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 video webinar with Q&A
This CLE course will guide healthcare counsel on ensuring compliance with the Anti-Kickback Statute (AKS) and Stark law in managed care contracting and downstream 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.
Outline
- Application of the AKS, Stark laws, and applicable safe harbors and exceptions
- Physician incentive plan rules
- 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 a physician constitute a financial arrangement under Stark?
- What rules are applicable when structuring downstream provider arrangements?
- What is the scope of the AKS and Stark safe harbors and exceptions?
- What are the exceptions and safe harbors in AKS and Stark that create flexibility for managed care contracts and downstream provider arrangements?
Faculty
Alexandra B. Shalom
Attorney
Foley & Lardner
Ms. Shalom focuses on counseling clients in the health care, pharmacy, and medical device industries with respect to a... | Read More
Ms. Shalom focuses on counseling clients in the health care, pharmacy, and medical device industries with respect to a wide range of regulatory and compliance matters. Her experience includes advising clients on Medicare and Medicaid reimbursement; internal investigations; managed care and value based payment arrangements; self-disclosures; federal and state fraud and abuse compliance; and state licensure issues. She also assists health care clients with a broad range of transactional matters, including mergers and acquisitions and formation of friendly professional corporations.
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Torrey K. Young
Partner
Mukasey Frenchman
Ms. Young represents clients in the health care and life sciences industries. A leader in her field, she has a wealth... | Read More
Ms. Young represents clients in the health care and life sciences industries. A leader in her field, she has a wealth of experience defending clients in civil and criminal government enforcement actions and cases arising out of the False Claims Act. She conducts internal investigations, provides fraud and abuse analyses, and advises her clients on Medicare/Medicaid reimbursement issues. She also implements compliance programs and assesses their effectiveness, as well as counsels clients on clinical research, research misconduct, and grant fraud. Her versatility is reflected in her representation of many different types of entities, including health systems, universities, laboratories, home health agencies, hospices, telehealth companies, pharmacy benefit managers, pharmaceutical companies, and DMEPOS companies.
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