• videocam On-Demand Webinar
  • signal_cellular_alt Intermediate
  • card_travel Health
  • schedule 90 minutes

Professional Services Arrangements: Stark Law and AKS Compliance, Finding the Best Model, Avoiding Key Deal Breakers

$297.00

This course is $0 with these passes:

CLE
ALL
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About the Course

Introduction

This CLE webinar will provide an overview of the key legal, business, and valuation issues implicated in professional services arrangements (PSAs), including Stark Law and anti-kickback compliance, and other key PSA issues. The panel will offer best practices for determining whether a PSA is the optimal model to use and, if so, for getting the deal done.

Description

PSAs provide hospitals and physicians an alternative to physician employment. When structured properly, PSAs can align hospitals and contracting medical groups to improve the quality and efficiency of healthcare services.

PSAs are a means of integrating hospitals and physicians to transform fragmented care processes into integrated healthcare models. They can be beneficial for the hospital, physicians, and patients and allow for increased flexibility to unwind the arrangements if the goals of the parties change.

Recent Stark Law changes and enforcement cases have impacted PSAs. Counsel must carefully structure the PSA to achieve physician-hospital alignment while complying with Stark, its state counterparts, and state and federal anti-kickback laws, as well as tax-exempt status when applicable.

Listen as our authoritative panel of healthcare attorneys provides an overview of the key legal, business, and valuation issues implicated in PSAs, including Stark Law and anti-kickback compliance and other key PSA issues. The panel will offer best practices for determining whether a PSA is the optimal model to use and, if so, for getting the deal done.

Presented By

Andrea Ferrari
Senior Counsel
Hancock Daniel & Johnson PC

Ms. Ferrari is a nationally recognized expert on fair market value and commercial reasonableness, the "Big Three" and their role in regulatory compliance, investigations, and litigation. She has authored over 100 publications and presentations on topics related to physician and healthcare provider compensation, contracting, investigations, and related ethical issues. She is known for her work with rural, academic, public, and clinically integrated, value-based healthcare systems. Ms. Ferrari's focus areas include compensation review for compliance with fraud and abuse laws, tax-exempt regulations, antitrust laws, anti-discrimination laws, and assisting clients in transition to value-based payments, including structuring participation agreements, compensation plans and incentive payments in the context of coordinated care and provider alignment strategies, such as clinically integrated networks, ACOs, gainsharing and "Hospital Quality and Efficiency Programs." Prior to joining Hancock Daniel, she was Principal and GC for a national advisory and healthcare solutions firm and a Partner at a well-known national compensation consulting and advisory firm, where she led the service line focused on CINs, ACOs, and other value-based care structures and worked with clinically integrated network and ACO participants across the U.S.

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Alyssa C. James
Shareholder
Hall, Render, Killian, Heath & Lyman PC

Ms. James works with clients in numerous aspects of health care law. Her work involves counsel regarding hospital/physician contracting matters, hospital and health system relationships, regulatory and compliance issues, organization governance and hospital/physician alignment. Ms. James regularly counsels clients on a national basis regarding fraud and abuse matters, including analyses related to federal Stark, Anti-Kickback and Civil Monetary Penalties laws.

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Wesley R. Sylla
Compliance Director - Investigations & Incidents
Ascension Health

Mr. Sylla has a decade of experience in helping hospitals and health systems comply with healthcare's fraud and abuse regulatory framework. Specializing in provider compensation arrangements, Mr. Sylla has used that experience to develop compensation plans, investigate and audit provider arrangements, and resolve problematic arrangements with governmental agencies.

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Credit Information

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


  • Live Online


    On Demand

Date + Time

  • event

    Thursday, November 30, 2023

  • schedule

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

  1. Key legal issues involved in PSAs
    1. Stark Law
    2. Anti-Kickback Statute
    3. Value-based rules
    4. Reassignment rules
    5. Provider-based status regulations
    6. Tax exemption
    7. Antitrust
  2. Valuation issues
    1. Determining an appropriate productivity metric (i.e., work relative value units (wRVUs))
    2. Determining market rate of compensation
    3. Appropriate productivity calculation for physicians and non-physician providers, multiple procedures, etc.
    4. Dealing with ancillary revenues
    5. Dealing with non-salary expenses: "pass through" or "gross up"
    6. Perils of compensation stacking
  3. Key deal maker/breaker issues
    1. Governance
    2. Exclusivity
    3. Harmonizing payment methodology with performance standards
    4. Term/duration
    5. Staffing issues
    6. Restrictive covenants
    7. Unwind rights

The panel will review these and other key issues:

  • What are the benefits of PSAs for hospitals and physician groups?
  • What anti-kickback and Stark Law/physician self-referral issues do PSAs face?
  • What are the additional issues for tax-exempt and for profit entities, respectively?
  • What does the recent case law say?
  • What are the best practices for determining the optimal PSA model to use?