Topics for this webinar included special issues encountered in context of the pandemic, including duty to care, access to limited treatment resources, end of life decision making, confidentiality issues, and disparities in access to/outcomes of care.
Do hospital subsidiaries qualify for small business loans? How about private practices? How about hybrid arrangements where a private physician practice may have entered into a professional services agreement with the health system? These and other issues were discussed.
The program focused on navigating antitrust issues related to health system-physician affiliation models (e.g., employment, PSAs, & CINs) and the degree of clinical integration needed for joint contracting. The panel includes lessons learned from the State of Washington's antitrust suit against CHI Franciscan related to its employment of orthopedic physicians (challenged as an illegal merger) and its PSA with a multispecialty group (challenged as illegal price fixing).
This webinar discussed how these new payment models work and their likely impact on the delivery of primary care. Specifically, the presentation addressed the program eligibility criteria, the financial incentives available to primary care physicians (including potential downside risk), the application process, and the relevant deadlines.
The panelists summarized recent areas of focus for government health care fraud and abuse investigations, including cases based on allegations of violations of the Federal False Claims Act, cases based on violations of the Anti-kickback Statute, and cases based on providers and suppliers that are alleged to have provided medically unnecessary services.
This webinar discussed developing best practices that health care organizations can follow to avoid compliance traps related to the technical requirements for payments to physicians and the Three Key Tenets of Defensibility: fair market value, commercial reasonableness, and not taking into account volume or value of referrals. The session also recapped trends in government and whistleblower enforcement
This presentation, given by retired U.S. Administrative Law Judge Bob Soltis, outlined strategies for successfully advocating Medicare cases to an ALJ in the most efficient and persuasive manner.
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