Stark After Tuomey, Intermountain Health, Akron General, Prime Healthcare and Kalispell Regional

Course Description:

Recent cases and/or enforcement actions involving the Federal Physician Self-Referral Law (Stark II) raise serious concerns regarding compliance issues with hospital, physician practices and other healthcare entities. However, Stark is greatly misunderstood by physicians, as well as healthcare executives.

The session will provide an overview of the physician anti-referral law (known as Stark II), and its available exceptions. It will also show how violation of Stark II can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially impact participants.

Claims filed by health care providers require compliance with the Stark rules and failure to comply can result in that failure being the basis of an enforcement action. We will provide an in-depth review of Stark, focusing on what is prohibited under the Act, what the exceptions are, and how to fit within and exception. While there are several exceptions, it is important to be able to meet the criteria of an exception. We will discuss these criteria, and the nuances that must be met. We will also review the case law and show how the courts interpret the law.

Finally, the webinar will review various cases to show how easy it is to run afoul of these rules, and how the courts view compliance with them.

Why Should You Attend?

This session is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Several recent cases bring home the realization that violations of Stark are common, and those violations can be used as the basis of a False Claims Act action.

As a health care executive, physician or other health care provider, you should be very concerned about the potential for violation of the Stark rules. In this webinar, you will learn about the elements of the Stark II law, along with the various exceptions that you can rely on for protection against enforcement under this law. This is important because under recently enacted health care laws, particularly The Affordable Care Act (also known as Obamacare), enforcement and health care fraud task forces have been greatly enhanced.

In Tuomey, the jury award was $279 million and the case settled for $74 million, with the system being sold and the CEO personally paying $1 million and agreeing to be barred from federal healthcare programs for 5 years.

The law actually codifies the American Medical Association ethics rules concerning referrals. We will review these rules and the various exceptions to Stark so that you can be aware of what you can and cannot do regarding referrals.

You will want to attend this webinar to learn how to protect yourself and your organization.

Areas Covered in the Webinar:

• Federal Physician Self-Referral Law (including a review of the designated health services)

• Exceptions to Stark II

• How the Stark II rules pose dangers for healthcare providers

• Review of case law

Why Should You Attend :

No matter what state you do business in, or how many employees you have, you will be subject to state and federal employment laws. Your handbook not only communicates these various entitlements and obligations to employees but is useful in demonstrating that your organization strives to be compliant with these regulations. Do not underestimate the legal impact your employee handbook can have on you risk strategy!

Who Will Benefit:

• Hospital executives, particularly CEOs, COOs, CFOs, CNOs, and CMOs

• Nursing home executives

• Physicians

• Physician practice managers

• Other healthcare provider executives

Instructor Profile:

William Mack Copeland, MS, JD, PhD, LFACHE, practices health care law in Harrison, Ohio at the firm of Copeland Law, LLC, where he is president and CEO. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services, on the board of QualityMD, and general counsel for the USAF MSC Association. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics. Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. A former hospital CEO, he was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007.