Gainsharing Arrangements and Bundled Payments: OIG Advisory Opinion and Other Developments
Complying With Legal and Regulatory Requirements, Overcoming Implementation and Operational Challenges
Recording of a 90-minute CLE webinar with Q&A
This CLE course will provide healthcare counsel with a review of current issues related to gainsharing arrangements whether they are freestanding or part of bundled payment programs. The panel will discuss the OIG's advisory opinions on gainsharing arrangements, outline implementation and operational aspects of gainsharing, and offer best practices for hospitals and physicians to identify business opportunities and minimize legal risks.
Outline
- OIG's advisory opinions on gainsharing arrangements
- Clinical and operational issues in structuring gainsharing arrangements
- Legal hurdles to structuring and documenting these types of arrangements
- Opportunities available under bundled payment programs
- FMV considerations of gainsharing and bundled payment arrangements
Benefits
The panel will review these and other key issues:
- What are the key operational and regulatory concerns for healthcare providers considering gainsharing arrangements either as stand alone programs or as part of bundled payment programs?
- What are implications of the OIG advisory opinions on gainsharing?
- What critical provisions should counsel document when formalizing these arrangements?
- What are different types of gainsharing arrangements and what are key features of each?
Faculty
Curtis H. Bernstein, CPA/ABV, ASA, CVA, MBA
Partner
Pinnacle Healthcare Consulting
Mr. Bernstein specializes in providing valuation, transaction advisory, strategic and operational consulting services... | Read More
Mr. Bernstein specializes in providing valuation, transaction advisory, strategic and operational consulting services to clients. He has extensive experience working closely with hospital systems, physician groups, ambulatory surgery centers and other healthcare providers. He also provides valuation services in the areas of business valuation and complex compensation structures.
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William T. (Bill) Mathias
Shareholder
Baker Donelson Bearman Caldwell & Berkowitz
Mr. Mathias represents clients across the U.S. in all areas of the health care industry, with a particular emphasis on... | Read More
Mr. Mathias represents clients across the U.S. in all areas of the health care industry, with a particular emphasis on fraud and abuse, internal and government investigations, and corporate compliance matters. His practice focuses on advising clients on compliance with the federal antikickback law, the Stark physician self-referral statute and the federal civil monetary penalty provisions. He also advises health systems and GPOs on compliance with the discount and GPO safe harbors as well as strategies for reducing legal risks associated with cutting edge supply chain management and purchasing programs. He is a former vice chair of the American Health Lawyers Association’s Fraud & Abuse Practice Group.
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Girard F. Senn, RN, MS, NEA-BC
Director
Pinnacle Healthcare Consulting
With more than 30 years of senior management and consulting experience, Mr. Senn adds significant depth and breadth to... | Read More
With more than 30 years of senior management and consulting experience, Mr. Senn adds significant depth and breadth to the Pinnacle team. As a Director, Girard will He focuses primarily on strategy and operations, having served on both the administrative and clinical side of healthcare where he was responsible for performance improvement of major revenue centers. Leveraging his management, accounting and clinical background, Mr. Senn is also a national expert on supply chain management and performance improvement and has developed highly-innovative, national implant pricing tools, as well as advanced techniques for demand matching.
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