Medical Office Leases: Navigating Stark Law, Anti-Kickback Statute, Operational Restrictions and More

Drafting to Address Reciprocal Easements, Ground Leases, HIPAA, ADA, and Environmental Issues Unique to Medical Office Use

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

Conducted on Wednesday, April 19, 2017

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will prepare real estate counsel to draft medical office leases that address regulatory and operational restrictions associated with medical office space. The panel will discuss how to draft leases which qualify for an exemption under the federal Stark Law and a safe harbor under the federal Anti-Kickback Statute, how hospital affiliations and environmental concerns may impact lease provisions, and more.


Medical office leases differ from standard commercial leases in several respects. There may be development and title issues unique to a medical office building (MOB) because it may be located within a hospital campus and may be subject to medical use restrictions and easements which impact its operation.

The hospital owner often desires to retain fee ownership of an entire medical campus, so the MOB might also be subject to a ground lease. Counsel for the landlord or the tenant will want to see these matters addressed in the lease.

There are also federal regulations that must be considered in drafting medical office leases. Medical office leases may be subject the Stark Law or the Anti-Kickback Statute, which apply to referrals for services payable under federal healthcare programs.

Leases meeting specified criteria comply with federal Stark and Anti-Kickback regulations; care must be taken in drafting leases which qualify for an exception and/or safe harbor. MOB leases should also address the obligations of the landlord and the tenant with regard to HIPAA, ADA and environmental compliance.

Listen as our authoritative panel discusses development and regulatory issues associated with medical office leases. The panel will review the operational constraints often presented by restrictive covenants, easements and ground leases affecting MOBs, the best leasing practices for achieving compliance with the Stark Law and the Anti-Kickback Statute, and compliance with HIPAA, ADA and environmental regulations particular to medical offices.



  1. Development and title matters that should be addressed in medical office leases
    1. Reciprocal easements and operational covenants relating to affiliated hospital
    2. Addressing ground lease of medical office building
  2. The Stark Law and the Anti-Kickback Statute
    1. Potential liability for landlords and tenants
    2. Exemptions from the statutes—drafting considerations
  3. Environmental issues particular to medical offices—hazardous waste disposal
  4. HIPAA
  5. ADA and other considerations


The panel will review these and other key issues:

  • Is there an affiliate relationship between the MOB and an existing hospital that will affect the obligations of the landlord or the tenant under a medical office lease?
  • What kinds of restrictions or easements should be addressed in the lease?
  • What leasing criteria must be satisfied to comply with the Stark Law and the Anti-Kickback Statute?
  • How should HIPAA be addressed in a medical office lease?
  • What are the other key provisions particular to a medical office lease?


Dick, Andrew
Andrew Dick

Hall Render Killian Heath & Lyman

Mr. Dick’s practice focuses on real estate transactions and environmental law. He advises hospitals and...  |  Read More

Nelson, Allison
Allison Nelson


Ms. Nelson focuses her practice on real estate and healthcare, guiding clients through complex commercial real...  |  Read More

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