Hospital Employment of Physicians: Stark Law and Anti-Kickback Statute Compliance, Physician-Hospital Alignment

Ms. Gross is a transactional and regulatory attorney whose knowledge of fraud and abuse law and managed care regulation allows her to help providers navigate a changing health care landscape. She frequently advises her clients on unique issues in the Medicare Advantage space and the regulation of value-based payment arrangements. Ms. Gross assists hospitals, health systems, medical groups, skilled nursing facilities, and other providers, as well as health services companies and digital health companies, in navigating payor relationships in their day-to-day operations, as well as entering into strategic partnerships and major transactions, including mergers and acquisitions. This involves counseling on fraud and abuse issues, including compliance with federal and state anti-kickback and self-referral laws, as well as state insurance licensing requirements, the corporate practice of medicine, and general corporate and regulatory compliance matters. She also frequently drafts and negotiates professional service and related agreements and assists clients in obtaining financing to meet their goals.

Mr. Oppenheim’s practice includes all aspects of transactional, operational and regulatory healthcare law, including mergers & acquisitions, affiliations, joint ventures and the formation of integrated delivery systems. Among his clients are many of the largest healthcare companies and hospital systems in the U.S. A nationally-recognized expert on anti-kickback and Stark Law issues, Mr. Oppenheim wrote the 2014 American Health Lawyers Association Monograph on Stark. He has served as an expert on anti-kickback and Stark Law issues in arbitration and litigation, in both civil and criminal proceedings. In addition, he creates and implements compliance programs, investigates compliance issues, responds to government enforcement actions, and negotiates settlements for many types of healthcare providers.

Mr. Ulrich is focused on providing valuation and consulting services for contractual service arrangements within the healthcare services industry. He has particular expertise in valuations relating to provider employment, on-call coverage, physician administrative and executive services, telemedicine, hospital-based coverage, management / billing, and quality initiatives. Prior to joining the Compensation Division, Mr. Ulrich worked in VMG Health’s Business Valuation division where he provided valuation services related to hospitals, specialty/surgical hospitals, ambulatory surgical centers, diagnostic imaging centers, and single and multi-specialty physician practices. He is currently designated as a Certified Valuation Analyst (CVA) and is a member of the National Association of Certified Valuation Analysts.