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
This CLE course 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.
- Brief overview of the Stark Law and the importance of compliance audits
- Stark Law overview
- The requirements of key exceptions
- Recent Changes to the Stark Law for 2016
- Risks inherent in hospital-physician transactions
- Sanctions for lack of compliance—penalties, denial of payments, exclusion from Medicare and Medicaid participation
- Process of auditing
- Audit priorities
- Fact gathering
- Common issues that arise in audits and resolutions to those issues
- Expired contracts
- Expired leases
- Absence of signed agreements
- Lack of FMV assessment
- Agreement is not commercially reasonable absent referrals
- Best practices for mitigating risks in physician arrangements and avoiding violations
- Policies and procedures
- Ongoing monitoring
- Post-payment reviews
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?
Curtis H. Bernstein, CPA/ABV, ASA, CVA, MBA
Pinnacle Healthcare Consulting
Mr. Bernstein specializes in providing valuation, transaction advisory, strategic and operational consulting services... | Read More
Mr. Bernstein specializes in providing valuation, transaction advisory, strategic and operational consulting services to clients. He has extensive experience working closely with hospital systems, physician groups, ambulatory surgery centers and other healthcare providers. He also provides valuation services in the areas of business valuation and complex compensation structures.Close
Joseph N. Wolfe
Hall Render Killian Heath & Lyman
Mr. Wolfe provides advice and counsel to many of the nation's largest health systems, hospitals and medical groups... | Read More
Mr. Wolfe provides advice and counsel to many of the nation's largest health systems, hospitals and medical groups on a variety of health care issues. He regularly counsels clients on a national basis regarding compliance-focused physician compensation strategies. Mr. Wolfe is a frequent speaker on issues related to the physician self-referral statute (Stark Law), hospital-physician transactions, physician compensation and health care fair market value issues. Before attending law school at the University of Wisconsin, he served as a combat engineer in the United States Army.Close