitled to possession of the home. It is only after the buyer pays the total purchase price that the seller transfers legal title over to the buyer.

As it remains difficult for people to be approved for mortgages, a land contract provides the buyer with the luxury of not having to go through a lending institution for financing. Therefore, if you are someone with a poor credit rating, you can still purchase a home through a land contract without your rating being reviewed, as the contract is strictly between the buyer and seller.
If you, or someone you know, are currently involved in a land contract transaction, or are on the verge of entering into one, it is always advised to consult with a professional attorney to make sure you have a sound agreement in place. However, as a starter, the following are three (3) commonly overlooked headings that often don’t get the attention they deserve in an agreement, but can cause substantial problems down the road.

1.    Names and Purchase Price: Too often people forget to include the names of the parties involved in the agreement. As important as it is, people tend to overlook this information. In addition to including the names of the parties, it is imperative to include, with clarity, the breakdown of the purchase price, including the down payment, monthly payments, interest rate, whether there is a balloon payment expected, and the term of years.

2.    Description: Another commonly overlooked heading is the description of the property being sold. Aside from the actual address of the property, it is highly advised to include the legal description of the property.

3.    Possession: Remember, throughout the period where the buyer is making payments to the seller, the seller has full legal title to the property; however the buyer has possession interest. Therefore, in order for the buyer to become the actual owner of the property, they must satisfy the terms of the contract and then receive title ownership from the seller.

4.    Utilities: Far too many people assume the buyer (or seller) will be paying for utilities. Having such a clause in your agreement will avoid future issues and will make it explicitly clear on whose responsibility it is. In the event the buyer fails to make consistent payments on its utility bills, the seller has the necessary evidence to prove it was the buyer’s responsibility; therefore the buyer must reimburse the seller for any payments made.

Despite the many advantages a land contract can offer, without the proper drafting it can just as easily be a disadvantageous document. It is therefore always advised to consult with a professional prior to signing any such contract. It is always better to seek counsel once and live with the peace of mind of knowing that the agreement is sound and drafted to serve your best interest.

Adil Daudi is an Attorney at Joseph, Kroll & Yagalla, P.C., focusing primarily on Asset Protection for Physicians, Physician Contracts, Estate Planning, Business Litigation, Corporate Formations, and Family Law. He can be contacted for any questions related to this article or other areas of law at adil@josephlaw.net or (517) 381-2663.

13-27

Community News (V10-I30)

July 17, 2008 by · Leave a Comment 

Mohammad Khan, President and Founder. ViVotech is the President and Founder of ViVOtech Inc.

Mr. Khan held several engineering, marketing, and business development management positions during the 15 years he worked with VeriFone.

Joining VeriFone in its early stage in 1983, Mr. Khan helped the company develop its payment automation systems and later helped successfully market these products in more than 96 countries.

Included were the smart card and security payment products he conceived for VeriFone and launched to its worldwide markets in the early ‘90s.

Mr. Khan was also a co-founder of the Internet Commerce Division within VeriFone and was responsible for expansion of its Internet payment systems business into more than 25 countries. Khan is a co-founder of Sparkice, Inc., China’s e-Hub for global commerce, where he worked as its senior vice president.

Mr. Khan holds a master’s degree in electrical engineering from the University of Hawaii at Manoa. In 2006 Mohammad Khan was recognized as a leader of the Electronic Payments Industry by the Transaction Trends Magazine and in 2005 as a “Mover and Shaker” of the Electronic Payments Industry by the Transaction World magazine.

ViVOtech is a market leader in contactless payment software, over the air (OTA) card provisioning, promotion, and transaction management infrastructure software, NFC smart posters, and contactless readers/writers.

These innovative solutions allow consumers to make contactless payments with radio frequency-enabled credit cards, debit cards, key fobs, and NFC-enabled mobile phones. ViVOtech’s products are used by some of the most prominent retailers in the United States.

ViVOtech’s products are in use at movie theaters, fast food restaurants (QSR), casual dining establishments, convenience stores, gas stations, drug stores, grocery stores, buses, taxicabs and vending machine locations, enabling a wide variety of businesses to accept contactless payments.

Nevada brings people of diverse faiths together

LAS VEGAS–With an interfaith picnic Sunday, Nevada showed to the world that Christians (various denominations), Muslims, Hindus, Jews, and others could discuss similarities and differences in their religions across the picnic tables and make friends with people of “other” faith.

There were prayers in Hebrew, Sanskrit, Arabic, and English when Christians Muslims, Hindus, Jews and others gathered at Second Annual Northern Nevada Interfaith Community Picnic in Rancho San Rafael Park of Reno.

Besides coordinators Methodist Pastor John J. Auer, Rabbi Myra Soifer, Imam Abdul Rahim Barghouthi, several other religious leaders from the area participated in the event.

Muslim and Christian leaders to meet at Yale

NEW HAVEN–More than 150 Muslim and Christian leaders, including some of the world’s most eminent scholars and clerics, will gather at Yale University July 28-31 to promote understanding between the two faiths, whose members comprise more than half the world’s population.

Prominent political figures and representatives of the Jewish community also will speak at the conference, which launches a series of interfaith events planned around the world over the next two years.

These gatherings respond to the call for dialogue issued in an open letter, A Common Word Between Us and You, written by major Islamic leaders, to which Yale scholars responded with a statement that garnered over 500 signatures.

A watershed in Muslim-Christian relations, this interfaith meeting was organized by Yale Divinity School’s Center for Faith & Culture under the leadership of its founder and director, Miroslav Volf, together with the director of the Center’s Reconciliation Program, Joseph Cumming. Volf will co-teach a course on faith and globalization at Yale this fall with former British Prime Minister Tony Blair.

“I firmly believe that few things are more vital to our shared future than that people of different faiths understand each other better, respect each other more, and work together more closely. That is why I, along with countless others, was hugely encouraged when A Common Word was published.

I warmly welcome the fact that one of the world’s premier academic institutions, by hosting this gathering, is seeking to carry the debate and the dialogue further and deeper,” said former Prime Minister Tony Blair.

Yale Divinity School Dean Harold Attridge said, “I am extremely pleased that Yale Divinity School is hosting this important conference.

The Divinity School is committed to bringing the best insights of faith and intellect to bear on contemporary life, and the relationship between Christians and Muslims is one of the most pressing issues of our time.”

Notable leaders expected at the conference include Prince Ghazi bin Muhammad of Jordan; former Prime Minister Sadiq al-Mahdi of Sudan; top Evangelical leaders Leith Anderson and Geoff Tunnicliffe; prominent Ayatollahs from Iran; Sheikh Tayseer Tamimi of Palestine, Grand Muftis of several Middle Eastern countries; Antonios Kireopoulos of the National Council of Churches; and John Esposito of Georgetown University. Senator John Kerry as well as other senior U.S. government officials also are expected to attend.

Residents pack meeting on Wallingford Mosque

WALLINGFORD, CT-Residents opposed to the construction of a mosque in Wallingford packed  Planning and Zoning Committee meeting. They held signs saying they don’t want any new development in the area.

The dispute is over the construction of the Salma K.Farid Islamic Centre on a 6.5 acre site. The mosque which would serve up to thirty people on Fridays is being built by Tariq Farid,39, a successful entrepreneur in the area.

Opponents of the mosque say that they are concerned about traffic. Some of them denied that they are anti-Islamic and said that they are only opposed to development.

A recent traffic study found the intersection and road satisfactory for the mosque’s traffic projections.

The Planning and Zoning Committee is expected to vote on the subject in September.

10-30