Many hospitals and health systems pursue practice affiliation and alignment strategies with physician practices as an alternative to traditional purchase and employment transactions. Some of the more popular of these arrangements are leased practice agreements, professional service agreements (PSAs), and management services agreements (MSAs).

The ultimate structure of these practice alignment arrangements can have operational, financial, and legal implications. Common affiliation arrangements may include clinical and administrative service arrangements, employee leases, equipment and space leases, acquisition of select assets, and various financial contracts consisting of RVU-based or collection-based payments, performance incentives, administrative mark-ups, and budgeted cost agreements, among others.

Hospitals, health systems, physician practices, and their counsel need to understand the regulatory requirements, including implications under the Stark Law, the Anti-Kickback Statute, and even the False Claims Act, as well as antitrust, HIPAA, and other applicable federal and state regulatory authorities, and must carefully evaluate critical economic considerations such as Medicare, Medicaid, and commercial payor billing and reimbursement rules when structuring these transactions.

Our panel will guide counsel to hospitals and physician groups on structuring and negotiating leased practice agreements, PSAs, and MSAs. The panel will explain how healthcare providers can leverage the benefits and understand and overcome the legal challenges associated with these kinds of alignment models.

We will review these and other noteworthy questions:

• What are the primary benefits of practice leasing agreements for hospitals and physician groups?
• What are the critical first questions counsel must answer before drafting and negotiating practice leasing arrangements to achieve the benefits?
• What Anti-Kickback Statute and Stark Law issues must practice leasing agreements address?
• How should counsel address billing matters to preserve Medicare, Medicaid, and commercial payor reimbursements to hospitals and physician groups?

Speakers:

Alice G. Gosfield, Founder, Alice G. Gosfield and Associates
David S. Sokolow, Partner, Fox Rothschild LLP

Please note there is a cost to attend.

CLE Credits available.