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Last Updated on: 13th October 2023, 05:17 pm
Hey there! If you’re a radiology provider or run an Independent Diagnostic Testing Facility (IDTF), you know there are a ton of complicated laws and regulations to follow. And if you ever get audited or investigated, you’ll definitely want an experienced lawyer on your side!That’s where healthcare lawyers who specialize in radiology and IDTF issues can be a huge help. They know all the ins and outs of Stark law, anti-markup rules, Medicare billing requirements, and more. Having the right legal advice can literally save your business.In this article, we’ll walk through some of the key legal issues facing radiologists and IDTFs today, when you need a lawyer on your team, and how to find the right one. Let’s dive in!
There are a few main areas where radiology practices and IDTFs tend to get tripped up legally:Stark Law – This prohibits referrals for certain designated health services (like imaging) if the referring physician has a financial relationship with the provider. There are exceptions, but Stark law is super complex! One misstep can mean big penalties.Anti-Markup Rules – Radiologists can’t mark up the technical component above the Medicare fee schedule without meeting certain requirements. But the rules differ for IDTFs versus physician practices.Medicare Billing – Both radiologists and IDTFs must follow Medicare’s strict billing guidelines. For example, IDTFs generally can’t share space or equipment with other physician practices. Mess this up and you risk losing Medicare billing privileges.HIPAA – Patient privacy is serious business. HIPAA violations for improper use or disclosure of protected health information can lead to massive fines.Accreditation – IDTFs usually need to maintain accreditation from organizations like the American College of Radiology. Lose your accreditation and your reimbursements go away.State Laws – Most states have their own laws governing imaging services. These cover things like supervision levels, licensing, and more. State rules vary wildly so it’s crucial to comply.As you can see, diagnostic imaging providers have to follow a boatload of technical regulations. And the consequences for noncompliance can be severe…
If you find yourself in any of these situations, it’s a bright red flag that you need an attorney who understands radiology regulations:
The key is to react quickly if one of these things occurs. The laws can be so complex that it’s easy for auditors and investigators to claim you’re out of compliance, even if you’re not!Having an experienced diagnostic imaging lawyer on your side early on can make a huge difference in resolving these types of issues favorably. Don’t wait until things escalate to bring in legal help.
Okay, so you’ve decided it’s time to get lawyer support for your radiology practice or IDTF. How do you find the right one?Here are some tips:
Doing your homework to find the right diagnostic imaging lawyer for your needs is time well spent. You want someone who can competently represent you and achieve optimal results.
Dealing with health regulators and auditors is no fun, but it doesn’t have to be scary if you have the right legal guidance. Lawyers well-versed in the myriad laws affecting radiology providers and IDTFs can help you successfully navigate any challenges that arise.Hopefully this overview gives you a better understanding of when and why to bring specialized diagnostic imaging counsel onto your team. Their expertise can prove invaluable in protecting your practice and your bottom line! Here’s to keeping your imaging business on the right side of the law.
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