Structuring and Managing Clinically Integrated Networks The View From 2020: What's New and What Do We Do Now?
Legal and Regulatory Issues for CINs, Organizational Structure, Governance, and More
Recording of a 90-minute CLE webinar with Q&A
This CLE course will discuss hospital-physician clinically integrated networks (CIN) organizations in the context of how such developments have affected the 2020 legal, regulatory, and financial environment. Topics will include changes in and a new perspective on Medicare payment rules (including PIP restrictions), Medicare fraud and abuse laws, antitrust laws, state and federal restrictions for tax-exempt entities, and a variety of other state and federal laws and regulations as they pertain to hospital and physician contributions and distributions to CINs.
- The realities of CINs and other alignment and payment methods in a changing environment
- Factors to consider when selecting the physician-alignment method platform
- CIN organization and governance and current challenges related to an evolving regulatory environment
- Regulatory challenges and opportunities, from PIP restrictions to the potential impact of the "Regulatory Sprint to Coordinated Care"
- Best practices for structuring CINs, as well as in advising them through their lifecycle
- Participant payment issues, including fair market value
The panel will review these and other key issues:
- The place of CINs among various alternative alignment and payment models
- Regulatory challenges CINs face under federal and state law, including the physician self-referral and anti-kickback laws and regulations, and those related to tax exemption
- Factors healthcare providers and their counsel should consider when selecting and/or managing a physician-alignment program in 2020
- When and why contributions to and payments from a CIN should be fair market value, and factors to consider when deciding fair market value
- Special considerations when CIN participants are hospital-employed physicians
Andrea M. Ferrari, JD, MPH
Ms. Ferrari focuses on physician payments related to hospital-physician alignment and efficiency improvement... | Read More
Ms. Ferrari focuses on physician payments related to hospital-physician alignment and efficiency improvement strategies, valuation of services provided by physician-hospital organizations, payments for services provided in connection with clinical research/clinical trial agreements, payments for physician supervision of midlevel practitioners, and health practitioner recruitment and support arrangements. She has provided counsel and representation to various types of clients in the healthcare industry, including hospitals, physicians and physician groups, and pharmaceutical and medical device vendors, distributors, and manufacturers. She works with clients in all 50 states.
Mark C. Watson
Mr. Watson focuses on the representation of various providers, including hospitals, health systems, physician groups,... | Read More
Mr. Watson focuses on the representation of various providers, including hospitals, health systems, physician groups, ambulatory surgery centers, and post-acute care providers, in connection with various transactional, operational, and regulatory matters. He handles transactional matters, including merger and acquisitions of healthcare entities. He also represents health system, hospitals and provider groups in the development and implementation of clinical integration strategies, including the formation of multiple clinically integrated networks taking on a variety of structures, including wholly-owned subsidiaries, hospital-physician joint ventures, and physician-owned networks.Close