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Structuring Healthcare Practice Leasing, PSA and Other Practice Alignment Arrangements

Complying With Stark, AKS, HIPAA, and Maximizing Reimbursement

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

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Wednesday, August 3, 2022

Recorded event now available

or call 1-800-926-7926

This CLE course will guide counsel to hospitals and physician groups on structuring and negotiating leased practice agreements, professional service agreements (PSAs), and management services agreements (MSAs). The panel will explain how healthcare providers can leverage the benefits and understand and overcome the legal challenges associated with these kinds of alignment models.


Many hospitals and health systems pursue 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 agreements, PSAs, and MSAs.

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

Hospitals, health systems, physician practices, and their counsel need to understand the regulatory requirements, including implications under the Stark Law, the Anti-Kickback Statute, and even the False Claims Act, as well as antitrust, HIPAA, and other applicable federal and state regulatory authorities, and must carefully evaluate critical economic considerations such as Medicare, Medicaid, and commercial payor billing and reimbursement rules when structuring these transactions.

Listen as our experienced panel of healthcare counsel examines structuring these practice arrangements and addresses essential contract terms for these transactions. The panel will discuss legal and regulatory concerns impacting the institution and ongoing administration of these agreements and 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: the practice lease
  3. Equipment leasing agreements
  4. Acquiring select assets, employing the group staff
  5. Financial and fair market value considerations: The value of the valuator
  6. Hospital/health system vs. physician/medical group perspective


The panel will review these and other noteworthy questions:

  • What are the primary benefits of practice leasing agreements for hospitals and physician groups?
  • What are the critical first questions counsel must answer before drafting and negotiating practice leasing arrangements to achieve the benefits?
  • What Anti-Kickback Statute and Stark Law issues must practice leasing agreements address?
  • How should counsel address billing matters to preserve Medicare, Medicaid, and commercial payor reimbursements to hospitals and physician groups?


Gosfield, Alice
Alice G. Gosfield

Alice G. Gosfield and Associates

Ms. Gosfield advises on problems involving a range of issues, including Medicare reimbursement, fraud and abuse...  |  Read More

Sokolow, David
David S. Sokolow

Fox Rothschild

Mr. Sokolow is Co-Chair of the firm’s Health Law Practice. He concentrates his practice in a variety of...  |  Read More

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