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 premium CLE webinar with Q&A

Conducted on Tuesday, October 20, 2020

Recorded event now available

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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 develop agreements that 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 agreement.

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

Leases require specified criteria to comply with federal Stark and Anti-Kickback regulations and to qualify for an exception and/or safe harbor. MOB leases should also address the obligations of the landlord and the tenant about HIPAA, ADA, and environmental compliance.

Listen as our authoritative panel discusses the 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 impacting 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 to address in medical office leases
    1. Reciprocal easements and operational covenants relating to an affiliated hospital
    2. Ground lease of MOB
  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 impact the obligations of the landlord or the tenant under a medical office lease?
  • What are the kinds of restrictions or easements to address 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 provisions particular to a medical office lease?


Maruca, William
William H. Maruca

Fox Rothschild

Mr. Maruca has extensive experience in healthcare law, including Medicare compliance. He counsels hospitals and...  |  Read More

Pinna, James
James M. Pinna

Hunton Andrews Kurth

Mr. Pinna advises health care clients on matters involving regulatory compliance (including fraud and abuse, licensure,...  |  Read More

Shay, Daniel
Daniel F. Shay

Alice G. Gosfield and Associates

Mr. Shay’s practice is restricted to health law and health care regulation focusing primarily on physician...  |  Read More

Vowell, Mark
Mark R. Vowell

Hunton Andrews Kurth

Mr. Vowell represents investors, landowners, developers, retailers, public companies and private equity funds in...  |  Read More

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