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About the Course
Introduction
This CLE course will review this government guidance through the lens of continuing and emerging risk areas seen in case law.
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.
Presented By
Ms. Ferrari is a member of Hancock Daniel’s corporate healthcare group, where she focuses on issues related to transactional and enterprise compensation planning, governance and review, particularly issues related to fair market value and commercial reasonableness. Although her past experience encompasses a multitude of regulatory, transactional, governance and investigation matters, Ms. Ferrari is known especially for her work in recruitment and retention of highly compensated thought leader physicians and executives; and incentive payment distributions through ACOs and clinically integrated networks to advance value-based care initiatives. She has worked extensively with clients navigating the intersection of regulatory and financial considerations in clinical research, including agreements for funding and support services and the related issues of contracting and compliance; transactional due diligence for compensation compliance; and navigating the intersection of compensation and antitrust issues. Ms. Ferrari's expertise also includes recruitment, compensation and procurement governance for “essential” hospitals such as public, rural, academic and pediatric hospitals.
Ms. Jacobs focuses her practice in the area of healthcare transactions. Calling upon her years of dedicated experience, she provides practical, pragmatic advice to help her clients achieve their strategic goals. Within the highly regulated health care industry, Ms. Jacobs advises clients, including hospitals, health systems, AMCs and large physician groups, on transactions. She serves as a regulatory adviser, providing fraud and abuse analysis in the context of a deal and ensuring her clients remain compliant with the regulations that govern health care transactions.
Mr. Wade has more than 25 years of experience in the healthcare industry and counsels clients on fraud and abuse issues, fair market value, commercial reasonableness and developing, monitoring, and documenting effective healthcare compliance programs. He serves clients nationally as a compliance professional and assists in negotiating and implementing corporate integrity agreements and in documenting and defending financial arrangements being of fair market value and commercially reasonable between healthcare providers. Mr. Wade has represented healthcare providers, including hospitals, large health systems, and referring physicians in such matters and has also represented healthcare clients under investigation by the U.S. Department of Justice and the Office of Inspector General.
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This 90-minute webinar is eligible in most states for 1.5 CLE credits.
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Live Online
On Demand
Date + Time
- event
Wednesday, October 23, 2024
- schedule
1:00 p.m. ET./10:00 a.m. PT
- New and evolving legal risk areas in compensation and other financial arrangements
- Under the Stark Law
- Under federal Anti-Kickback Statute
- Under federal False Claims Act
- Under federal, state, and local tax exemption laws
- Under federal and state antitrust laws
- Under other select federal and state laws and regulations
- Examples of enforcement activities and resulting liabilities in the evolving risk areas
- The due diligence process: how it may work, what it should do, and how it can shape transactions
- Tips and takeaways for healthcare transactions and compliance programs
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
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