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Operationalizing Stark: From Complexity to Reality 

March 24, 2009
Baltimore Marriott Waterfront Hotel
Baltimore, MD
HealthCare Appraisers, Inc. has provided sponsorship in support of this program.

Program Description

This practical, one-day program will use a series of case studies to analyze recent complex changes in the physician self-referral law. These interactive case studies will explore the following nuts and bolts issues for the practicing health lawyer, finance officer, compliance officer, and valuation specialist:

  • Hospital/Physician Joint Ventures: Life after the October 2009 Changes to "Under Arrangements" and "Per-Click/Percentage Compensation" Rules Under Stark
  • Stark's Significant Impact on Academic Medicine
  • Stark's Expanding Influence on Group Practice and Recruitment Activities
  • Stark and Quality Initiatives: Pay-for-Performance and Shared Savings

Case studies and other materials will be available to the attendees on a website. The link to the website will be emailed prior to the program.

Register for this one-day program on Stark by itself or add it on to your registration for the Institute on Medicare and Medicaid and save $50 off the registration fee.

Schedule for Tuesday, March 24, 2009
9:00 am - 5:00 pm

9:30-9:45 am

Welcome and Introduction

Elizabeth Carder-Thompson, AHLA President-Elect
Beth Schermer, Program Chair

9:45-11:15 am

Hospital/Physician Joint Ventures: Life after the October 2009 Changes to "Under Arrangements" and "Per-Click/Percentage Compensation" Rules Under Stark

Ann E. DesRuisseaux,
Assistant General Counsel, DaVita Inc.
S. Craig Holden, OBER l KALER
Donald H. Romano, Arent Fox LLP
 

Effective October 1, 2009, new Stark rules governing the use of "under arrangements," and "per-click" and "percentage compensation" leases, go into effect. This will require many existing hospital/physicians arrangements to either restructure or terminate. This session will provide analysis on:

  • Potential restructuring options 
  • How to handle non-compliance when discovered
11:15 am-12:15 pm

 The Stark Morass in Academic Medicine

Robert G. Homchick, Davis Wright Tremaine LLP
Michael W. Paddock, Crowell & Moring LLP

This session will analyze the range of financial relationships among the various components of an AMC: hospital, school of medicine, faculty practice plans, community physicians and volunteers. The hypotheticals will:

  • Ilustrate the application of the stand in the shoes concept, indirect financial relationships, and the effect of layered financial relationships
  • Eplore the Dean's tax, mission support, flow of remuneration among the AMC components and the treatment of volunteer physicians
12:30-1:30 pm  Group Lunch (all attendees and speakers welcome)

Interactive Discussion: Fair Market Value Issues in the Case Studies

Daryl P. Johnson, HealthCare Appraisers, Inc. (Moderator)

1:45-2:45 pm

 Group Practice and Recruitment Activities

David E. Matyas, Epstein Becker & Green PC
 Cynthia Y. Reisz, Bass, Berry & Sims PLC

Although the Stark Law exception for physician recruitment might appear to many as straightforward, this case study will provide participants with examples of some of the complexities that can arise when hospitals participate in the recruitment of physicians into a community.  The factual scenario will address:

  • Stark issues when a hospital not only provides financial assistance directly to the physician recruit but also to another existing group practice within the community; and
  • Nuances between recruiting a new physician into the community and offering a package to a physician in order to retain him or her in the community
2:45-3:45 pm

  Stark and Quality Initiatives: Pay-for-Performance and Shared Savings

Kevin G. McAnaney, Law Office of Kevin G. McAnaney
Lisa M. Ohrin, Sonnenschein Nath & Rosenthal LLP
Beth Schermer, Coppersmith Gordon Schermer &
Brockelman PLC

Patients and the government are demanding that the healthcare community improve quality while enhancing efficiency. In order to achieve these twin goals, incentives must be aligned between insurers, hospitals and physicians. This case study will explore:

  • The applicability of Stark exceptions to specific pay for performance (P4P) and shared savings situations
  • Different legal issues that arise in insurer-driven P4P and hospital-based P4P arrangements
  • The line between P4P quality initiatives and other shared saving arrangements
  • The Stark implications of service line quality initiatives
3:45-4:00 pm

Break

4:00-5:00 pm   Self-Disclosure Round Table: How to Advise the Client and What to Expect from the Government

Kevin G. McAnaney, Moderator

5:00 pm

Adjournment

CLE Information

This program will be worth approximately 5.5 credits for 60-minute states and approximately 6.6 credits for 50-minute states. Participants will be given CLE Request forms at the program. Forms must be completed and returned to AHLA staff to receive credit. The sessions, unless otherwise designated, are intermediate to advanced in level. There are no prerequisites required to register for this program.

This seminar will be worth approximately 6.0 CPE credits. AHLA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN 37219-2417. NASBA's web site is located at http://www.nasba.org.

This program is designed to be an update on developments in the area of Stark. There are no prerequisites or advanced preparations required to register for this group live program. Those seeking accounting credits should be familiar with the basic concepts of law and terminology associated with this area in order to obtain the full educational benefit of this program.

Hotel Information
Baltimore Marriott Waterfront Hotel
700 Aliceanna Street
Baltimore, MD 21202
Reservations Phone: (800) 228-9290
Reservations Fax: (410) 895-1900
Hotel Website


 
Related Resources

 Program Brochure

2009 Institute on Medicare and Medicaid program brochure

 Registration Information

Stark Program Only:
AHLA Member $375
Non-Member $475

 

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