Anti-Kickback Statute and Stark Law Compliance in Managed Care Contracts

Navigating Safe Harbors and Physician Incentive Plan Rules, Limiting Civil Monetary Penalty Exposure

Recording of a 90-minute CLE webinar with Q&A


Conducted on Wednesday, May 9, 2018

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will guide healthcare counsel on ensuring compliance with the Anti-Kickback Statute (AKS) and Stark law in managed care contracting and down-stream provider arrangements. The panel will also provide best practices for counsel on structuring arrangements to fit within the AKS safe harbors and Stark exceptions and the applicable physician incentive plan rules.

Description

As providers enter into new payment models, the federal government continues its focus on reigning in healthcare fraud, including ensuring provider compliance with the AKS and Stark law. The AKS and Stark laws provide several safe harbors and exceptions that shield healthcare providers from the prohibitions outlined by the AKS and Stark. These safe harbors, such as those for eligible managed care organizations, create flexibility in managed care contracting and allow payment arrangements that could otherwise present a risk of violating the AKS.

Counsel for healthcare providers and payers must consider the requirements of the AKS and Stark law and the safe harbors and exceptions when contracting with managed care companies and when structuring down-stream arrangements with providers. Counsel must also understand when physician incentive payments are subject to Civil Monetary Penalty (CMP) Statute liability, or conversely, are protected under the PIP rules.

Listen as our authoritative panel of health law counsel reviews the various AKS safe harbors potentially applicable to managed care arrangements and downstream provider arrangements. The presenters will address situations that trigger Stark concerns, examine the Stark exceptions for managed care arrangements and safe harbors, and discuss the CMP Statute and the PIP rules. The panel will also outline guidance for counsel to healthcare providers and payers on structuring arrangements to fit within the AKS safe harbors and Stark exceptions and the PIP rules for managed care contracting.

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Outline

  1. Application of the AKS, the Stark law and the safe harbors
  2. Physician incentive plan rules
  3. Civil monetary penalty exposure

Benefits

The panel will review these and other key issues:

  • When does a risk-sharing arrangement between a managed care organization and physician constitute a financial arrangement under Stark?
  • What rules are applicable when structuring down-stream provider arrangements?
  • What is the scope of the AKS and Stark safe harbors?
  • What are the exceptions in AKS and Stark that create flexibility for managed care contracts and down-stream provider arrangements?

Faculty

Bortniker, Alexis
Alexis Finkelberg Bortniker

Partner
Foley & Lardner

Ms. Bortniker is a member of the firm’s Healthcare Industry Team. Her practice focuses on transactional and...  |  Read More

Gabrielsen, Lindsey
Lindsey E. Gabrielsen

Atty
Foley & Lardner

Ms. Gabrielsen is a member of the firm’s Government Enforcement Defense & Investigations Practice 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