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C F MacKelvie

Publications and source records attributed to C F MacKelvie.

15 recordsLinked to original sources
PubMed1992

Practitioner-provider joint ventures, the OIG, and the IRS.

Increased forays by hospitals and physicians into joint ventures make both parties subject to a complex network of laws and regulations and to scrutiny by many Federal agencies. Institutional healthcare providers should be aware of the legal pitfalls and exercise extreme caution when creating such arrangements. This is the second of a two-part examination of issues relative to taxes and Medicare and Medicaid fraud and abuse regulations. (Part I was published in the October 1992 issue of HFM.)

Charities↗
PubMed1989

Mooring in safe harbors. Proposed rules set out what's legal, what's not under Medicare fraud and abuse laws.

The 1977 Fraud and Abuse Amendments, which prohibit business relationships that increase Medicare utilization, have created uncertainty among healthcare providers as to which commercial arrangements are legal and which are not. In response to this uncertainty, Congress enacted the Medicare and Medicaid Patient and Program Protection Act of 1987, which required the Department of Health and Human Services to develop regulations that would specify allowable practices. The regulations proposed Jan. 23, 1989, specify "safe harbors" from criminal and civil penalties in the following areas: sales of physician practices, rental agreements, investments by providers, and personal services and management contracts. In addition, the Fraud and Abuse Amendments exempted referrals arising out of a bona fide employment relationship, properly disclosed discounts, and group purchasing arrangements. The proposed regulations attempt to clarify these exemptions. Unfortunately, the proposals do little to calm a healthcare industry that is jumpy about which transactions are permitted and which are not. This is partly because the Internal Revenue Service, Health and Human Services, and the Department of Justice often issue conflicting pronouncements regarding prohibited business transactions by tax-exempt providers.

Contract Services↗
PubMed1988

Hospitals face loss of federal tax-exempt status.

Because of governmental challenges, not-for-profit hospitals can no longer take for granted their right to be tax exempt. The Internal Revenue Service is auditing nearly 1,500 tax-exempt healthcare organizations to determine how accurately they are reporting unrelated business income. At greatest risk are those hospital systems that have become overly acquisitive or have strayed from the charitable mission that originally entitled them to tax exemption. To protect their tax-exempt status, currently exempt healthcare institutions must be careful that any activities, such as joint ventures and affiliate corporations, conform to their charitable mission. In the face of tougher legislation and Federal scrutiny, hospitals must make sure they are devoted to and performing a charitable purpose if they want to keep their tax-exempt status.

Charities↗
PubMed1988

ABC's of monitoring federal tax exemption.

Congress and the Internal Revenue Service (IRS) are taking a close look at the Internal Revenue Code (IRC) as it applies to Catholic institutions' activities. Although most Catholic institutions' exempt status is secured by reserved power organizational characteristics, it would behoove healthcare leaders to become familiar with the tax system and the IRS operation and, if necessary, make appropriate accommodations. They should understand what triggers an IRS audit and the audit process itself. The IRS subjects exempt institutions to organizational and operational tests. It deems that a healthcare entity is organized exclusively for an exempt (and charitable) purpose when that entity's articles of incorporation: 1. Limit the organization's purposes to charitable purposes. 2. Limit the organizations's activities to those which further its exempt purposes only, with other purposes furthered in only an insubstantial way. 3. Limit activities to those specified in IRC Section 501(c)(3). 4. Limit distribution of the organization's assets on dissolution to another organization with a like or similar exempt purpose. 5. Limit legislative and bar political activities Although most Catholic healthcare entities are "tax managed" conservatively, from an operational perspective, they often enter into transactions that the IRS considers "red flags." Some of these "red flag" transactions involve: Joint venture operations. Physician recruitment and physician handling plans. Rental/lease arrangements. Defined compensation plans. Hospital productivity plans. Profit-sharing plans. Contingent compensation arrangements. Acquisition, mergers, and divestitures. Taxable subsidiaries and unrelated business income.

Catholicism↗