(Total Views: 418)
Posted On: 03/13/2019 6:48:29 AM
Post# of 36564
Re: icaredoyou #2736
I brought your concerns up on this board some time back and Joe responded. I also shared with Joe privately another example of one of these schemes in my home state.
No doubt about the potential pitfalls with MSO's that are improperly operated. MSO's are a huge part of healthcare and have been around for decades. Most healthcare systems operate MSO's under one type of organizational system or another. Most doctors are employed by a system now and are on a salary and sometimes bonus money for meeting certain criteria(ie making the organization more money by sending labs to the systems central lab or MRI's etc to the central testing center). Most are properly set up and operated. Don't forget, it is the insurance company's responsibility to contract with labs and pharmacies and set the fees for reimbursement. Was the service medically necessary? Remember some of this care is being provided to avoid prescribing of opioids which is a prudent measure. We may find most of these investigations will not be about the MSO model itself but will be about the inappropriate actions of the "runners" to find new business from sham patients and outright kick backs to providers outside of the MSO. Obviously not a good thing and yes, not doing these inappropriate activities will decrease the business but that does not mean it can't be profitable and legal moving forward.
Meanwhile, back at HQ, GNBT continues hiring highly experienced top level executives, making acquisitions and selling their products, opening up new states with the MSO, reviewing additional opportunities etc.
We have a 10Q coming out pretty soon that may provide additional insight.
I appreciate your info. Thanks for posting.
No doubt about the potential pitfalls with MSO's that are improperly operated. MSO's are a huge part of healthcare and have been around for decades. Most healthcare systems operate MSO's under one type of organizational system or another. Most doctors are employed by a system now and are on a salary and sometimes bonus money for meeting certain criteria(ie making the organization more money by sending labs to the systems central lab or MRI's etc to the central testing center). Most are properly set up and operated. Don't forget, it is the insurance company's responsibility to contract with labs and pharmacies and set the fees for reimbursement. Was the service medically necessary? Remember some of this care is being provided to avoid prescribing of opioids which is a prudent measure. We may find most of these investigations will not be about the MSO model itself but will be about the inappropriate actions of the "runners" to find new business from sham patients and outright kick backs to providers outside of the MSO. Obviously not a good thing and yes, not doing these inappropriate activities will decrease the business but that does not mean it can't be profitable and legal moving forward.
Meanwhile, back at HQ, GNBT continues hiring highly experienced top level executives, making acquisitions and selling their products, opening up new states with the MSO, reviewing additional opportunities etc.
We have a 10Q coming out pretty soon that may provide additional insight.
I appreciate your info. Thanks for posting.
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