Any time a health care organization structures a contract involving physicians, it must be aware of the federal laws that are unique to the healthcare industry (e.g., the Stark Law, Anti-Kickback Statute, Civil Monetary Penalties Law, False Claims Act, etc.).
These laws affect any contract with physicians who are in a position to refer, including employment or service contracts, group compensation structures, joint ventures, leases for space or equipment, free or discounted items or services and virtually any other exchange of remuneration.
Why Should You Attend:
Given the substantial awards and settlements in recent enforcement actions, compensation-focused compliance in provider contracting has become more than just a compliance concern: it is now considered an enterprise risk management issue.
As health care organizations develop and implement provider contracts, they must manage their compliance and enterprise risk by ensuring the contracts are defensible under the applicable laws, both in substance and in technical detail. Recent government and qui tam enforcement actions have concentrated on technical noncompliance and alleged violations related to Three Key Tenets of Defensibility.
This webinar will include a “Contracting Toolkit” of best practices that health care organizations can follow to avoid compliance traps related to the technical requirements for payments to physicians and the Three Key Tenets of Defensibility: fair market value, commercial reasonableness, and not taking into account volume or value of referrals. The session will also recap trends in government and whistleblower enforcement.
Areas Covered
- Summarize the enforcement trends and the “Three Key Tenets of Defensibility.”
- Provide a focused review of the technical requirements of the health care laws.
- Describe emerging physician contracting compliance traps.
- Discuss the “Provider Contracting Toolkit” and best practices for enhancing defensibility.
Instructor
Joseph Wolfe is a partner with Hall Render, the largest health care focused law firm in the country, now with offices nationwide. Hall Render attorneys provide advice and counsel to many of the nation's largest health systems, hospitals and medical groups on a broad range of regulatory, operational and strategic matters. Mr. Wolfe regularly counsels clients on a national basis regarding compliance-focused physician governance, alignment and compensation strategies.
He is a frequent speaker and author on issues related to the physician self-referral statute (Stark Law), hospital-physician transactions, medical group structures, value-based payment strategies (MACRA, MIPS, APM, bundled payments, etc.), physician compensation and health care valuation issues. Before attending law school at the University of Wisconsin, he served as a combat engineer in the United States Army.