BarbriSFCourseDetails

Course Details

This CLE course will review this government guidance through the lens of continuing and emerging risk areas seen in case law.

Faculty

Description

Financial relationships between and among healthcare providers- including both the methods and amounts of compensation--continue to be an area of significant scrutiny and government enforcement activity. With government prosecutors having both civil and criminal enforcement tools in their current toolbox, the stakes can be high. Civil penalties and settlement amounts for actions brought under healthcare fraud and abuse laws have reached tens and even hundreds of millions of dollars, while the government's alternative and complementary use of its criminal enforcement tools has increased. Recent government focus areas include professional services agreements, medical director agreements, management agreements, physician practice support arrangements, employment agreements and ancillary goods and services agreements such as for laboratory services.

In a 2020 memo regarding "Evaluation of Corporate Compliance Programs," the U.S. Department of Justice stated that in its view a well-designed compliance program includes comprehensive due diligence of any transaction targets to identify compensation compliance issues, and that failure to undertake such due diligence can result in significant liabilities. The November 2023 update to OIG’s compliance guidance for healthcare providers contained similar themes.

Listen as our authoritative panel of healthcare attorneys examines the issues in healthcare compensation compliance and the historical and emerging risk areas and related focus areas for due diligence review.

Outline

  1. New and evolving legal risk areas in compensation and other financial arrangements
    1. Under the Stark Law
    2. Under federal Anti-Kickback Statute
    3. Under federal False Claims Act
    4. Under federal, state, and local tax exemption laws
    5. Under federal and state antitrust laws
    6. Under other select federal and state laws and regulations
  2. Examples of enforcement activities and resulting liabilities in the evolving risk areas
  3. The due diligence process: how it may work, what it should do, and how it can shape transactions
  4. Tips and takeaways for healthcare transactions and compliance programs

Benefits

We will discuss:

  • Surprising and recurring themes in the recent government guidance and case law
  • An update on new enforcement cases to watch and what might be learned from them
  • What a typical compensation compliance due diligence review might entail in 2024
  • Methods to mitigate the costs and maximize benefits of due diligence for compensation compliance
  • Attorney-client privilege protections and other questions that may come up in due diligence review