Developing Patient Healthcare Incentive Programs: AKS and CMPL Compliance, Safe Harbors, Exceptions

Ms. Yount’s practice involves a variety of regulatory, compliance, and transactional matters for a broad range clients across the healthcare industry, including healthcare systems, managed care organizations, pharmacies, device and pharmaceutical manufacturers, long-term and post-acute care providers, and private equity firms investing in the health care industry. She is particularly well versed in the federal anti-kickback statute, the Stark Law, state fraud and abuse laws, beneficiary inducement prohibitions, provider-based rules, Medicare and Medicaid program requirements, and the federal Physician Payments Sunshine Act. Ms. Yount regularly advises clients on the regulatory framework for value-based healthcare, including new and evolving CMS-sponsored payment models (e.g., ACO REACH, Medicare Shared Savings Program, Kidney Care Choices). She is particularly adept at assisting healthcare companies in navigating the anti-kickback statute safe harbors and Stark Law exceptions for value-based care. Ms. Yount is frequently invited to speak on healthcare fraud and abuse, compliance, and other health law matters.

Ms. Haviland’s practice focuses primarily on healthcare enforcement defense. She defends laboratories, physicians, and other clients facing government investigations and qui tam litigation arising from alleged violations of the federal False Claims Act, the Stark Law, and alleged criminal and civil violations of the anti-kickback statute. Ms. Haviland assists clients with negotiating and structuring of global settlements with the DOJ and its US Attorneys’ Offices and state Attorneys' General Offices as well as corporate integrity agreements with the HHS Office of Inspector General. She also defends clients in consumer protection and unfair or deceptive trade practices investigations initiated by the FTC or state Attorneys’ General Offices. In addition, Ms. Haviland advises clients regarding cannabis licensing, compliance, and regulatory matters.