Alternative Payment Models and Related Regulatory Issues: Stark Law, Anti-Kickback Statute, Gainsharing, PIP, MLR
Recording of a 90-minute CLE webinar with Q&A
This CLE course will guide counsel for healthcare providers and payors on managing the shift from fee-for-service to value-based alternative payment models (APMs). The panel will discuss the different payment models and the associated risks of the models. The panel will also examine the related regulatory issues, including Stark and AKS compliance, as well as valuation.
Outline
- Different payment model options
- Associated risks of the models
- Legal issues and regulatory concerns
- Valuation issues
Benefits
The panel will review these and other principal issues:
- What different APM options do healthcare providers and payors have?
- What are the risks of each option? What are the regulatory issues for APMs?
- What hurdles do healthcare providers and payors face while shifting from a fee-for-service model to APMs?
Faculty
Michael B. Lampert
Partner
Ropes & Gray
Mr. Lampert provides strategic, regulatory, and transactional advice to health care clients, including hospitals,... | Read More
Mr. Lampert provides strategic, regulatory, and transactional advice to health care clients, including hospitals, universities, schools of medicine, medical device and pharmaceutical companies, investors, physician practices, laboratories, and emerging providers. He has extensive familiarity with fraud and abuse laws, in both an advisory and enforcement context, and other regulation such as Medicare reimbursement rules, requirements of the LCME and other accreditation bodies, the Food, Drug & Cosmetic Act, and HIPAA. Mr. Lampert also advises in mergers, acquisitions, restructurings, affiliations, and financings in both the for-profit and nonprofit context.
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Donald H. Romano
Special Counsel
Foley & Lardner
Mr. Romano has extensive experience counseling hospitals, skilled nursing facilities and academic medical centers and... | Read More
Mr. Romano has extensive experience counseling hospitals, skilled nursing facilities and academic medical centers and health systems on compliance, reimbursement and litigation issues involving the complex array of federal regulations governing relationships with physicians. He counsels clients on payment issues relating to the Medicare and Medicaid programs, and regulatory compliance matters, particularly those pertaining to the Anti-Kickback Statute, the physician self-referral statute (Stark Law), HIPAA, and the Medicare enrollment regulations. He previously was a partner in another D.C. based law firm, and prior to that he had over 25 years of experience in the Department of Health and Services, including as a senior attorney in the Office of General Counsel.
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