Hospitals often, for a number of reasons, raise quick and unfair allegations against their nursing staff. How you respond and handle these allegations is important. Knowing the resources available and their limitations is also important if you find yourself being unfairly accused, as well as preserving future options with respect to your license and nursing career.
Every physician and health care provider has heard of the term “fee splitting”. Unfortunately, few really look beyond the most simplistic application of the prohibition, a mistake that could have serious consequences for their career as fee splitting is a violation of professional misconduct regulations.
An allegation of fee splitting is more likely to arise in a dispute with a third party such as an insurance company, independent contractor, or an employee than it is by direct investigation by the Department of Health or Department of Education. This exposes a provider to a greater risk since an adversarial party is the one bringing it to attention of the Office of Professional Medical Conduct (OPMC) or Office of Professional Discipline (OPD in the case of a non physician health care provider).
Any arrangement where one party’s compensation or contract fees are based on a percentage of a provider’s revenue is likely to fall under fee splitting prohibitions. There are limited exemptions, one of the most common being partners/shareholders/owners of a professional organization or professional employee’s incentive bonus (providing they are the same license). Non-professionals do not have a license to lose and are not affected by an allegation for professional misconduct based on fee splitting. As laypeople the OPMC and OPD have no authority over them, so physicians and other health care providers must be extra cautious when dealing with them.
An Article 28 facility is approved by the New York State Department of Health through the Certificate of Need process. The same application process and law (Article 28 of the New York State Public Health Law) also applies to Surgical Centers and Nursing Homes as well as general hospitals. There are similar and specific requirements as far as what the Department of Health is looking for from each facility. Understanding the process and these requirements is important in order to obtain a Certificate of Need to own and operate a Diagnostic and Treatment Center. An Article 28 Diagnostic and Treatment Center can be the proper tool for you to operate your practice. Much about them is misunderstood leading to many misconceptions about what they are and are not. The following are the four most important factors to consider when determining if a Diagnostic and Treatment Center is right for you: