Fair Market Value (Audio Conference)

Fair Market Value: Analysis and tools to comply with Stark and Anti-kickback rules

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Healthcare Auditing Strategies

presented on March 19, 2008

Hospital-physician financial arrangements are always fraught with compliance risks. Such arrangements are on the CMS and the OIG watch list as evidenced with new and proposed regulations in the Stark II Phase III final rule, the 2008 Medicare Physician Fee Schedule, and the 2008 OIG Work Plan.

In short, government investigations continue to scrutinize inappropriate referrals. Many investigations boil down to whether the compensation paid by a hospital to a physician or physician group is consistent with fair market value.  But the standards for what constitutes fair market value are not always clearly defined or easily attainable. The consequences of compliance are high. Inappropriate arrangements could cost your facility big money, or even result in criminal prosecution.

For example, what if a hospital requires a minimum amount of neurosurgery call coverage to maintain its Level One trauma status, yet only one neurosurgeon lives within a 50-mile radius. What would constitute fair market value compensation to that one neurosurgeon for providing the needed call coverage?  What would constitute fair market value compensation to one or more locum tenens physicians to provide additional coverage?

Develop compliant fair market value contracts in hospital-physician negotiations

Listen to HCPro's 90-minute audioconference Fair Market Value: Analysis and tools to comply with Stark and Anti-kickback rules Leading healthcare compliance attorneys Robert Wade, Esq. and Marci Rose Levine, Esq. Discuss how to ensure fair market value consistent compensation for physicians. The speakers discuss potential benchmarking sources (both national and local), as well as how to approach some of the more common hospital-physician compensation arrangements that can still get your facility in trouble, like medical directorships and call coverage arrangements.

At the end of this audioconference, you and your staff will be able to:

• Recognize the risk involved when fair market value is not documented properly
• Identify methods to document fair market value in an appropriate and compliant manner
• Negotiate with physicians and help them understand the seriousness of ensuring that compensation is commercially reasonable and consistent with fair market value
• Recognize which benchmarks to apply to your negotiations for specific financial arrangements

AGENDA

• Defining fair market value
• Distinguish commercial reasonableness
• Illustrate the importance of fair market value documentation
• Stark Law
• Anti-Kickback Statute
• Intermediate sanctions (applicable to tax-exempt organizations)
• How to determine and document fair market value and commercial reasonableness
• General steps
• Policies and procedures
• Compensation models
• Use of consultants
• Specific arrangements
• Employment agreements
• Medical directorships
• Clinical vs. administrative compensation
• Timekeeping
• On-call coverage arrangements
• Factors impacting fair market value(e.g., frequency, intensity, payer mix)
• OIG Advisory Opinion 07-10
• Documentation guidelines
• Lessons learned from device settlements
• Annual needs assessments 
• Question & Answer Session

MEET THE SPEAKERS

Robert A. Wade, Esq., Partner, Baker and Daniels, LLP. Mr. Wade concentrates his practice in representing a variety of healthcare clients. His specialization includes representing clients with respect to the Stark Law, Anti-Kickback Statute, False Claims Act, and Emergency Medical Treatment and Labor Act. Mr. Wade is a nationally-recognized expert in all aspects of healthcare compliance and he has experience in representing clients with respect to issues being investigated by the Department of Justice and the Office of Inspector General.

Marci Rose Levine, Esq., Partner, Sonnenschein Nath & Rosenthal LLP. Ms. Levine is vice chair of Sonnenschein’s national Health Care Group.  She has extensive corporate and contracting experience and advises clients with respect to the full range of healthcare fraud and abuse laws. Ms. Levine has worked with the Stark Law and the Anti-Kickback Statute in connection with a wide range of corporate transactions and contracting practices, including physician recruitment, medical directorships, and professional services arrangements.

WHO SHOULD LISTEN?

• Compliance officers
• Directors of compliance
• Legal council
• Contract administrators
• Healthcare administrators
• CEO, CFO, COO and other top-level executives
• Human resources
• Compensation analysts
• Finance/audit committee members
• Board members

PROGRAM MATERIALS

Program materials are provided with PDF links. Purchase a CD or audio archive of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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