Professional Services Arrangements: Stark Law and AKS Compliance, Finding the Best Model, Avoiding Key Deal Breakers
Recording of a 90-minute CLE video webinar with Q&A
This CLE webinar will provide an overview of the key legal, business, and valuation issues implicated in professional services arrangements (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.
- Key legal issues involved in PSAs
- Stark Law
- Anti-Kickback Statute
- Value-based rules
- Reassignment rules
- Provider-based status regulations
- Tax exemption
- Valuation issues
- Determining an appropriate productivity metric (i.e., work relative value units (wRVUs))
- Determining market rate of compensation
- Appropriate productivity calculation for physicians and non-physician providers, multiple procedures, etc.
- Dealing with ancillary revenues
- Dealing with non-salary expenses: "pass through" or "gross up"
- Perils of compensation stacking
- Key deal maker/breaker issues
- Harmonizing payment methodology with performance standards
- Staffing issues
- Restrictive covenants
- Unwind rights
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/physician self-referral issues do PSAs face?
- What are the additional issues for tax-exempt and for profit entities, respectively?
- What does the recent case law say?
- What are the best practices for determining the optimal PSA model to use?
Andrea M. Ferrari, JD, MPH
Principal and General Counsel
Pinnacle Healthcare Consulting
Ms. Ferrari has more than 25 years of experience in the healthcare industry in various counsel, consulting and... | Read More
Ms. Ferrari has more than 25 years of experience in the healthcare industry in various counsel, consulting and leadership roles. She serves clients inside and outside of Pinnacle, providing assistance with compliance strategy, risk management, due diligence, investigations, and litigation.
Her practice experience is national in scope and includes providing transactional, operational, governance, and dispute resolution support for a broad array of nonprofit, for-profit, and governmental clients, including hospitals and health systems, physicians and physician groups, clinical laboratories, and pharmaceutical and medical device vendors, distributors, and manufacturers. She has assisted clients with structuring, documenting, managing, and, when appropriate, defending financial arrangements involving healthcare providers, often with attention to requirements and implications of the Stark Law, Anti-kickback Statute, False Claims Act, non-profit tax regulations, Foreign Corrupt Practices Act and/or the various state laws concerning billing, payment and corporate practice of medicine. Her work has included assisting clients with mergers and acquisitions, affiliations, joint ventures, public-private partnerships, enterprise-level compliance programs, and healthcare workforce recruitment and management arrangements, including significant incentive, independent contractor, and employment arrangements that exceed $1 million in annual compensation. Her work has also included outside general and special counsel services for healthcare clients, focusing on their contracting and compensation practices.Close
Alyssa C. James
Hall Render Killian Heath & Lyman
Ms. James works with clients in numerous aspects of health care law. Her work involves counsel regarding... | Read More
Ms. James works with clients in numerous aspects of health care law. Her work involves counsel regarding hospital/physician contracting matters, hospital and health system relationships, regulatory and compliance issues, organization governance and hospital/physician alignment. Ms. James regularly counsels clients on a national basis regarding fraud and abuse matters, including analyses related to federal Stark, Anti-Kickback and Civil Monetary Penalties laws.Close
Wesley R. Sylla
Compliance Director - Investigations & Incidents
Mr. Sylla has a decade of experience in helping hospitals and health systems comply with healthcare's fraud... | Read More
Mr. Sylla has a decade of experience in helping hospitals and health systems comply with healthcare's fraud and abuse regulatory framework. Specializing in provider compensation arrangements, Mr. Sylla has used that experience to develop compensation plans, investigate and audit provider arrangements, and resolve problematic arrangements with governmental agencies.Close