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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 program is included with the Strafford CLE Pass. Click for more information.
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Conducted on Thursday, November 30, 2023

Recorded event now available

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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.

Description

PSAs provide hospitals and physicians 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 changes and enforcement cases have impacted PSAs. Counsel must carefully structure the PSA to achieve physician-hospital alignment while complying with Stark, its state counterparts, and state and federal anti-kickback laws, as well as tax-exempt status when applicable.

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. Value-based rules
    4. Reassignment rules
    5. Provider-based status regulations
    6. Tax exemption
    7. 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

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/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?

Faculty

Ferrari, Andrea
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

James, Alyssa
Alyssa C. James

Shareholder
Hall Render Killian Heath & Lyman

Ms. James works with clients in numerous aspects of health care law. Her work involves counsel regarding...  |  Read More

Sylla, Wesley
Wesley R. Sylla

Compliance Director - Investigations & Incidents
Ascension Health

Mr. Sylla has a decade of experience in helping hospitals and health systems comply with healthcare's fraud...  |  Read More

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