Ftc Case

The PHO served as a vehicle through which competing hospitals and physicians could bargain collectively with health plans to obtain higher fees for themselves. The owner PHOs, member hospitals, and member physicians canceled contracts with payors and informed them that the PHO would be the sole entity through which they would enter into payor contracts. To contract with the PHO, payors allegedly have had to accept the fixed physician fee schedule and fixed discount of no more than 10 percent off hospital list prices.

1. What are several red flags that E&Y either was or should have been aware of in the audit of HealthSouth?

The competitor would provide similar services that could potentially hinder PHC’s progress toward accomplishing its service and profitability goals.

The health facility in this case study experienced several problems and issues beyond possible solution efforts by the time. One of the main problems is based on the perfect way of handling the various challenges attributed to a shift from the hospital’s fee-for-service in the case of managing care environment. Besides, some local physicians were loyal to Dr. William and had the necessary flexibility and availability to assist the doctor in various ways, but today they are no longer available to assist the doctor towards the achievement of his medical and societal mission. The physicians were always available and loyal to the doctor and they could volunteer their efforts especially in cases of physician shortages in the health center. The physicians cannot afford the time they once used for volunteering activities in the health facility to assist Dr. Williams (Swayne, 2008). The reason behind this problem is that the physicians have now been employed by various managed health care organizations. Others have been involved in various contractual agreements such that the partners prohibit them from working with the health care facility. Although the health care facility has a few small groups or individuals offering primary care, these individuals and small groups are still struggling to survive in the industry. As such, the majority of them cannot

In order to deduct her moving expenses, she must meet certain conditions outlined in Reg. 1.217-2 (c). Helen meets the first two requirements (relevance to work test and distance test) without any issue. The third requirement has not yet been met yet though. This requirement is a minimum period of employment. Since she is a full-time employee, she must work full-time in this general location for at least 39 weeks during the 12 month period after the move. This does not mean she is not required to remain employed at her current place of work to meet this test. Even though she does not meet this requirement yet, she can deduct these expenses on the current years return or the year the reimbursement is paid to her by her employer. If she recognizes the expenses on this year’s return and does not end up meeting the requirement, she will have to include the deductions she took on this year’s return in next year’s gross income.

Despite in the United States, PHOs or Physician-Hospital Organizations have been in decline, they are making a comeback. The PHO is defined as a legal entity formed by physicians and one or more hospital with the intention of negotiating contracts with payers and sharing in the financial rewards of controlling cost while delivering high-quality care. (Farlex, 2014). PHO is best described in three ways:

Agro-Chem, Inc. is a regional producer of agricultural chemicals based in Houston Texas that needs help making a lease versus purchase decision. By understanding the material presented, we will be able to come to a decision. However, after reviewing the information presented, there are a few problems that need to be investigated before finalizing our recommendation. Agro-Chem, Inc. chose to go with the financial manager’s idea of using a discount rate of 14% (average risk) to figure out the present value costs of leasing and purchasing even though the assistant treasure suggested a 12% (low risk) discount rate. Agro-Chem, Inc. brought in the company’s CPA to help settle the debate

I appreciate the opportunity to advise you regarding the tax treatment for your loss of $25,406 in 2015 from your dog breeding activities. I understand that you decided to start breeding purebred terriers to keep yourself busy after your divorce with your husband in January. There are two possible ways to treat the loss under rulings in the Internal Revenue Code. One option is to treat your dog breeding activity as a business and deduct the losses on Schedule C, Profit or Loss from Business, of your individual income tax return. The second option is to treat your dog breeding as an activity not engaged in for profit, which does not allow you to deduct the

Since it’s founding in 1951, The Joint Commission has set standards and completed evaluations and accreditations for over 20,000 health facilities. Though not a government agency,The Joint Commission has a great level of authority in the field of healthcare and approval from the organization is often required by local health departments and CMS. Receiving the Commission’s seal of approval also goes a long way with potential clients familiar with the high standard of

The Federal Trade Commission is an independent agency of the U.S. government that was established in 1915 and charged with keeping American business competition free and fair. The FTC has no jurisdiction over banks and common carriers, which are under the supervision of other governmental agencies. It has five members, not more than three of whom may be members of the same political party, appointed by the President, with the consent of the Senate, for seven-year terms. The act was part of the program of President Wilson to check the growth of monopoly and preserve competition as an effective regulator of business.

Last February, the Supreme Court issued its opinion in North Carolina State Board of Dental Examiners v. Federal Trade Commission (Dental Examiners). The case concerned the Board’s decision to stop teeth whitening services by non-dentists in the state. The Federal Trade Commission alleged that the Board had violated antitrust laws by attempting to limit competition by its teeth whitening decision. State entities such as the Board generally were thought to have immunity from antitrust laws, but the Supreme Court’s decision reversed this long-held belief and found that state boards could be held liability if certain conditions were met. The major condition was that the board be made up of a majority of active market

In this instance, BSA Provider Network as a messenger under the contracting terms of ‘’ messenger model’’ was implemented has made a conspiracy plot of making its own decisions by making its own fee schedule instead the decision should be coming from the physicians association in receiving and offering contracts to the payers. Although, BSA provider network has fixed charges many physicians would provide healthcare procedures under their own fee-for-schedule to independent patients, self-insured employers coming out of the terms of BSAPN. Also, BSA provider network many renegotiations with several payers on behalf of physicians intending that the independent physician

It strongly important for institutions to strategically follow the health regulations and laws regarding technology as well as addressing any violations immediately. The law that was made for each company to follow to avoid and violations is “The False Claims Act (FCA) is was put into place in 1863 where its mission is hold those responsible who submit fraudulent claims to government programs like Medicare and Medicaid. In Featherfall Medical Center an issue of breaching of patient security and confidentiality, but they contribute to the financial and operational burden of the organization. When it comes to impacting the violations these health regulations and laws regarding technology on institutions, the damage could significantly affect

The Pharmaceutical industry has been in the spotlight for decades due to the fact that they have a reputation for being unethical in its marketing strategies. In The Washington Post Shannon Brownlee (2008) states, “We try never to forget that medicine is for the people. It is not for the profits. The profits follow.” This honorable statement is completely lost in today’s world of pharmaceutical marketing tactics. These tactics are often deceptive and biased. Big Pharma consistently forgets their moral purpose and focuses primarily on the almighty dollar. Big Pharma is working on restoring their reputation by reforming their ethical code of conduct.

On March 19 of the year 2003, Securities and Exchange Commission brought the trading of HealthSouth to an end on the New York stock exchange, charging the company for inflating its earnings by more than 10 percent and overstated its profits by more than $2.5 billion between 1999 and 2002. HealthSouth’s trading reached to $30.81 in the year 1998, but ever since the trading of the company has been put to an end it reached to $3.91 per share. One week later, Owens pleaded guilty to changing and editing the company’s financial statements.