Discuss the United States v. Greber and United States v. McClatchey case questions 1. How, if at all, can you distinguish Greber from other instances of payment for professional services? Suppose the percentage Dr. Greber paid to the physicians had not exceeded Medicare’s guideline? Would that payment still amount to prohibited remuneration in this court’s eyes?

Yes. I think Dr. Gerber is still responsible. Although the payments made had legitimate purposes, they could still be viewed as intent to induce referrals. And as long as one purpose among all was intended to induce referrals then a statute becomes violated. Secondly, the law views remuneration as anything that has monetary value. Therefore, I would agree the court would view that payment as a prohibited remuneration.
2. Suppose you were a lawyer or a compliance officer advising a hospital cardiology department. The department has a contract under the terms of which it will pay a certain cardiology group a fixed dollar amount for every electrocardiogram (ECG) interprets, and the hospital will bill Medicare accordingly. The dollar amount is equal to Medicare’s allowable charge for ECG’s (less $10 at this writing), and all readings are medically necessary. You ask why the hospital does not just let the doctors bill Medicare themselves, and the reply is, “ Oh, it’s such a hassle for them. We already have a billing department, and we can do it for them easily.” What is your response, and why?
I would respond in this way: I would prefer that the Doctors be the ones involved in the billing but if the Hospital imposes then they must follow all regulatory guidelines. I will remind them that every aspect of the billing process will be monitored so as to eliminate fraudulent charges. I will also reiterate that Medicare’s allowable charge for ECG’s (less $10 at this writing) in the contract must be observed.