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Patient equipment management: integrating a flexible alternative to purchase or lease.

As hospital CSS and OR departments work together to manage patient equipment, alternatives to purchase are available that can provide them with needed flexibility and responsiveness. A rental equipment provider that can meet the standards demanded for quality health care can become a valuable asset when developing and refining a hospitalwide equipment management program. But in order to receive the level of quality and service they should expect, hospitals must continually communicate their changing needs while holding their providers accountable to established standards.

Central Supply, Hospital↗

GE tax-exempt lease plan saves time, money.

A new tax-exempt lease financing program in Massachusetts is expected to save the state's hospitals time and money when they acquire medical equipment from GE Medical Systems. GE is looking to expand the program to other states, and it could serve as a model for other equipment manufacturers.

Capital Financing↗

Special report on reimbursement. Final Medicare fraud and abuse safe harbors are published.

There has been great concern in the health care industry that business arrangements that do not comply with the Safe Harbors will automatically be deemed illegal. HHS has confirmed that this is not so; the commentary to the Regulations expressly states that "The failure of a particular business arrangement to comply with these provisions does not determine whether or not the arrangement violates the statute because...this regulation does not make conduct illegal. Any conduct that could be construed to be illegal after the promulgation of this rule would have been illegal at any time since the current law was enacted in 1977....This regulation is intended to provide a formula for avoiding risk in the future." 56 Fed. Reg. at 35955. In the final analysis, the majority of transactions will fall outside the Safe Harbors and thus will continue to be judged by the standards established by the Medicare antifraud statute enacted 14 years ago. Under these standards, as HHS states, "the degree of the risk [in any particular transaction] depends on an evaluation of the many factors which are part of the decision-making process regarding case selection for investigation and prosecution." Id. at 35954. Providers that are mindful of these criteria should therefore still be able to accomplish, with relative safety, transactions that do not qualify for Safe Harbor protection.

Commerce↗

The Medicare and Medicaid anti-kickback law: charting your safe harbors.

The Medicare and Medicaid fraud and abuse provisions create many potential pitfalls for physicians; navigating around these problem areas can be tricky. This article discusses recently published federal regulations providing "safe harbors" from the anti-kickback provisions of Medicare and Medicaid law, with particular emphasis on the more common relationships between physicians and hospitals. Those safe harbors that are most and least useful to the physician are highlighted, and advice is offered for evaluating the relative risks involved where no safe harbor is available or fully applicable.

Contract Services↗

The Anti-Kickback Statute and hospital-physician financial arrangements.

Hospital-physician financial arrangements often involve transactions that could be construed by the government as illegal remuneration under the federal "anti-kickback" statute. This article discusses some of the questionable types of relationships that arise and explores the government's reaction to these arrangements as manifested by a recent Office of Inspector General management advisory report and proposed and final safe harbor regulations.

Crime↗

Tools for decision making on capital expenditures.

The above methods are useful to determine a project's worth. They can provide senior management with information that will be helpful when analyzing potential capital investments. Managers should make it their job to help administrators select the best investment projects.

Budgets↗