Instructor Profile

If you are a healthcare manager, should you be concerned about how Stark, the physician anti-referral legislation, affects you organization and specifically you? After Toumey Health System, Intermountain Health, Akron General Hospital, Prime Healthcare and Kalispell Regional Health System, you should be. In two of these cases, the CEO settled their liability for hefty settlements.

This webinar is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare.  Several recent cases bring home the realization that violations of Stark are common, and those violations can be used as the basis of a False Claims Act action. 

As a health care executive, physician or other health care provider, you should be very concerned about the potential for violation of the Stark rules. In this webinar, you will learn about the elements of the Stark II law, along with the various exceptions that you can rely on for protection against enforcement under this law. This is important because under recently enacted health care laws, particularly The Affordable Care Act (also known as Obamacare), enforcement and health care fraud task forces have been greatly enhanced. 

The law actually codifies the American Medical Association ethics rules concerning referrals. We will review these rules and the various exceptions to Stark so that you can be aware of what you can and cannot do regarding referrals.

You will want to attend this webinar to learn how to protect yourself and your organization.

The session will provide an overview of the Anti-Kickback Statute (AKS) and review what it prohibits, as well as review the Statute's available safe harbors.

It will also show how violation of the AKS can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially impact participants.

We will provide an in-depth review of the AKS, focusing on what is prohibited under the Act and what the exceptions are. We will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law.

Since one of the exceptions to enforcement under the Act is regulations promulgated by the Secretary, the "safe harbors," payment practices will not be subject to criminal prosecution and that will not provide a basis for civil monetary penalties or exclusion from the Medicare or Medicaid programs, we will examine these safe harbors, particularly those more frequently used, to show how protection from enforcement can be achieved. Specifically, we will review the investment, space and equipment rental, personal services/management contracts, and physician recruitment safe harbors.

In addition, we will discuss the OIG’s Joint Venture Advisory Opinion, where a hospital expands into a related service line by contracting with an existing provider of that service.

The OIG has significant problems with such an arrangement. We will also discuss the recent advisory opinion by the OIG regarding Physician-Owned Entities. OIG views PODs as inherently suspect under the AKS because the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, could constitute illegal remuneration under the AKS.

Finally, the webinar will review various cases to show how easy it is to run afoul of the Statute, and how the courts view compliance with it.

We will review the various elements of the physician employment agreement, focusing on the pitfalls and the problems that can develop when the agreement does not clearly define the relationship, and/or when the parties do not fully understand what is being agreed to, such items as term and termination, termination for cause, duties of the physician, call, non-compete clauses, and compensation are all items that should be clearly set out in the agreement and fully understood by the parties.

Attend the webinar to gain an understanding of what should and what should not be in a physician employment agreement.

Disruptive activity by practitioners in the hospital takes many forms. When it happens, it is important that the hospital and/or the medical staff take appropriate steps to see that it does not affect patient care or disrupt operations.
This session will explain how a hospital medical staff should deal with the practitioner who is disruptive of hospital operations. It will discuss disruptive practitioner policies a hospital should have in place and practical tips to correct or terminate the disruptive activity.

This webinar will provide an in-depth understanding of the Federal False Claims Act, Federal Anti-Kickback and Stark Laws, and discuss how marketing activities can trigger either or both.

2022 was an eventful year, and 2023 will undoubtedly be exciting. Also, because technology is always a few years ahead of the law, federal and state legislators and regulators are constantly scrambling to keep up with what is happening in the marketplace.

This webinar will provide the basic building blocks you will need to develop and maintain your company’s precious commodity – your reputation – and eliminate exposure to fraud charges based on marketing practices. It will also cover the practical requirements and operations, principles of compliance and the basic elements that every business has to have to reduce civil and criminal liabilities and economic sanctions.