Structuring Healthcare Practice Leasing, PSA and Other Practice Alignment Arrangements

Complying with Stark, AKS, HIPAA and Maximizing Reimbursement

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

Conducted on Thursday, August 28, 2014

Recorded event now available

or call 1-800-926-7926
Course Materials

This CLE course will provide guidance to counsel for hospitals and physician groups on structuring and negotiating practice agreements. The panel will explain how healthcare providers can leverage the benefits and understand and overcome the legal challenges.


Many hospitals and health systems are pursuing practice affiliation and alignment strategies with physician practices as an alternative to traditional purchase and employment transactions. Some of the more popular of these arrangements are Leased Practice, Professional Service Agreements (PSAs) and Management Services Agreements (MSAs).

The ultimate structure of these practice alignment arrangements can have operational, financial, and legal implications. Common affiliation arrangements may include employee leases, equipment leases, acquisition of select assets, and various financial arrangements that may include wRVU based payments, performance incentives, administrative mark-ups and budgeted cost agreements among others. 

It is critical for hospitals, health systems, physician practices and their counsel need to understand the regulatory requirements, including Stark law, Anti-Kickback, antitrust  and HIPAA, and carefully evaluate key economic considerations, such as Medicare and Medicaid billing, when structuring these transactions.

Listen as our experienced panel of healthcare counsel examines structuring these practice arrangements. The panel will discuss the key legal and regulatory concerns impacting the the institution and ongoing administration of these agreements as well as fair market value issues.  The panel will also offer insight into these arrangements from the hospitals' and physicians' perspectives.



  1. Employee leasing arrangements
  2. PSA/MSA arrangements
  3. Equipment leasing agreements
  4. Acquiring select assets
  5. Financial and fair market value considerations
  6. Hospital/health system v. physician/medical group perspective


The panel will review these and other key questions:

  • What are the primary benefits of leasing agreements for hospitals and physician groups?

  • What are the critical first questions counsel must answer before drafting and negotiating practice arrangements to achieve the benefits?

  • What anti-kickback and Stark law issues must leasing agreements address? How should counsel address billing matters to preserve Medicare and Medicaid reimbursements to hospitals and physician groups?


Blau, Michael
Michael L. Blau

Foley & Lardner

Mr. Blau is a partner and health transactional lawyer. His practice focuses on advising clients on health care...  |  Read More

Lara, Fred
Fred M. Lara, CFA, ASA, CVA

HealthCare Appraisers

Mr. Lara has more than eleven years of fulltime healthcare valuation experience, focusing on complex compensation...  |  Read More

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