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A recent fraud alert published by the OIG listing "suspect hospital incentive arrangements" in physician recruitment practices is compelling hospital executives to review their recruitment strategies. "What is new about this fraud alert," says an attorney, "is that the OIG has put them into one document as an indication of its enforcement priorities."

The release of the "safe harbors" regulations by the Department of Health and Human Services has left a variety of important issues unresolved. Health care attorneys and their clients are now poring over the new regulations, trying to determine, among other things, how much risk tolerance to accept in relation to the new restrictions, and what level and types of monitoring the federal government will apply. Ultimately, say many experts, the regulations could result in a strong trailoff in joint venture volume.

The controversy over the national guidelines for health planning and appropriateness review is well-founded. There is no question that planning tools are required if the planning process is to have validity, but simplistic rules will only make planning chaotic. There must be room for input from the grass roots.