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Course Details

Course Information
  • smart_display Format

    On-Demand

  • signal_cellular_alt Difficulty Level

  • work Practice Area

    Health

Date & Time
  • event Date

    Tuesday, March 31, 2020

  • schedule Time

    1:00 p.m. ET./10:00 a.m. PT

  • timer Program Length

    90 minutes

Credit Information

  • This 90-minute webinar is eligible in most states for 1.5 CLE credits.

$297.00
CLE
ALL

This CLE course will guide counsel to healthcare providers on auditing hospital-physician arrangements to ensure compliance with the Stark Law. The panel will offer best practices for mitigating the risks in physician arrangements and avoiding violations.

Faculty

Joseph Wolfe
Attorney
Hall, Render, Killian, Heath & Lyman PC

Mr. Wolfe provides advice and counsel to many of the nation's largest health systems, hospitals and medical groups on a variety of health care issues. He regularly counsels clients on a national basis regarding compliance-focused physician compensation strategies. Mr. Wolfe is a frequent speaker on issues related to the physician self-referral statute (Stark Law), hospital-physician transactions, physician compensation and health care fair market value issues. Before attending law school at the University of Wisconsin, he served as a combat engineer in the United States Army.      

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Allison Carty
Director
Pinnacle Healthcare Consulting

Mr. Carty joined Pinnacle in late 2015 as a Director of Compensation Valuation following nearly a decade of experience focused on physician-hospital arrangements. She focuses on physician compensation and related plan structuring and compliance. In addition to valuation work, Ms. Carty maintains an interest in health care regulatory matters pertaining to physician-hospital transactions, including requirements associated with commercial reasonableness.

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Description

Healthcare reform invigorated the government's focus on healthcare fraud, including enforcement of the Stark Law. Improper design and implementation of hospital-physician arrangements can result in penalties, denial of payments, and exclusion from federal healthcare programs.

Proposed new Stark Law exceptions for "value-based arrangements"--along with other changes to Stark Law--will apply broadly to compensation arrangements between physicians and hospitals, other healthcare providers, and qualifying payors. Healthcare counsel must ensure compliance.

Internally auditing hospital-physician arrangements is crucial to ensuring Stark compliance. Our panel will offer best practices to counsel for healthcare providers to minimize liability exposure and penalties, including conducting compliance audits, instituting policies, and establishing ongoing monitoring and reviews.

Listen as our panel of healthcare attorneys and advisers discusses the auditing process and examines the issues that arise in audits and the resolutions to those issues. The panel will offer their perspectives and experiences to mitigate the risks in physician arrangements and to avoid Stark violations.

Outline

  1. A brief overview of the importance of compliance audits
    1. Risks inherent in hospital-physician transactions
    2. Sanctions for lack of compliance: penalties, denial of payments, exclusion from Medicare and Medicaid participation
  2. Process of auditing
    1. Audit priorities
    2. Fact gathering
  3. Common issues that arise in audits and resolutions to those issues
    1. Expired contracts
    2. Expired leases
    3. Absence of signed agreements
    4. Lack of FMV assessment
    5. Agreement is not commercially reasonable absent referrals
  4. Best practices for mitigating risks in physician arrangements and avoiding violations
    1. Policies and procedures
    2. Ongoing monitoring
    3. Post-payment reviews

Benefits

The panel will review these and other vital questions:

  • What are the inherent risks in hospital-physician arrangements for Stark violations?
  • What issues do audits often flag--and what steps can counsel take to resolve those issues?
  • What practices can counsel and providers employ to reduce the risks of compliance violations under Stark?