Auditing Hospital-Physician Arrangements Under the New 2016 Stark Rules: Mitigating Provider Liability

Implementing Monitoring Processes to Avoid Penalties, Denial of Payment, and CMS Program Exclusion

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


Conducted on Tuesday, April 12, 2016

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will provide guidance for counsel to healthcare providers on auditing hospital-physician arrangements to ensure compliance with the Stark Law. The panel will offer best practices for mitigating the risks in physician arrangements and avoiding violations.

Description

Healthcare reform has invigorated the government’s focus on healthcare fraud, including enforcement of the Stark Law. Improper design and implementation of hospital-physician arrangements can result in penalties, denial of payments and exclusion from federal healthcare programs.

The panel will also offer best practices to counsel for healthcare providers to minimize liability exposure and penalties, including conducting compliance audits, instituting policies, and establishing ongoing monitoring and reviews.

Listen as our panel of healthcare attorneys and advisors discusses the auditing process and examines the issues that arise in audits and the resolutions to those issues. The panel will offer their perspectives and experiences to mitigate the risks in physician arrangements and to avoid Stark violations.

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Outline

  1. Brief overview of the Stark Law and the importance of compliance audits
    1. Stark Law overview
    2. The requirements of key exceptions
    3. Recent Changes to the Stark Law for 2016
    4. Risks inherent in hospital-physician transactions
    5. Sanctions for lack of compliance—penalties, denial of payments, exclusion from Medicare and Medicaid participation
  2. Process of auditing
    1. Audit priorities
    2. Fact gathering
  3. Common issues that arise in audits and resolutions to those issues
    1. Expired contracts
    2. Expired leases
    3. Absence of signed agreements
    4. Lack of FMV assessment
    5. Agreement is not commercially reasonable absent referrals
  4. Best practices for mitigating risks in physician arrangements and avoiding violations
    1. Policies and procedures
    2. Ongoing monitoring
    3. Post-payment reviews

Benefits

The panel will review these and other key issues:

  • What are the inherent risks in hospital-physician arrangements for Stark violations?
  • What issues are often flagged in audits and what steps can counsel take to resolve those issues?
  • What practices can counsel and providers employ to reduce the risks of compliance violations under Stark?
  • How will the new 2016 Stark Law changes impact how healthcare providers audit their hospital-physician arrangements?

Faculty

Curtis H. Bernstein, CPA/ABV, ASA, CVA, MBA
Curtis H. Bernstein, CPA/ABV, ASA, CVA, MBA
Managing Director
Pinnacle Healthcare Consulting

Mr. Bernstein specializes in providing valuation, transaction advisory, strategic and operational consulting services...  |  Read More

Joseph N. Wolfe
Joseph N. Wolfe

Partner
Hall Render Killian Heath & Lyman

Joseph Wolfe is a partner with Hall, Render, Killian, Heath & Lyman, P.C., the largest health care focused law firm...  |  Read More

Other Formats
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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:

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