Understanding Anti-Kickback and Self-Referral Laws for Fair Market Value in Hospital and Physician Transactions
The government has a remarkable record in prosecuting healthcare fraud. The U.S. Department of Justice (DOJ) has recovered over $29.9 billion through False Claims Act cases since January 2009. More than $18.3 billion recovered were through fraud claims involving federal health care programs. This continued increase in the government’s enforcement actions focusing on the health care industry implies a critical need for health care providers to proactively ensure compliance with the Anti-Kickback Statute, the Physician Self-Referral Law (Stark Law), and other laws governing Medicaid and Medicare fraud and abuse.
One of the issues confronting almost every healthcare-related transaction is Fair Market Value (FMV) determination, which has been disputed in several government litigation and investigations. Unfortunately, many healthcare providers have failed to use FMV as defense in several cases.
In this LIVE Webcast, a panel of thought leaders and professionals assembled by The Knowledge Group will provide the audience with an overview and in-depth discussion of Anti-Kickback and Self-Referral Laws for Fair Market Value involving Hospital and Physician Transactions. Speakers will also offer best practices in developing and implementing compliance policies and procedures.
Key topics include:
- Anti-Kickback Statute and Self-Referral Law – Overview
- FMV Compliance Challenges
- Best Compliance Practices
- Regulatory Outlook
Jen Johnson, CFA, Managing Director
- Physician compensation trends
Elise Schuller Barajas, Board Certified Health Law Attorney
Gray Reed & McGraw
- Overview of Stark Law and Anti-Kickback Statute
- Stark Law (42 U.S.C. § 1395nn, et seq.)
- Federal Anti-Kickback Statute (42 U.S.C. §1320a-7b(b))
- Texas Illegal Remuneration Act (Section 102.001 of the Texas Occupations Code)
- Exceptions and Safe Harbors
- Stark Law Exceptions
- Anti-Kickback Statute Safe Harbors
- Regulatory Guidance – Fair Market Value
Jen Johnson, CFA, Managing Director
- Tips on how to ensure commercially reasonable and FMV for compensation arrangements
Who Should Attend:
- Fraud Analyst/Monitoring
- Compliance and Ethics Managers
- State Health Executives
- Healthcare Finance Executives
- Healthcare Consultants
- Healthcare Law Attorneys
- Medical Directors
- Healthcare Providers
- Hospital Executives (Finance, CFOs, General Counsel and Related)
- Healthcare Facilities
- Other Related Professionals
Board Certified in Health Law, Elise focuses primarily on healthcare business transactions and other healthcare compliance issues. Prior to joining Gray Reed & McGraw, she practiced in Tulsa, Oklahoma, focusing on healthcare and general business transactions. Elise represents a variety of healthcare providers in both Texas and Oklahoma, including acute care hospitals, joint venture hospitals, physicians, physician practices, dental practices, skilled nursing facilities and assisted living facilities.
Elise earned her J.D. from the University of Tulsa College of Law. During law school, she served as an intern for the Honorable Keith Rapp on the Oklahoma Court of Civil Appeals. Elise received her B.S. in Communication Sciences and Disorders summa cum laude from Oklahoma State University.
Board Certified in Health Law, Elise focuses primarily on healthcare business transactions and other healthcare compliance issues. Prior to joining …
Jen Johnson is a Managing Director with VMG Health and oversees the Professional Service Agreements Division. Her expertise is related to determining Fair Market Value and understanding regulatory guidelines associated with valuing professional service and compensation arrangements. Mrs. Johnson has valued nearly every type of arrangement in the healthcare market and is a thought leader related to valuing pay for performance arrangements. She has also been integral in developing internal compensation tools for some of the largest health systems in the country and has served as an expert witness related to Fair Market Value and physician compensation. She earned her BBA and MBA in Finance, as well as the Chartered Financial Analyst designation, and served as a finance professor for the University of North Texas.
Jen Johnson is a Managing Director with VMG Health and oversees the Professional Service Agreements Division. Her expertise is related …
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Method of Presentation:
NASBA Field of Study:
Specialized Knowledge - Technical
NY Category of CLE Credit:
Areas of Professional Practice
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About Gray Reed & McGraw
For more than 30 years, Gray Reed has been a full-service, Texas based law firm with more than 120 lawyers practicing in Dallas and Houston. Gray Reed offers a wide range of legal services including business litigation, corporate transactions, oil & gas, tax planning and litigation, real estate, healthcare, trusts and estates, employment law, family law, intellectual property and bankruptcy.
About VMG Health
VMG Health was founded in 1995 and is one of the largest healthcare dedicated valuation and transaction advisory firms in the United States. We are exclusively focused in healthcare, have unmatched credentials, and perform more than 1,500 engagements each year. Leading health systems, attorneys, and investors rely on VMG Health as their trusted valuation and transaction advisory source.