Private Direct/Concierge Medicine: Complying With Medicare Regulations, State Laws, and Business Regulations
Recording of a 90-minute CLE video webinar with Q&A
This CLE course will provide a review of pertinent 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.
- General Overview of Private Direct Medicine Practice
- Practice/Business Model Variations
- Concierge practice models/businesses
- Integrative/functional healthcare
- Direct primary care
- Primary care innovation models: updated business models
- Employer-funded models
- Legal considerations
- State/medical board CPOM and ethical issues
- PC/MSO arrangements
- State insurance and consumer protection laws
- Anti-kickback/anti-referral/improper remuneration
- Medicare/Medicaid and private plan integration
- IRC eligibility as "medical expenses" and HSA/HRA/FSA funds
- Employer funding: IRC and ERISA challenges
- Future market and regulatory trends
- The rise of telehealth offerings and reimbursement challenges and the need for private direct medicine compliance solution evolution
The panel 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?
- What are the state laws and ethical prohibitions that limit or restrict the organizational structure and operations under these models?
- 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?
Charles C. Dunham, IV
Mr. Dunham is a corporate healthcare attorney providing counsel in business, regulatory, compliance, reimbursement, and... | Read More
Mr. Dunham is a corporate healthcare attorney providing counsel in business, regulatory, compliance, reimbursement, and white-collar defense matters. He represents an array of healthcare providers, suppliers, and other health-related entities with a distinct focus on the laboratory and telehealth industries. Mr. Dunham also advises private equity firms and venture capital groups on their investments in the healthcare industry, including due diligence reviews of target acquisitions, negotiated contracts, and health regulatory compliance by such investments post-closing.Close
James J. Eischen, Jr.
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.Close