FMV and Commercial Reasonableness Challenges in Physician Compensation Arrangements: Meeting Compliance and Regulatory Requirements
Complexities in PSAs, ED Call Coverage, Service Line Co-Management, and Shared Savings Arrangements

Course Details
- smart_display Format
On-Demand
- signal_cellular_alt Difficulty Level
- work Practice Area
Health
- event Date
Tuesday, August 4, 2020
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
-
This 90-minute webinar is eligible in most states for 1.5 CLE credits.
This CLE course will analyze vexing issues in the valuation of professional service arrangements/employment deals, emergency department call coverage, and service line management arrangements. The panel will address valuation and regulatory concerns that result and offer best practices for overcoming fair market value/commercial reasonableness challenges.
Faculty

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.

Mr. Wade has more than 25 years of experience in the healthcare industry and counsels clients on fraud and abuse issues, fair market value, commercial reasonableness and developing, monitoring, and documenting effective healthcare compliance programs. He serves clients nationally as a compliance professional and assists in negotiating and implementing corporate integrity agreements and in documenting and defending financial arrangements being of fair market value and commercially reasonable between healthcare providers. Mr. Wade has represented healthcare providers, including hospitals, large health systems, and referring physicians in such matters and has also represented healthcare clients under investigation by the U.S. Department of Justice and the Office of Inspector General.

Ms. Kolarik focuses on health law issues, including federal and state fraud issues such as anti-kickback, self-referral and regulatory compliance; enrollment, accreditation and licensure; and health regulatory requirements and risks related to acquisitions/sales of health care entities. She advises clients regarding Medicare and Medicaid enrollment, coverage and payment issues.
Description
Compliance in establishing and implementing physician compensation arrangements is challenging in a changing healthcare landscape. Many aspects of effective compliance begin with an understanding of the regulatory issues involved and the ever-changing valuation dynamics, including challenges under the Stark Law and Anti-Kickback Statute.
Current valuation and regulatory challenges exist in physician compensation arrangements, such as (1) employment/professional services arrangements; (2) emergency department call coverage; (3) service line management arrangements; and (4) real estate rental arrangements. Each of these compensation areas is becoming increasingly complex and nuanced, further complicating the resulting valuation and regulatory concerns facing healthcare attorneys and compliance professionals today.
As the use of these arrangements grows, these types of arrangements continue to increase in complexity. As a result, new issues that require attention in the valuation process arise. Healthcare counsel and advisers must take into consideration a variety of healthcare regulatory requirements, including AKS, Stark, and False Claims Act.
Listen as our authoritative panel of healthcare advisers addresses critical issues involved in valuation in PSA/employment deals, ED call coverage, and service line co-management arrangements. The panel will address valuation and regulatory concerns that result and offer best practices for overcoming valuation challenges.
Outline
- Critical issues in valuation
- PSA/employment deals
- ED call coverage
- Service line management arrangements
- Real estate rental arrangements
- Regulatory concerns
- Avoiding volume or value
- Tacking arrangements
- Sharing the savings
- Revenue procedure 97-13
- Best practices for overcoming FMV/commercial reasonableness challenges
Benefits
The panel will review these and other key issues:
- What are the valuation challenges in PSAs? In ED call coverage? Service line management arrangements?
- What steps can healthcare advisers take to ensure regulatory compliance when valuing physician compensation?
- What best practices can counsel employ to overcome valuation challenges?
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