Structuring Physician Compensation Arrangements

Physician compensation arrangements are increasingly sophisticated and present liability risks. Recent enforcement actions involving compensation arrangements and guidance published by the Office of Inspector General (OIG) put physicians on notice that compensation arrangements must be for bona fide services and at fair market value (FMV).

Compensation arrangements must also comply with the Stark law and FCA, among others. Any attempt to compensate a physician for past or future referrals may violate the Anti-Kickback Statute (AKS) and expose the parties to penalties and sanctions, including exclusion from Medicare and other federal healthcare programs.

Similarly, risks for fraud in compensation arrangements are rife; key risk areas include reporting, accounting practices, descriptions of work performed, and more. Healthcare counsel must seek to minimize liability exposure while ensuring compliance when structuring physician compensation arrangements.

Listen as our authoritative panel of healthcare attorneys examines the legal requirements for physician compensation arrangements and addresses commercial reasonableness and FMV issues. The panel will also discuss lessons that can be learned from recent enforcement actions and will offer best practices for structuring and auditing physician compensation arrangements.

I. Legal requirements for physician compensation arrangements

A. Stark Law

B. AKS

C. FCA

II. Commercial reasonableness and FMV

A. Understanding regulatory definitions and application to operations

B. Compensation stacking

C. Physician losses

III. Enforcement

IV. Best practices for structuring and auditing physician compensation arrangements

The panel will review these and other key issues:

• What steps can healthcare advisers take to ensure regulatory compliance when valuing physician compensation?
• What are the implications for compliance with the Stark Law, the AKS, and other laws and regulations?
• What lessons can healthcare counsel take away from recent enforcement actions?