Structuring Physician Incentives: Regulatory Compliance, Avoiding Potential Pitfalls
Fair Market Value, Commercial Reasonableness, and Volume/Value of Referrals Considerations
A live 90-minute CLE video webinar with interactive Q&A
This CLE course will guide healthcare counsel on physician incentives, examining the legal requirements and the potential risks. The panel will compare current incentives and value-based incentives and will discuss the impact on regulatory compliance. The panel will offer best practices for structuring physician incentives.
Outline
- Comparison of typical physician incentive arrangements historically vs. in the current environment
- The current and evolving regulatory environment and the dangers in improperly structured incentive arrangements in this environment, including:
- New (and unchanged) standards of what is FMV, commercially reasonable, and/or improperly based on volume or value of referrals
- Recent regulatory enforcement actions and court cases that are illustrative of the pitfalls of certain newer types of incentives, including those that on their face may seem reasonable
- Observations and best practices for avoiding pitfalls in the design and structuring of incentive arrangements
Benefits
The panel will review these and other key issues:
- What steps can healthcare advisers take to ensure regulatory compliance when structuring physician incentives?
- What are the implications for compliance with the Stark Law, the AKS, and other laws and regulations?
- What lessons can healthcare counsel take away from recent enforcement actions?
Faculty
Andrea M. Ferrari, JD, MPH
Principal and General Counsel
Pinnacle Healthcare Consulting
Ms. Ferrari has more than 25 years of experience in the healthcare industry in various counsel, consulting and... | Read More
Ms. Ferrari has more than 25 years of experience in the healthcare industry in various counsel, consulting and leadership roles. She serves clients inside and outside of Pinnacle, providing assistance with compliance strategy, risk management, due diligence, investigations, and litigation.
Her practice experience is national in scope and includes providing transactional, operational, governance, and dispute resolution support for a broad array of nonprofit, for-profit, and governmental clients, including hospitals and health systems, physicians and physician groups, clinical laboratories, and pharmaceutical and medical device vendors, distributors, and manufacturers. She has assisted clients with structuring, documenting, managing, and, when appropriate, defending financial arrangements involving healthcare providers, often with attention to requirements and implications of the Stark Law, Anti-kickback Statute, False Claims Act, non-profit tax regulations, Foreign Corrupt Practices Act and/or the various state laws concerning billing, payment and corporate practice of medicine. Her work has included assisting clients with mergers and acquisitions, affiliations, joint ventures, public-private partnerships, enterprise-level compliance programs, and healthcare workforce recruitment and management arrangements, including significant incentive, independent contractor, and employment arrangements that exceed $1 million in annual compensation. Her work has also included outside general and special counsel services for healthcare clients, focusing on their contracting and compensation practices.
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Clevonne M. (Vonne) Jacobs
Principal & Founder
Creating Equity
Ms. Jacobs focuses her practice in the area of healthcare transactions. Calling upon her years of dedicated experience,... | Read More
Ms. Jacobs focuses her practice in the area of healthcare transactions. Calling upon her years of dedicated experience, she provides practical, pragmatic advice to help her clients achieve their strategic goals. Within the highly regulated health care industry, Ms. Jacobs advises clients, including hospitals, health systems, AMCs and large physician groups, on transactions. She serves as a regulatory adviser, providing fraud and abuse analysis in the context of a deal and ensuring her clients remain compliant with the regulations that govern health care transactions.
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