Professional Services Agreements: A Physician-Hospital Integration Model

Complying With Stark Law and Anti-Kickback Statute, Protecting Tax Status, and Avoiding Key Deal Breakers

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


Conducted on Wednesday, May 25, 2016

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will provide guidance to counsel for hospitals and physician groups on leveraging the benefits and confronting the legal challenges of professional services agreements (PSAs).

Description

PSAs provide hospitals and doctors an alternative to physician employment. When structured properly, PSAs can align hospitals and contracting medical groups to improve the quality and efficiency of healthcare services.

PSAs are a means of integrating hospitals and physicians to transform fragmented care processes into integrated healthcare models. They can be beneficial for the hospital, physicians and patients and allow for increased flexibility to unwind the arrangements if the goals of the parties change.

Recent Stark Law cases and settlements, as well as Section 603 of the Bipartisan Budget Act, have impacted PSAs. Counsel must carefully structure the PSA to achieve physician-hospital alignment while complying with Stark and anti-kickback laws and maintaining tax exempt status.

Listen as our authoritative panel of healthcare attorneys provides an overview of the key legal, business and valuation issues implicated in PSAs, including Stark law and anti-kickback compliance, and other key PSA issues. The panel will offer best practices for determining whether a PSA is the optimal model to use and, if so, for getting the deal done.

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Outline

  1. Key legal issues involved in PSAs
    1. Stark law
    2. Anti-kickback statute
    3. Reassignment rules
    4. Provider based status regulations
    5. Tax exemption
    6. Antitrust
  2. Valuation issues
    1. Determining an appropriate productivity metric (i.e., work relative value units (wRVUs))
    2. Determining market rate of compensation
    3. Appropriate productivity calculation for physicians and non-physician providers, multiple procedures, etc.
    4. Dealing with ancillary revenues
    5. Dealing with non-salary expenses: “pass through” or “gross up”
    6. Perils of compensation stacking
  3. Key deal maker/breaker issues
    1. Governance
    2. Exclusivity
    3. Harmonizing payment methodology with performance standards
    4. Term/duration
    5. Staffing issues
    6. Restrictive covenants
    7. Unwind rights
    8. Impact on patient co-pays and payors

Benefits

The panel will review these and other key issues:

  • What are the benefits of PSAs for hospitals and physician groups?
  • What anti-kickback and Stark law issues do PSAs face?
  • What are the best practices for structuring PSAs to avoid jeopardizing the hospital’s tax exempt status?

Faculty

Blau, Michael
Michael L. Blau

Partner
Foley & Lardner

Mr. Blau's practice focuses on advising clients on corporate and regulatory matters, including mergers,...  |  Read More

Safriet, Scott
Scott M. Safriet

Partner
HealthCare Appraisers

Mr. Safriet has over 15 years of broad healthcare experience, the last five of which have been spent exclusively...  |  Read More

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