Physician-Hospital Clinical Integration: Navigating the Complexities

Outline

1. Compliance with antitrust law
   1. Limitations on provider network
   2. Core elements of clinically integrated provider network within the meaning of antitrust law
   3. Competitive activities provider participants in a clinically integrated provider network may engage in
   4. Significant of exclusive v. non-exclusive provider network under antitrust law
2. Issues facing ACOs under
   1. Anti-kickback law
   2. Stark law
   3. Civil monetary penalty
3. Tax exempt status
   1. Qualification for tax exempt status under section 501(c)(3) or (c)(4)
   2. Structure of service contract arrangements
4. Practical do's and dont's
   1. Feasibility and gap analysis
   2. Payment and clinical episodes
   3. Infrastructure and data issues
   4. Physicians and hospital alignment

Benefits

The panel will review these and other key questions:

• What are the core elements of a clinically integrated provider network within the meaning of the antitrust laws?
• What issues do ACOs face under anti-kickback and Stark laws?
• How do service contract arrangements have to be structured to avoid jeopardizing the hospital's tax exempt status?

Following the speaker presentations, you'll have an opportunity to get answers to your specific questions during the interactive Q&A.