Private Direct/Concierge Medicine: Complying with Medicare Regulations, State Laws, and Business Regulations
Recording of a 90-minute CLE webinar with Q&A
This CLE course will provide a review of critical legal issues involved in organizing and operating various models of private direct healthcare practices (often referred to as concierge, direct care, integrative/Functional Medicine and connected care practices) and affiliated business models, including a discussion of compliance challenges and solutions.
Outline
- Private direct medicine practice and business models: Updated market trends
- Practice/business model variations
- Concierge practice models/businesses
- Integrative/functional healthcare
- Direct primary care/DPC
- Primary care innovation models: Updated business models
- Employer-funded models
- The future: Health data tracking, behavioral modification, and AI
- Legal considerations
- Medicare/Medicaid and private plan integration: The fork in the road
- State insurance and consumer protection laws
- State/Medical Board CPOM Issues
- Anti-kickback/anti-referral/improper remuneration
- IRC eligibility as "medical expenses" and HSA/HRA/FSA funds
- Employer funding: IRC & ERISA challenges
- Navigating data privacy & best practices
- Future regulatory trends: The rise of telehealth reimbursement and the need for private direct medicine compliance solution evolution
Benefits
The panelist will review these and other noteworthy questions:
- What are primary compliance challenges relating to federal and state laws applicable to private fee healthcare services?
- How do federal tax and employment laws impact the packaging and delivery of healthcare services to employees?
- Can private direct practice fees be packaged such that they may qualify as a "medical expense" such that they are eligible for HSA/HRA/FSA funds?
- What are the risks for Medicare compliance with private direct healthcare practices? What are the downsides to formally opting out of Medicare? Does opting out mitigate all risks?
Faculty

James J. Eischen, Jr.
Founder
Eischen Law Office & Lofty Learning
Mr. Eischen is a licensed California attorney with over 32 years of experience handling complex corporate,... | Read More
Mr. Eischen is a licensed California attorney with over 32 years of experience handling complex corporate, business planning, health care, and real estate matters. He is a national expert in creating compliant private fee practice models and structuring business transactional relationships with innovative healthcare and wellness models throughout the United States. His work has included compliance solutions for forming private fee practice models (concierge, direct primary care/DPC, integrative/Functional Medicine, connected care platforms) for self-employed healthcare professionals and larger provider networks and systems. Mr. Eischen also offers an extensive webinar library on forming innovative and compliant private direct practice models, concierge, DPC, connected care, health data tracking and guidance, as well as wellness empowerment for healthcare professionals at www.loftylearning.com.
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