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  • videocam On-Demand
  • 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

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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 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.

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.

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.

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?