Healthcare Valuation: The Four Pillars of Healthcare Value, Volume 1

CHAPTER 3

Regulatory Environment

3.1 Overview and Trends

3.2 Tax Regulations

3.2.1 Individual Health Insurance Mandate

3.2.2 501(c)(3) Tax Exempt Organizations

3.2.3 Bona Fide Employees vs. Form 1099 Independent Contractors

3.2.4 Provider Taxes

3.2.5 Ad Valorem Tax and Personal Property Tax

3.2.6 Excise, Sales, and Use Tax

3.2.7 Election of Tax Status—C-Corporations vs. S-Corporations

3.3 Fraud and Abuse Regulations

3.3.1 Anti-Kickback Statute

3.3.2 Stark Law

3.3.3 False Claims Act (FCA)

3.3.4 Fraud and Abuse Reimbursement Monitoring Programs

3.3.5 ACA Initiatives Aimed at Combatting Fraud and Abuse

3.3.6 Racketeer Influenced and Corrupt Organizations Act (RICO)

3.4 Competition

3.4.1 Antitrust Regulations

3.4.2 Any Willing Provider Statutes

3.4.3 Certificate of Need

3.4.4 Covenants Not to Compete

3.5 Privacy Regulations

3.5.1 Health Insurance Portability and Accountability Act (HIPAA)

3.5.2 Red Flags Rules

3.5.3 Health Information Technology for Economic and Clinical Health (HITECH) Act

3.5.4 Patient Safety and Quality Improvement Act

3.5.5 Custodial Rights to Patient Charts

3.6 Safety Regulations

3.6.1 Clinical Laboratory Improvement Amendments (CLIA)

3.6.2 Occupational Safety and Health Act (OSHA)

3.6.3 United States Nuclear Regulatory Commission (NRC)

3.6.4 Environmental Laws

3.6.5 Food and Drug Administration (FDA) Enforcement

3.7 Corporate Practice of Medicine and Related Provisions

3.7.1 False Advertising

3.8 Licensure, Certification, and Accreditation Regulations

3.8.1 ...