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


Conducted on Wednesday, December 5, 2018

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar 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.

Description

Healthcare payors and providers are working to align financial incentives and allocate financial risk. As a result, providers managing patient care are absorbing more exposure to financial burden in exchange for greater potential financial gains. The healthcare industry continues to transition from a fee-for-service model to APMs.

Among the legal and regulatory issues relating to value-based contracting are state insurance laws, medical loss ratio (MLR) requirements, Medicare physician incentive plan (PIP) rules, the Anti-Kickback Statute (AKS), the Stark law, and the gainsharing portion of the Civil Monetary Penalties law.

Healthcare providers and their counsel need to understand the different options available along with the related regulatory issues for a health system to ensure compliance while shifting to a value-based model.

Listen as our authoritative panel discusses different payment models and the associated risks of the models. The panel will examine the related regulatory issues, including Stark and AKS compliance, as well as valuation, and provide insight for ensuring compliance.

READ MORE

Outline

  1. Different payment model options
  2. Associated risks of the models
  3. Legal issues and regulatory concerns
  4. 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

Lampert, Michael
Michael B. Lampert

Partner
Ropes & Gray

Mr. Lampert provides strategic, regulatory, and transactional advice to health care clients, including hospitals,...  |  Read More

Donald H. Romano
Donald H. Romano

Of Counsel
Foley & Lardner

Mr. Romano has extensive experience counseling hospitals, skilled nursing facilities and academic medical centers and...  |  Read More

Other Formats
— Anytime, Anywhere

Strafford will process CLE credit for one person on each recording. All formats include program handouts. To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video

48 hours after event

$297

Download

48 hours after event

$297