Foley senior counsel Allie Shalom, co-chair of the firm’s Payor Provider Convergence Area of Focus, is speaking in American Health Law Association’s (AHLA) Fraud and Abuse Forum in the session “Physician Practice Management Companies and Incentive Compensation” on October 9.
The session will provide overview and analysis of the fraud and abuse risks related to direct and indirect incentive compensation and other payments between physician practice management (PPM) companies and licensed practitioners. The panelists will provide an overview of different payment structures that, if structured appropriately, can mitigate risk with respect to applicable health care fraud and abuse laws, including the Anti-Kickback Statute and the Stark law. These types of payments can be common in privately owned PPM companies, both when affiliating or acquiring new providers, as well as in the context of restructurings. The discussion will include:
- Common instances where such payments may be desired including:
- Annual bonuses
- Equity in the management services organization
- Retention payments
- Common Payment structures, their relative risk under applicable fraud and abuse laws, and historic enforcement actions related to such payments. This would include, but not be limited to:
- True-up payments in the context of physician practice acquisitions
- Management Services Organizations (MSO) equity purchase through
- Fair market value (FMV) purchase
- MSO financing
- Payment of bonuses, and/or
- Rollovers; and
- Phantom equity
- Best practices to mitigate risk under the forgoing arrangements. This would include a discussion of statutory and regulatory guidance regarding practices that were determined to be noncompliant, as well as possible alternatives to consider
CLE Credit
AHLA applies for Continuing Education Credits (CLE, CCB, and CPE) for all of our conferences. Participants will be able to receive credits for sessions they attend in person and watch on demand.
The maximum number of credits available for IN-PERSON is 13.8 (including 1.0 of ethics) for a 60-minute state and 16.5 (including 1.2 of ethics) for a 50-minute state. Please note that the actual number of credits may vary from state to state.
Please Note: We are now working with ABA CLE for our CLE accreditation needs. Those who scan in and out of the conference each day will receive a personalized CLE affidavit from [email protected] following the conference. All inquiries should be directed to [email protected].
