Co-Management Arrangements in Healthcare: Compliance in Hospital-Physician Arrangements
Recording of a 90-minute CLE webinar with Q&A
This CLE course will provide guidance to counsel for healthcare facilities and physicians on the legal implications of co-management arrangements. The panel will review applicable laws, regulations, and fair market value considerations to structure the arrangements to meet compliance requirements.
Outline
- Co-management arrangements defined
- Service line co-management arrangements
- Model
- Payment arrangements
- Key regulatory concerns
- Civil monetary penalty statute
- Anti-kickback statute
- Physician self-referral statute (Stark)
- False Claims Act
- Provider-based status rules
- Tax exemption/intermediate sanctions
- Antitrust
- Co-management arrangements: hospital vs. physician perspective
- Fair market value and business considerations
Benefits
The panel will review these and other key issues:
- What steps can hospitals, physicians, and their counsel take to ensure compliance with healthcare laws?
- What are the critical regulatory concerns for healthcare providers considering co-management arrangements?
- What are the key drivers of the valuation process regarding these arrangements?
- What are some common pitfalls to avoid in these arrangements?
Faculty
Thomas E. Dutton
Partner
Jones Day
For 38 years, Mr. Dutton has helped hospitals, health systems, insurance companies, and large physician groups design... | Read More
For 38 years, Mr. Dutton has helped hospitals, health systems, insurance companies, and large physician groups design and successfully implement cutting-edge integration and delivery strategies. He has led deal teams in innovative service line revenue mergers; dozens of hospital, HMO, insurance company, and clinical laboratory mergers, acquisitions, and joint operating agreements; statewide/multistate health system collaboratives; and distressed company transactions. Mr. Dutton has handled dozens of specialty/primary care physician practice acquisitions, including physician private equity transactions, and developed regulatory-compliant physician employment compensation models, created dozens of provider-based clinics and co-management arrangements, developed accountable care organizations (ACOs) and advised regarding the use of ACO waivers, and implemented every type of physician-hospital joint venture. Mr. Dutton is a frequent lecturer at national conferences on the latest models for physician-hospital integration and has authored numerous articles on health law-related topics.
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Jeffrey L. Kapp
Partner
Jones Day
Mr. Kapp practices in the area of healthcare transactions and has more than 25 years of experience in M&A and... | Read More
Mr. Kapp practices in the area of healthcare transactions and has more than 25 years of experience in M&A and various types of unique and innovative joint ventures, affiliations, and outsourcing transactions. He represents hospitals and health systems in strategic transactions, such as hospital mergers and acquisitions, joint ventures, and contractual arrangements, including transactions involving ambulatory surgery centers, hospice and home health services, and federally qualified health centers. Mr. Kapp also represents hospitals and health systems in a variety of physician contracting matters, including co-management, recruitment, employment, medical director, and hospital-based physician agreements. He also has represented these clients regarding significant business functions, such as the negotiation of strategic supply management, equipment leasing, and consulting agreements. Mr. Kapp counsels health systems, hospitals, emergency medical service providers, academic medical centers, and medical device companies regarding compliance matters, including Medicare fraud and abuse and Stark Law compliance, tax-exempt organization rules, HIPAA's privacy and security regulations, security breach notification laws, and other general health law issues. His outsourcing practice focuses on negotiating and drafting customer-side transactions for information technology, benefit plan administration, and other administrative services.
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William T. (Bill) Mathias
Shareholder
Baker Donelson Bearman Caldwell & Berkowitz
Mr. Mathias represents clients across the U.S. in all areas of the health care industry, with a particular emphasis on... | Read More
Mr. Mathias represents clients across the U.S. in all areas of the health care industry, with a particular emphasis on fraud and abuse, internal and government investigations, and corporate compliance matters. His practice focuses on advising clients on compliance with the federal antikickback law, the Stark physician self-referral statute and the federal civil monetary penalty provisions. He also advises health systems and GPOs on compliance with the discount and GPO safe harbors as well as strategies for reducing legal risks associated with cutting edge supply chain management and purchasing programs. He is a former vice chair of the American Health Lawyers Association’s Fraud & Abuse Practice Group.
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