Medical Directorships: Key Considerations, Fraud and Abuse Compliance, Lessons From Recent Enforcement

A live 90-minute CLE webinar with interactive Q&A


Tuesday, October 20, 2020

1:00pm-2:30pm EDT, 10:00am-11:30am PDT

or call 1-800-926-7926

This CLE webinar will provide guidance to healthcare counsel for medical directorship arrangements. The panel will discuss relevant healthcare laws and lessons from recent government enforcement activity. The panel will offer best practices to ensure compliance with applicable laws and avoid violations of these laws when entering into medical directorship and other physician administrative arrangements.

Description

Medical directorships and other physician administrative arrangements are common throughout the healthcare industry. Hospitals, health systems, and other healthcare stakeholders frequently engage physicians to serve as service line or organizational leaders and to lead or oversee organizational change, including initiatives to advance quality and value goals. However, although administrative arrangements often add value to an organization, parties must be aware of the potential pitfalls in such arrangements.

Historically, the government examines medical director and physician administrative arrangements with significant scrutiny. The federal Anti-Kickback Statute (AKS), which can attach both criminal and civil liability, prohibits anyone from offering or paying remuneration to induce or reward referrals for services paid for under federal healthcare programs. The Stark Law, which carries steep civil penalties, forbids certain medical providers from submitting Medicare claims for services provided to patients who were referred by a physician with whom the provider has a prohibited financial relationship, including, in many cases, a compensation arrangement that is not fair market value. The federal False Claims Act provides an avenue for identifying and magnifying liability under these and other laws. And, for not-for-profit entities, the stakes may be even higher as obligations of tax exemption bring scrutiny and potential financial consequences to compensation deemed unreasonable.

In the event an arrangement does not comply with applicable law, parties may be at risk of incurring substantial penalties. As such, it is important for parties to understand the legal and regulatory pitfalls of these arrangements and have strong compliance programs in place to prevent arrangements that are fraught with significant risk.

Listen as our authoritative panel of healthcare attorneys examines medical directorship arrangements. The panel will discuss key considerations the parties should keep in mind before entering directorship arrangements. The panel will examine healthcare fraud and abuse laws and lessons from recent government enforcement activity. The panel will offer best practices to ensure compliance with Stark, AKS, HIPAA and other applicable laws, and avoid violations of the healthcare fraud and abuse laws when entering into medical directorship arrangements.

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Outline

  1. Medical directorship arrangement risks
  2. Stark and AKS compliance
  3. Fraud and abuse compliance
  4. Recent government enforcement
  5. Best practices for structuring medical directorship arrangements
    1. Key provisions
    2. Valuation considerations

Benefits

The panel will review these and other key issues:

  • What are the characteristics and pitfalls of medical directorship arrangements? How do they vary based on circumstances?
  • What are the legal risks of medical directorships?
  • What key considerations should counsel keep in mind when structuring directorship arrangements, including related to scope of services, nature of services, who is performing them, and how and how much they are compensated?/li>

Faculty

Ferrari, Andrea
Andrea M. Ferrari, JD, MPH

Partner
HealthCare Appraisers

Ms. Ferrari focuses on physician payments related to hospital-physician alignment and efficiency improvement...  |  Read More

Sylla, Wesley
Wesley R. Sylla

Attorney
Hall Render Killian Heath & Lyman

Mr. Sylla practices in the area of health care law with a focus on hospital-physician arrangements and transactions,...  |  Read More

Wolfe, Joseph
Joseph N. Wolfe

Attorney
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

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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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