BarbriSFCourseDetails
  1. keyboard_arrow_leftBack

Course Details

Course Information
  • smart_display Format

    On-Demand

  • signal_cellular_alt Difficulty Level

    Intermediate

  • work Practice Area

    Health

Date & Time
  • event Date

    Thursday, June 29, 2023

  • 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 provide a review of key legal issues involved in forming physician supergroups, including applicable laws and regulations, as well as business considerations. The panel will offer guidance on structuring practice management arrangements and selecting compensation models.

Faculty

Adria Warren
Partner
Foley & Lardner LLP

Ms. Warren is a healthcare M&A and regulatory lawyer with deep experience advising hospitals, providers, and healthcare enterprises on complex transactions, corporate, and regulatory compliance matters. Her experience includes mergers, acquisitions, joint ventures, and other affiliations and strategic transactions; forming provider groups, networks, and alliances; and advising on fraud and abuse and HIPAA compliance, employment, reporting and disclosure requirements, and marketing compliance.  Ms. Warren has over two decades of experience and brings a wealth of business and transactional experience to assist clients in the healthcare industry, including providers, private equity, medical device companies, life sciences companies, and healthcare IT companies. In addition, she counsels entrepreneurs and established companies on a wide range of day-to-day legal and business issues from starting-up through going public, including corporate governance issues, securities laws compliance, tax, and employment matters. 

expand_circle_down Expand to View Full Bio expand_circle_up Collapse Bio
Hannah E. Zaitlin
Partner
Foley & Lardner LLP

Ms. Zaitlan focuses on advising providers and investors in the healthcare sector on mergers, acquisitions and affiliations, entity formation and restructurings, corporate and non-profit governance, debt and equity financings, and commercial contracting. She frequently counsels clients on a range of healthcare compliance and regulatory matters, including state and federal fraud and abuse laws, HIPAA, professional and facility licensure and change of ownership requirements, and payor/reimbursement issues.

expand_circle_down Expand to View Full Bio expand_circle_up Collapse Bio

Description

Healthcare organizations are facing increased pressure to improve quality while cutting costs. Physicians are banding together to form supergroups to achieve scale to generate cost efficiencies. Physician consolidation can improve the group's negotiating position with payers and make the provision of ancillary services possible.

However, supergroup formation is not without its challenges. There are structural issues and regulatory hurdles to consider when creating supergroups. The parties should consider the type of entity to form, the impact on reimbursement, and Stark Law requirements.

Another consideration is the application of the Anti-Markup Rule, which prohibits a billing physician or supplier from marking up either the technical component or professional component of a diagnostic test ordered by the billing physician or supplier unless the performing physician shares a practice with the billing physician or supplier.

If the performing physician does not share a practice with the billing physician or supplier, then the rule applies; the healthcare provider/supplier cannot bill Medicare an amount that exceeds payment to the physician.

Listen as our authoritative panel examines the structural and regulatory challenges involved when forming physician supergroups, including Stark and Anti-Markup Rule compliance and the impact of ancillary services.

Outline

  1. Structural considerations in forming a supergroup
    1. Due diligence
    2. Governance
    3. Entity structure
    4. Distribution of profits
  2. Regulatory challenges
    1. Federal and state Stark laws
    2. Federal Anti-Markup Rule
  3. Best practices for forming physician supergroups

Benefits

The panel will review these and other high priority issues:

  • What are the critical legal and business concerns for physicians considering forming a physician supergroup?
  • What considerations should healthcare counsel weigh when selecting the appropriate legal entity for the business?
  • What are the main regulatory hurdles under Stark with forming and operating a physician supergroup?