Physicians and Physician Organizations Law Institute - American ...
Physicians and Physician Organizations Law Institute - American ...
Physicians and Physician Organizations Law Institute - American ...
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<strong>American</strong> Health lawyers association<br />
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
February 11-12, 2013<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
February 12-13, 2013<br />
JW Marriott Desert Ridge Resort & Spa • Phoenix, AZ<br />
<strong><strong>Physician</strong>s</strong> Planning Committee<br />
Cynthia Y. Reisz, Esq., Program Chair<br />
David J. Hyman, Esq.<br />
Kim Harvey Looney, Esq.<br />
Donald “Rocky” P. Wilcox, Esq.<br />
Hospitals Planning Committee<br />
S. Allan Adelman, Esq., Program Co-Chair<br />
Lisa J. Gilden, Esq., Program Co-Chair<br />
Louise M. Joy, Esq.<br />
Richard L. Shackelford, Esq.<br />
Robert A. Wade, Esq.<br />
Cynthia F. Wisner, Esq.<br />
HORNE LLP has provided sponsorship<br />
in support of both programs.
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Make plans to join us in Phoenix!<br />
Table of Contents<br />
<strong><strong>Physician</strong>s</strong> <strong>Law</strong> <strong>Institute</strong> Agenda................................................. 3<br />
<strong><strong>Physician</strong>s</strong> <strong>Law</strong> <strong>Institute</strong> Faculty.................................................. 7<br />
Hospitals <strong>Law</strong> <strong>Institute</strong> Agenda................................................... 8<br />
Hospitals <strong>Law</strong> <strong>Institute</strong> Faculty.................................................. 13<br />
Programs-at-a-Glance.................................................................. 15<br />
Practice Group Luncheon Presentations................................. 19<br />
Registration Form......................................................................... 21<br />
Program Information................................................................... 23<br />
The <strong>American</strong> Health <strong>Law</strong>yers Association is pleased to once<br />
again offer the <strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong><br />
<strong>Institute</strong> <strong>and</strong> the Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong>.<br />
These programs provide in-house <strong>and</strong> outside counsel<br />
with the latest information needed to advise clients in these<br />
two segments of the healthcare industry. The programs have<br />
been scheduled so that you can attend either the <strong><strong>Physician</strong>s</strong><br />
program or the Hospitals program, if your practice focuses on<br />
a particular provider, or you can register for both programs<br />
for a more comprehensive curriculum that will prepare you<br />
to address legal issues facing both segments <strong>and</strong> gain a better<br />
underst<strong>and</strong>ing of their distinct legal challenges.<br />
This brochure includes the agenda for each program as well as<br />
a grid on pages 15-18, which shows the full 3-days of programming<br />
with an indication of which sessions are on each<br />
program. In addition to the educational sessions, there are a<br />
number of networking opportunities including breakfasts held<br />
each day, receptions on Monday <strong>and</strong> Tuesday evenings, <strong>and</strong><br />
Practice Group luncheons held each day.<br />
This year’s programs take place in Phoenix at the beautiful JW<br />
Marriott Desert Ridge Resort <strong>and</strong> Spa. We look forward to seeing<br />
you in February!<br />
Program Materials<br />
All materials will be available on a website prior to the<br />
program <strong>and</strong> h<strong>and</strong>ed out on CD at the program. For<br />
those who still do want the binders they will be available<br />
for an additional fee; please order on the registration<br />
form on pages 21-22.<br />
Exhibitors <strong>and</strong> Sponsors<br />
AHLA would like to thank the following companies for their<br />
support of the <strong><strong>Physician</strong>s</strong> <strong>and</strong> Hospitals <strong>Law</strong> <strong>Institute</strong>s <strong>and</strong><br />
encourages attendees to visit their exhibit booths:<br />
j Affiliated Monitors<br />
j Carnahan Group, Inc.<br />
j DGA Partners<br />
j HealthCare Appraisers, Inc.<br />
j Health Capital Consultants LLC<br />
j HORNE LLP<br />
j MDReview<br />
j Medical Protective<br />
j NTracts LLC<br />
j Pinnacle Healthcare Consulting<br />
j PYA<br />
j Sheridan Healthcare, Inc.<br />
j Towers Watson<br />
Hotel Reservations<br />
Hotel accommodations are not included in the registration<br />
fee. AHLA has reserved a block of rooms at JW Marriott at a<br />
discounted rate of $259 per night. To make reservations, please<br />
call (800) 835-6206. The room block expires January 21, 2013.<br />
Please make your reservations early. The room block may sell<br />
out prior to the hotel cutoff.<br />
Announcing the <strong><strong>Physician</strong>s</strong> <strong>and</strong> Hospitals<br />
<strong>Law</strong> <strong>Institute</strong>s Mobile Device App<br />
Put all the conference details in the<br />
palm of your h<strong>and</strong> with AHLA app.<br />
Attendees at the <strong><strong>Physician</strong>s</strong> <strong>and</strong><br />
Hospitals <strong>Law</strong> <strong>Institute</strong>s will be able<br />
to access information about the<br />
programs on their mobile device.<br />
The app, sponsored by PYA, will include<br />
the program schedule, faculty<br />
list, course materials <strong>and</strong> more. The<br />
app will be available to Blackberry,<br />
Android, Windows Mobile, Tablets,<br />
iPhone <strong>and</strong> iPad users.<br />
Information on how to download<br />
the app <strong>and</strong> the password necessary<br />
to access the information will be<br />
sent to attendees shortly before the<br />
programs.<br />
2
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
Monday, February 11, 2013<br />
7:30 am-5:15 pm<br />
Registration <strong>and</strong> Information<br />
General Session<br />
8:30-8:45 am<br />
Welcome <strong>and</strong> Introduction<br />
Kristen B. Rosati, AHLA President-Elect<br />
Cynthia Y. Reisz, <strong><strong>Physician</strong>s</strong> Program Chair<br />
8:45-9:45 am<br />
Keynote Address<br />
Robert K. DeConti<br />
CONCURRENT SESSIONS<br />
10:00-11:00 am<br />
A. A Marketing Compliance Primer for Healthcare<br />
Providers<br />
Anna M. Grizzle<br />
Lori S. Richardson Pelliccioni<br />
j Applicable healthcare statutes <strong>and</strong> regulations, such as the<br />
Anti-Kickback Statute, <strong>Physician</strong> Self-Referral Statute, Health<br />
Insurance Portability <strong>and</strong> Act (HIPAA), beneficiary inducement<br />
statute, impacting healthcare providers’ marketing efforts<br />
j The FTC <strong>and</strong> FCC requirements, particularly when telemarketing<br />
is a part of the marketing program<br />
j Special considerations for DMEPOS suppliers engaged in<br />
direct patient contact or telemarketing<br />
j Suggestions <strong>and</strong> practical tips for conducting marketing<br />
activities in a compliant manner<br />
B. The MSO’s Prognosis after the ACA: A Viable<br />
Integration Tool?<br />
Gregory D. Anderson<br />
Emily B. Grey<br />
j History of management service organizations<br />
j Post-ACA implications for MSOs<br />
j Legal <strong>and</strong> regulatory issues affecting MSOs<br />
j Valuation of MSOs <strong>and</strong> MSO compensation arrangements<br />
j Hypothetical case study of an MSO involving legal, valuation<br />
<strong>and</strong> commercial reasonableness analyses<br />
C. The Evolution of HIPAA: Impact of HITECH <strong>and</strong><br />
Increased HIPAA Enforcement on <strong>Physician</strong> Practices<br />
Kimberly Short Kirk<br />
Brad M. Rostolsky<br />
j The key changes from HITECH that impact physician<br />
practices, with a focus the Access Report Rule <strong>and</strong> breach<br />
notification requirements<br />
j Significant enforcement actions, reported incidents, <strong>and</strong> the<br />
Office for Civil Rights HIPAA Audit protocol to provide practices<br />
with a roadmap to successfully navigate compliance hotspots.<br />
The Office for Civil Rights has made it clear that once it<br />
has a reason to talk with a covered entity about a compliance<br />
3<br />
issue (typically through a self-reported breach or a third-party<br />
complaint), any compliance deficiencies that come to light<br />
j Key aspects of HIPAA training<br />
j Best practices for compliance, such as use of social media,<br />
internet email <strong>and</strong> portable devices by practice employees,<br />
engagement of “cloud” storage vendors <strong>and</strong> management of<br />
business associate relationships<br />
j Responding to patient complaints <strong>and</strong> OCR inquiries <strong>and</strong><br />
providing breach notifications to affected individuals <strong>and</strong><br />
government agencies<br />
11:15 am-12:15 pm<br />
D. Audits <strong>and</strong> Appeals: Pre- <strong>and</strong> Post-Audit Strategies<br />
(not repeated)<br />
Frank Cohen<br />
j Create utilization tables from your own data<br />
j Identifying which code/modifier sets are most at risk<br />
j How auditors profile your practice<br />
j Basic analytical <strong>and</strong> statistical techniques<br />
E. How to Determine Commercial Reasonableness of<br />
Hospital-<strong>Physician</strong> Compensation Arrangements<br />
Marc D. Goldstone<br />
Daryl P. Johnson<br />
Daniel H. Melvin<br />
j Characteristics of arrangements that help establish a favorable<br />
commercial reasonableness determination, <strong>and</strong> factors that can<br />
cast doubt on the appropriateness of proposed arrangements<br />
j Transactions involving the acquisition of ancillary service<br />
lines from physicians (e.g., chemo infusion <strong>and</strong> diagnostic<br />
modalities). In particular, heightened risks may exist for<br />
certain structures <strong>and</strong> possible challenges when a DCF valuation<br />
approach is used<br />
j Hospitals are entering into a wide variety of arrangements<br />
with physicians entailing compensation for management<br />
services <strong>and</strong> the achievement of metrics <strong>and</strong>/or quality<br />
goals. The presenters will discuss the l<strong>and</strong>scape of such arrangements,<br />
<strong>and</strong> provide guidance regarding what works.<br />
j The commercial reasonableness concerns involved in structuring<br />
such arrangements with non-employed physicians<br />
j Some OIG <strong>and</strong> other similar guidance on application of the<br />
commercial reasonableness st<strong>and</strong>ard to specific transactions<br />
(including recent Advisory Opinion guidance)<br />
F. Staying the Course: Maintaining a <strong>Physician</strong> Group<br />
Practice in Today’s Healthcare Environment<br />
R. Michael Barry<br />
Barbara Grant<br />
j Practical <strong>and</strong> legal information describing how physicians<br />
may continue to operate independently, physician practice<br />
strategic planning<br />
j Growth through mergers<br />
j <strong>Physician</strong> leadership <strong>and</strong> developing strategic alliances;<br />
recruiting <strong>and</strong> retention of physicians
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
j Compensation formulas designed to align with practice goals<br />
j Key corporate documents, including buy-in/buy-out provisions,<br />
restrictive covenants , dispute resolution, <strong>and</strong> governance<br />
<strong>and</strong> decision-making<br />
12:15-1:35 pm<br />
Lunch on your own or attend a Practice Group<br />
Luncheon: Antitrust; <strong>Physician</strong> <strong>Organizations</strong>,<br />
sponsored by PYA; or Labor <strong>and</strong> Employment<br />
(additional fee; limited attendance; pre-registration required;<br />
see page 19 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
CONCURRENT SESSIONS<br />
1:45-2:45 pm<br />
G. Building a Practice Acquisition <strong>and</strong> Employment<br />
Strategies that St<strong>and</strong> the Test of Time in a Changing<br />
Regulatory Environment<br />
Christopher T. Carnahan<br />
David T. Lewis<br />
j Legal requirements applicable to practice acquisitions<br />
j The roles <strong>and</strong> responsibilities of client business representatives,<br />
legal counsel <strong>and</strong> valuation professionals<br />
j Reasons why practice acquisitions fail <strong>and</strong> how failures can<br />
be avoided<br />
j Building a strategic plan for practice acquisitions <strong>and</strong> hospital‐physician<br />
alignment<br />
H. Caught between Scylla <strong>and</strong> Charybdis: Reconciling<br />
Incentive Payments for Value with Government<br />
Concerns about Clinical Quality <strong>and</strong> Overutilization<br />
Daniel F. Murphy<br />
Bruce J. Toppin<br />
j Use of a service line co-management agreement with pay<br />
for performance <strong>and</strong> gainsharing elements as a case study,<br />
focusing on areas of tension between the current drive for<br />
value <strong>and</strong> existing regulatory guidance<br />
j Ideas to address these tensions in ways that satisfy quality<br />
<strong>and</strong> cost objectives, while minimizing regulatory risk<br />
j Quality of care metrics tied to P4P incentive payments <strong>and</strong><br />
identify guidelines for providing clinical justification for<br />
selecting those metrics<br />
j Gainsharing categories <strong>and</strong> identify controls <strong>and</strong> safeguards<br />
that can be implemented to prevent <strong>and</strong> detect quality of<br />
care concerns<br />
J. Reimbursement: Getting <strong><strong>Physician</strong>s</strong> Paid<br />
Andrew H. Selesnick<br />
j Determining <strong>and</strong> collecting usual, customary, <strong>and</strong> reasonable<br />
charges for non-contracting physicians<br />
j Managed care <strong>and</strong> payor contracting tips<br />
j Litigating against payors<br />
j Coding <strong>and</strong> documentation issues<br />
j Preparing for <strong>and</strong> defending government <strong>and</strong> payor<br />
reimbursement audits<br />
4<br />
3:00-4:00 pm<br />
K. A 12-Step Program to Better Compliance: A Practical<br />
Approach<br />
Julie E. Kass<br />
Kim Harvey Looney<br />
j Steps providers need to take to have an effective compliance plan<br />
j Strategies to deal with real life compliance issues<br />
C. The Evolution of HIPAA: Impact of HITECH <strong>and</strong> Increased<br />
HIPAA Enforcement on <strong>Physician</strong> Practices (repeat)<br />
J. Reimbursement: Getting <strong><strong>Physician</strong>s</strong> Paid (repeat)<br />
4:15-5:15 pm<br />
A. A Marketing Compliance Primer for Healthcare<br />
Providers (repeat)<br />
E. How to Determine Commercial Reasonableness of<br />
Hospital-<strong>Physician</strong> Compensation Arrangements (repeat)<br />
G. Building a Practice Acquisition <strong>and</strong> Employment<br />
Strategies that St<strong>and</strong> the Test of Time in a Changing<br />
Regulatory Environment (repeat)<br />
5:15-6:15 pm<br />
Networking Reception, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
6:15-7:15 pm<br />
Celebrating Diversity <strong>and</strong> Inclusiveness Reception,<br />
sponsored by AHLA’s Advisory Council on Diversity<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
Tuesday, February 12, 2013<br />
7:00 am-5:15 pm<br />
Registration <strong>and</strong> Information<br />
7:00-8:00 am<br />
Continental Breakfast, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
General Session<br />
8:00-8:15 am<br />
Welcome <strong>and</strong> Introduction<br />
Kristen B. Rosati, AHLA President-Elect<br />
Lisa J. Gilden, Hospitals Program Co-Chair<br />
8:15-9:45 am<br />
Top Legal Developments for Hospitals <strong>and</strong> <strong><strong>Physician</strong>s</strong><br />
Elizabeth B. Carder-Thompson<br />
Jack S. Schroder, Jr.
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
CONCURRENT SESSIONS<br />
10:15-11:15 am<br />
L. Why Quality of Care Should Matter to You: FCA<br />
Enforcement in 2013 <strong>and</strong> Beyond (not repeated)<br />
George B. Breen<br />
Kevin A. Cornish<br />
Jeffrey Dickstein<br />
j The government’s theory of FCA liability in “quality of care”<br />
<strong>and</strong> “worthless services” cases against hospitals <strong>and</strong> against<br />
individual physicians<br />
j Challenging the government’s effort to utilize the False<br />
Claims Act as a mechanism to enforce quality st<strong>and</strong>ards<br />
j What providers <strong>and</strong> hospitals can do proactively, to try to<br />
stave off this enforcement effort <strong>and</strong> how compliance programs<br />
should be adapted to address this risk area<br />
M. Complex Fair Market Value/ Commercial Reasonableness<br />
Compensation Issues<br />
Robert A. Wade<br />
j Compensation stacking<br />
j How to apply benchmark data<br />
j When is it safe to exceed the benchmark data range?<br />
j Call compensation issues<br />
j How to apply commercial reasonableness to compensation<br />
arrangements – including shifting of business risk<br />
j Productivity compensation issues<br />
j Mid-level provider supervision compensation<br />
j Stipends for hospital-based services (ER, Anesthesiology,<br />
Hospitalist, Radiology)<br />
j Real estate – what is a defensible market assessment <strong>and</strong><br />
how to apply<br />
j Time share leasing arrangements – how to develop <strong>and</strong><br />
manage compliant arrangements<br />
N. You Say Tomato: Employer <strong>and</strong> Employee Perspectives<br />
on the <strong>Physician</strong> Employment Contract<br />
Philip M. Bluestein<br />
Martha S. Henley<br />
j Generic/st<strong>and</strong>ard physician employment contract<br />
j Contentious issues from the employer’s <strong>and</strong> employee’s<br />
counsel’s perspective<br />
j Non-competition <strong>and</strong> non-solicitation provisions<br />
j Medical records – ownership, disclosure, appropriate access<br />
to <strong>and</strong> use of during <strong>and</strong> post-employment<br />
j Government audits <strong>and</strong> recapture of funds from employed<br />
physicians<br />
j Intellectual property<br />
j Issues surrounding moonlighting <strong>and</strong> other outside employment<br />
opportunities<br />
j Meaningful use<br />
j Compensation structures<br />
j Offsetting compensation for funds owed<br />
O. Bundled Payments – Practicalities, Contractual <strong>and</strong><br />
Governance Issues<br />
Alice G. Gosfield<br />
j Defining terms: Bundles vs episodes vs. gainsharing, etc<br />
j What do we really know about bundled payment? Experiences<br />
to date<br />
j Principles of bundling: Triggering, breaking, ending<br />
j How bundles affect governance <strong>and</strong> contracting<br />
j Governance among participating providers: Avoiding food<br />
fights, sueprmajorities, adding, terminating participants<br />
j Dispute resolution<br />
P. I’ll Have What She’s Having… Harry Hospital Meets<br />
Sally Specialist<br />
Robert G. Homchick<br />
Cynthia Y. Reisz<br />
j Integration options <strong>and</strong> the factors driving how <strong>and</strong> to what<br />
degree hospitals <strong>and</strong> specialists are coming together<br />
j Use of hypotheticals to explore:<br />
– Professional Services Agreements in combination with<br />
Management Services Agreements<br />
– Innovative models facilitating Hospital or <strong>Physician</strong> Network<br />
participation in or ownership of traditional <strong>Physician</strong><br />
practices<br />
K. A 12-Step Program to Better Compliance: A Practical<br />
Approach (repeat)<br />
11:25 am-12:25 pm<br />
Q. Buyer Beware! The Value of Due Diligence in<br />
Hospital-<strong>Physician</strong> Transactions (not repeated)<br />
Lori A. Foley<br />
Judd A. Harwood<br />
j Practical regulatory, financial <strong>and</strong> transactional issues both<br />
in‐house <strong>and</strong> outside counsel need to navigate when evaluating<br />
physician‐provider transactions<br />
j Identification of economic <strong>and</strong> operational issues that<br />
should be evaluated pre-acquisition<br />
j Importance of evaluating documentation, coding <strong>and</strong> billing<br />
compliance<br />
j Identification of common diligence issues <strong>and</strong> strategies for<br />
resolving uncovered regulatory problems, including voluntary<br />
self‐disclosures<br />
5
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
R. <strong>Physician</strong> Compensation: Legal <strong>and</strong> Valuation Trends<br />
Today, Tomorrow <strong>and</strong> Beyond<br />
Kimberly A. Mobley<br />
Claire M. Turcotte<br />
j Compensating physicians for quality, performance—how,<br />
when <strong>and</strong> why?<br />
j Compensating for administrative services<br />
j When do hours need to be tracked (<strong>and</strong> how)?<br />
j Compensation <strong>and</strong> FMV challenges in alignment strategies:<br />
– Co-management arrangements<br />
– Professional services arrangements<br />
– Income support arrangements<br />
j Operational challenges when changing the physician<br />
compensation plan<br />
j Best practices for governance <strong>and</strong> approval, <strong>and</strong> monitoring<br />
of physician compensation arrangements<br />
S. Legal Ethics: What Penn State <strong>and</strong> Lehman Brothers Can<br />
Teach Healthcare <strong>Law</strong>yers about Conflicts of Interest<br />
William W. Horton<br />
Jeff Sconyers<br />
j Conflict rules under the Model Rules of Professional Conduct<br />
j Conflicts: Waivable <strong>and</strong> the other kind<br />
j Representing an entity vs. advising individual stakeholders<br />
j Separate representation, indemnification <strong>and</strong> advancement<br />
of expenses<br />
j Lessons from Penn State, Lehman Brothers <strong>and</strong> other cases<br />
T. A Practitioner’s Toolkit for Addressing “Technical”<br />
Violations of the Stark <strong>Law</strong><br />
Kristin M. Bohl<br />
Robert D. Stone<br />
j Some of the most common technical violations that occur<br />
j Approaches for analyzing the facts to determine if a violation<br />
exists or if an arrangement may be compliant<br />
j If you decide a violation exists, what is the self-disclosure process<br />
j The Voluntary <strong>Physician</strong> Self-Referral Disclosure Protocol,<br />
including the process, best tips when submitting a disclosure<br />
<strong>and</strong> potential pitfalls to avoid<br />
H. Caught between Scylla <strong>and</strong> Charybdis: Reconciling<br />
Incentive Payments for Value with Government Concerns<br />
about Clinical Quality <strong>and</strong> Overutilization (repeat)<br />
12:25-1:35 pm<br />
Lunch on your own or attend a Practice Group Luncheon:<br />
Medical Staff, Credentialing, <strong>and</strong> Peer Review,<br />
sponsored by MDReview, or Hospitals <strong>and</strong> Health Systems/In-House<br />
Counsel/Enterprise Risk Management<br />
Task Force (joint luncheon), sponsored by Health Capital<br />
Consultants LLC<br />
(additional fee; limited attendance; pre-registration required;<br />
see page 19 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
CONCURRENT SESSIONS<br />
1:45-2:45 pm<br />
U. How Health Reform Has Reduced Fraud Enforcement<br />
Risk for Hospitals <strong>and</strong> Systems (not repeated)<br />
Patrick S. Coffey<br />
Linda A. Wawzenski<br />
j The cases for <strong>and</strong> against the position that PPACA has brought<br />
about a fundamental shift in fraud enforcement focus <strong>and</strong><br />
initiatives relating to physicians <strong>and</strong> physician groups<br />
j The enforcement data <strong>and</strong> trends relating to the FCA, Anti‐Kickback<br />
<strong>and</strong> Stark cases being pursued against physicians <strong>and</strong> groups<br />
j The impact of Post‐PPACA enforcement trends <strong>and</strong> government<br />
initiatives on physician compliance efforts <strong>and</strong> programs<br />
j Comparison of recent/past cases involving alleged healthcare<br />
fraud by physicians <strong>and</strong> physician groups<br />
j Best practices for avoiding enforcement, exclusion <strong>and</strong> other<br />
fraud related risks to physicians <strong>and</strong> groups<br />
j The future of healthcare fraud enforcement<br />
V. <strong>Physician</strong> <strong>and</strong> Hospital Investment in Ambulatory<br />
Surgery Centers (not repeated)<br />
Melissa S. Szabad<br />
Martha J. Talley<br />
j Application of the anti-kickback law <strong>and</strong> safe harbor to physician<br />
<strong>and</strong> hospital investment in ASCs<br />
j Conversion of ASCs to hospital out-patient departments<br />
W. Clinically Integrated Networks: The PHOs of the 21st Century<br />
Peter A. Pavarini<br />
Michael F. Schaff<br />
j Clinically integrated networks, if properly structured <strong>and</strong><br />
operated, can avoid the regulatory <strong>and</strong> financial mistakes<br />
made by PHOs in the past<br />
j Existing clinically integrated networks, demonstrate how these<br />
organizations have promoted better care at lower cost, offering<br />
a compelling value proposition to payers in their markets<br />
j Contemporary governance structures <strong>and</strong> contractual provisions<br />
can address the competing interests of physicians who<br />
wish to preserve their independence with a hospital’s expectation<br />
of loyalty to the goals <strong>and</strong> objectives of the organization<br />
j The challenges <strong>and</strong> opportunities presented by clinically<br />
integrated networks when they seek to negotiate enhanced<br />
payment arrangements with payers in order to share in the<br />
value created by coordinated care<br />
j Apply these concepts <strong>and</strong> strategies to factual scenarios<br />
where physician employment is not an option or has been<br />
tried unsuccessfully<br />
B. The MSO’s Prognosis after the ACA: A Viable<br />
Integration Tool? (repeat)<br />
M. Complex Fair Market Value/ Commercial<br />
Reasonableness Compensation Issues (repeat)<br />
6
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
<strong><strong>Physician</strong>s</strong><br />
Hospitals<br />
<strong>and</strong><br />
<strong>and</strong><br />
<strong>Physician</strong><br />
Health<br />
<strong>Organizations</strong><br />
Systems <strong>Law</strong> <strong>Institute</strong><br />
<strong>Law</strong> <strong>Institute</strong><br />
3:00-4:00 pm<br />
F. Staying the Course: Maintaining a <strong>Physician</strong> Group<br />
Practice in Today’s Healthcare Environment (repeat)<br />
N. Employer <strong>and</strong> Employee Perspectives on the <strong>Physician</strong><br />
Employment Contract (repeat)<br />
O. Bundled Payments – Practicalities, Contractual <strong>and</strong><br />
Governance Issues (repeat)<br />
S. Legal Ethics: What Penn State <strong>and</strong> Lehman Brothers Can<br />
Teach Healthcare <strong>Law</strong>yers about Conflicts of Interest (repeat)<br />
4:15-5:15 pm<br />
P. I’ll Have What She’s Having… Harry Hospital Meets<br />
Sally Specialist (repeat)<br />
R. <strong>Physician</strong> Compensation: Legal <strong>and</strong> Valuation Trends<br />
Today, Tomorrow <strong>and</strong> Beyond (repeat)<br />
T. A Practitioner’s Toolkit for Addressing “Technical”<br />
Violations of the Stark <strong>Law</strong> (repeat)<br />
W. Clinically Integrated Networks: The PHOs of the 21st<br />
Century (repeat)<br />
Adjournment<br />
7
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
Planning Committee<br />
Cynthia Y. Reisz, Esq., Program Chair<br />
Bass Berry & Sims PLC<br />
Nashville, TN<br />
David J. Hyman, Esq.<br />
Doerner Saunders Daniel & Anderson LLP<br />
Tulsa, OK<br />
Kim Harvey Looney, Esq.<br />
Waller Lansden Dortch & Davis LLP<br />
Nashville, TN<br />
Donald “Rocky” P. Wilcox, Esq.<br />
General Counsel<br />
Texas Medical Association<br />
Austin, TX<br />
Gregory D. Anderson, CPA/ABV, CVA<br />
HORNE LLP<br />
Hattiesburg, MD<br />
R. Michael Barry, Esq.<br />
Arnall Golden Gregory LLP<br />
Atlanta, GA<br />
Philip M. Bluestein, Esq.<br />
<strong>Law</strong> Office of Philip M. Bluestein<br />
Boulder, CO<br />
Kristin M. Bohl, Esq.<br />
Adelman Sheff & Smith LLC<br />
Annapolis, MD<br />
George B. Breen, Esq.<br />
Epstein Becker & Green PC<br />
Washington, DC<br />
Elizabeth B. Carder-Thompson, Esq.<br />
Reed Smith LLP<br />
Washington, DC<br />
Christopher T. Carnahan<br />
Carnahan Group, Inc.<br />
Tampa, FL<br />
Patrick S. Coffey, Esq.<br />
Locke Lord Bissell & Liddell LLP<br />
Chicago, IL<br />
Frank Cohen, Esq.<br />
The Frank Cohen Group LLC<br />
Clearwater, FL<br />
Kevin A. Cornish<br />
Navigant<br />
Phoenix, AZ<br />
Robert K. DeConti, Esq.<br />
Assistant Inspector General for Legal Affairs<br />
Office of the Inspector General<br />
US Department of Health <strong>and</strong> Human<br />
Services<br />
Washington, DC<br />
<strong><strong>Physician</strong>s</strong> Program Faculty<br />
Jeffrey Dickstein, Esq.<br />
AUSA<br />
US Department of Justice<br />
Miami, FL<br />
Lori A. Foley<br />
PYA<br />
Atlanta, GA<br />
Marc D. Goldstone, Esq.<br />
Vice President <strong>and</strong> Associate General<br />
Counsel<br />
Community Health Systems<br />
Franklin, TN<br />
Alice G. Gosfield, Esq.<br />
Alice G. Gosfield & Associates PC<br />
Philadelphia, PA<br />
Barbara Grant<br />
PYA<br />
Atlanta, GA<br />
Emily B. Grey, Esq.<br />
Breazeale Sachse & Wilson LLP<br />
Baton Rouge, LA<br />
Anna M. Grizzle, Esq.<br />
Bass Berry & Sims PLC<br />
Nashville, TN<br />
Judd A. Harwood, Esq.<br />
Bradley Arant Boult Cummings LLP<br />
Birmingham, AL<br />
Martha S. Henley, Esq.<br />
Operations Counsel<br />
Community Health Systems<br />
Franklin, TN<br />
Robert G. Homchick, Esq.<br />
Davis Wright Tremaine LLP<br />
Seattle, WA<br />
William W. Horton, Esq.<br />
Johnston Barton Proctor & Rose LLP<br />
Birmingham, AL<br />
Daryl P. Johnson, MACC, AVA<br />
HealthCare Appraisers, Inc.<br />
Delray Beach, FL<br />
Julie E. Kass, Esq.<br />
OBER | KALER<br />
Baltimore, MD<br />
Kimberly Short Kirk, Esq.<br />
Moore & Van Allen PLLC<br />
Charlotte, NC<br />
David T. Lewis, Esq.<br />
Vice President <strong>and</strong> Associate General<br />
Counsel<br />
Lifepoint Hospitals<br />
Brentwood, TN<br />
Daniel H. Melvin, Esq.<br />
McDermott Will & Emery LLP<br />
Chicago, IL<br />
8<br />
Kimberly A. Mobley, Esq.<br />
Sullivan Cotter <strong>and</strong> Associates, Inc.<br />
Southfield, MI<br />
Daniel F. Murphy, Esq.<br />
Bradley Arant Boult Cummings LLP<br />
Birmingham, AL<br />
Peter A. Pavarini, Esq.<br />
Squire S<strong>and</strong>ers LLP<br />
Columbus, OH<br />
Lori S. Richardson Pelliccioni, JD, PhD<br />
Chief Risk Officer <strong>and</strong> Chief<br />
Compliance Officer<br />
Simplex Healthcare, Inc.<br />
Beverly Hills, CA<br />
Brad M. Rostolsky, Esq.<br />
Reed Smith LLP<br />
Philadelphia, PA<br />
Michael F. Schaff, Esq.<br />
Wilentz Goldman & Spitzer PA<br />
Woodbridge, NJ<br />
Jack S. Schroder, Jr., Esq.<br />
Ret. Alston & Bird LLP<br />
Big Canoe, GA<br />
Jeff Sconyers, Esq.<br />
Senior Vice President <strong>and</strong> General Counsel<br />
Seattle Children’s Hospital<br />
Seattle, WA<br />
Andrew H. Selesnick, Esq.<br />
Michelman & Robinson LLP<br />
Encino, CA<br />
Robert D. Stone, Esq.<br />
Alston & Bird LLP<br />
Atlanta, GA<br />
Melissa S. Szabad, Esq.<br />
McGuire Woods LLP<br />
Chicago, IL<br />
Martha J. Talley, JD<br />
Chief, Industry Guidance Branch<br />
Office of Inspector General<br />
US Department of Health <strong>and</strong> Juman Services<br />
Washington, DC<br />
Bruce J. Toppin, Esq.<br />
Vice President <strong>and</strong> General Counsel<br />
North Mississippi Health Services<br />
Tupelo, MS<br />
Claire M. Turcotte, Esq.<br />
Bricker & Eckler LLP<br />
West Chester, OH<br />
Robert A. Wade, Esq.<br />
Krieg DeVault LLP<br />
Mishawaka, IN<br />
Linda A. Wawzenski, Esq.<br />
Assistant US Attorney <strong>and</strong> Deputy Chief of<br />
Civil Division<br />
United States Attorney’s Office, Northern<br />
District of Illinois<br />
Chicago, IL
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Tuesday, February 12, 2013<br />
7:00 am-5:15 pm<br />
Registration <strong>and</strong> Information<br />
7:00-8:00 am<br />
Continental Breakfast, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
GENERAL SESSION<br />
8:00-8:15 am<br />
Welcome <strong>and</strong> Introduction<br />
Kristen B. Rosati, AHLA President-Elect<br />
Lisa J. Gilden, Hospitals Program Co-Chair<br />
8:15-9:45 am<br />
Top Legal Developments for Hospitals <strong>and</strong> <strong><strong>Physician</strong>s</strong><br />
Elizabeth B. Carder-Thompson<br />
Jack S. Schroder, Jr.<br />
CONCURRENT SESSIONS<br />
10:15-11:15 am<br />
A. Why Quality of Care Should Matter to You: FCA<br />
Enforcement in 2013 <strong>and</strong> Beyond<br />
George B. Breen<br />
Kevin A. Cornish<br />
Jeffrey Dickstein<br />
j The government’s theory of FCA liability in “quality of care”<br />
<strong>and</strong> “worthless services” cases against hospitals <strong>and</strong> against<br />
individual physicians<br />
j Challenging the government’s effort to utilize the False<br />
Claims Act as a mechanism to enforce quality st<strong>and</strong>ards<br />
j What providers <strong>and</strong> hospitals can do proactively, to try to<br />
stave off this enforcement effort <strong>and</strong> how compliance programs<br />
should be adapted to address this risk area<br />
B. Complex Fair Market Value/ Commercial Reasonableness<br />
Compensation Issues<br />
Robert A. Wade<br />
j Compensation stacking<br />
j How to apply benchmark data<br />
j When is it safe to exceed the benchmark data range?<br />
j Call compensation issues<br />
j How to apply commercial reasonableness to compensation<br />
arrangements – including shifting of business risk<br />
j Productivity compensation issues<br />
j Mid-level provider supervision compensation<br />
j Stipends for hospital-based services (ER, Anesthesiology,<br />
Hospitalist, Radiology)<br />
j Real estate – what is a defensible market assessment <strong>and</strong><br />
how to apply<br />
j Time share leasing arrangements – how to develop <strong>and</strong><br />
manage compliant arrangements<br />
Program Agenda<br />
C. You Say Tomato: Employer <strong>and</strong> Employee Perspectives<br />
on the <strong>Physician</strong> Employment Contract<br />
Philip M. Bluestein<br />
Martha S. Henley<br />
j Generic/st<strong>and</strong>ard physician employment contract<br />
j Contentious issues from the employer’s <strong>and</strong> employee’s<br />
counsels perspective<br />
j Non-competition <strong>and</strong> non-solicitation provisions<br />
j Medical records – ownership, disclosure, appropriate access<br />
to <strong>and</strong> use of during <strong>and</strong> post-employment<br />
j Government audits <strong>and</strong> recapture of funds from employed<br />
physicians<br />
j Intellectual property<br />
j Issues surrounding moonlighting <strong>and</strong> other outside<br />
employment opportunities<br />
j Meaningful use<br />
j Compensation structures<br />
j Offsetting compensation for funds owed<br />
j Malpractice claims, settlement <strong>and</strong> tail insurance <strong>and</strong> more<br />
D. Bundled Payments – Practicalities, Contractual <strong>and</strong><br />
Governance Issues<br />
Alice G. Gosfield<br />
j Defining terms: Bundles vs episodes vs. gainsharing, etc<br />
j What do we really know about bundled payment?<br />
Experiences to date<br />
j Principles of bundling: Triggering, breaking, ending<br />
j How bundles affect governance <strong>and</strong> contracting<br />
j Governance among participating providers: Avoiding food<br />
fights: sueprmajorities, adding, terminating participants<br />
j Dispute resolution<br />
E. I’ll Have What She’s Having… Harry Hospital Meets<br />
Sally Specialist<br />
Robert G. Homchick<br />
Cynthia Y. Reisz<br />
j Integration options <strong>and</strong> the factors driving how <strong>and</strong> to what<br />
degree hospitals <strong>and</strong> specialists are coming together<br />
j Use of hypotheticals to explore:<br />
– Professional Services Agreements in combination with<br />
Management Services Agreements<br />
– Innovative models facilitating Hospital or <strong>Physician</strong> Network<br />
participation in or ownership of traditional <strong>Physician</strong><br />
practices<br />
9
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
11:25 am-12:25 pm<br />
F. Buyer Beware! The Value of Due Diligence in<br />
Hospital-<strong>Physician</strong> Transactions (not repeated)<br />
Lori A. Foley<br />
Judd A. Harwood<br />
j Practical regulatory, financial <strong>and</strong> transactional issues both<br />
in‐house <strong>and</strong> outside counsel need to navigate when evaluating<br />
physician‐provider transactions<br />
j Identification of economic <strong>and</strong> operational issues that<br />
should be evaluated preacquisition<br />
j Importance of evaluating documentation, coding <strong>and</strong> billing<br />
compliance<br />
j Identification of common diligence issues <strong>and</strong> strategies<br />
for resolving uncovered regulatory problems, including<br />
voluntary self‐disclosures<br />
G. Consolidation in a Rapidly Changing Industry:<br />
Navigating Options, Antitrust <strong>and</strong> Other Obstacles<br />
David A. Ettinger<br />
Lynn Gordon<br />
j Consolidation drivers<br />
j The range of hospital/health system collaboration <strong>and</strong> consolidation<br />
models; key components of each model<br />
j Legal hurdles <strong>and</strong> requisite regulatory approvals, with strategic<br />
guidance, leading into a more in-depth antitrust discussion<br />
j Viability of “3 to 2” <strong>and</strong> “4 to 3” mergers after Toledo <strong>and</strong><br />
Rockford: Are they dead?<br />
j Antitrust limits on hospital acquisitions of physician practices<br />
j Strategic guidance on navigating an antitrust sensitive transaction<br />
j Sample transaction overview: a change of control/membership<br />
Substitution; key steps <strong>and</strong> parallels to other models,<br />
with a timeline<br />
H. <strong>Physician</strong> Compensation: Legal <strong>and</strong> Valuation Trends<br />
Today, Tomorrow <strong>and</strong> Beyond<br />
Kimberly A. Mobley<br />
Claire M. Turcotte<br />
j Compensating physicians for quality, performance—how,<br />
when <strong>and</strong> why?<br />
j Compensating for administrative services<br />
j When do hours need to be tracked (<strong>and</strong> how)?<br />
j Compensation <strong>and</strong> FMV challenges in alignment strategies:<br />
– Co-management arrangements<br />
– Professional services arrangements<br />
– Income support arrangements<br />
j Operational challenges when changing the physician<br />
compensation plan<br />
j Best practices for governance <strong>and</strong> approval, <strong>and</strong> monitoring<br />
of physician compensation arrangements<br />
Program Agenda<br />
J. Legal Ethics: What Penn State <strong>and</strong> Lehman Brothers Can<br />
Teach Healthcare <strong>Law</strong>yers about Conflicts of Interest<br />
William W. Horton<br />
Jeff Sconyers<br />
j Conflict rules under the Model Rules of Professional Conduct<br />
j Conflicts: Waivable <strong>and</strong> the other kind<br />
10<br />
j Representing an entity vs. advising individual stakeholders<br />
j Separate representation, indemnification <strong>and</strong> advancement<br />
of expenses<br />
j Lessons from Penn State, Lehman Brothers <strong>and</strong> other cases<br />
K. A Practitioner’s Toolkit for Addressing “Technical”<br />
Violations of the Stark <strong>Law</strong><br />
Kristin M. Bohl<br />
Robert D. Stone<br />
j Some of the most common technical violations that occur<br />
j Approaches for analyzing the facts to determine if a<br />
violation exists or if an arrangement may be compliant<br />
j If you decide a violation exists, what is the<br />
self-disclosure process<br />
j The Voluntary <strong>Physician</strong> Self-Referral Disclosure Protocol,<br />
including the process, best tips when submitting a disclosure<br />
<strong>and</strong> potential pitfalls to avoid<br />
12:25-1:35 pm<br />
Lunch on your own or attend a Practice Group Luncheon:<br />
Medical Staff, Credentialing, <strong>and</strong> Peer Review, sponsored<br />
by MDReview, or Hospitals <strong>and</strong> Health Systems/<br />
In-House Counsel/Enterprise Risk Management Task<br />
Force (joint luncheon) sponsored by Health Capital<br />
Consultants LLC<br />
(additional fee; limited attendance; pre-registration required;<br />
see page 19 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
CONCURRENT SESSIONS<br />
1:45-2:45 pm<br />
L. <strong>Physician</strong> <strong>and</strong> Hospital Investment in Ambulatory<br />
Surgery Centers (not repeated)<br />
Melissa S. Szabad<br />
Martha J. Talley<br />
j Application of the anti-kickback law <strong>and</strong> safe harbor to physician<br />
<strong>and</strong> hospital investment in ASCs<br />
j Conversion of ASCs to hospital out-patient departments<br />
M. The Top 10 Conflicts of Interest Developments<br />
Healthcare <strong>Law</strong>yers Need to Know About<br />
Gregory S. Radinsky<br />
j New laws <strong>and</strong> industry guidance on Conflicts of Interest<br />
<strong>and</strong> Gifts<br />
j Tips to avoid Stark <strong>and</strong> Anti-kickback issues<br />
j Practical tips for on auditing <strong>and</strong> monitoring for compliance<br />
with your Conflicts of Interest <strong>and</strong> Gifts policy<br />
j Pitfalls to avoid in implementing a more stringent Conflicts<br />
of Interest policy<br />
N. How Health Reform Has Reduced Fraud Enforcement<br />
Risk for Hospitals <strong>and</strong> Systems<br />
Patrick S. Coffey<br />
Linda A. Wawzenski<br />
j The cases for <strong>and</strong> against the position that PPACA has<br />
brought about a fundamental shift in fraud enforcement focus<br />
<strong>and</strong> initiatives relating to physicians <strong>and</strong> physician groups
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
j The enforcement data <strong>and</strong> trends relating to the FCA, Anti‐Kickback<br />
<strong>and</strong> Stark cases being pursued against physicians <strong>and</strong> groups<br />
j The impact of Post‐PPACA enforcement trends <strong>and</strong> government<br />
initiatives on physician compliance efforts <strong>and</strong><br />
programs<br />
j Comparison of recent/past cases involving alleged healthcare<br />
fraud by physicians <strong>and</strong> physician groups<br />
j Best practices for avoiding enforcement, exclusion <strong>and</strong><br />
other fraud related risks to physicians <strong>and</strong> groups<br />
j The future of healthcare fraud enforcement<br />
O. Clinically Integrated Networks: The PHOs of the<br />
21st Century<br />
Peter A. Pavarini<br />
Michael F. Schaff<br />
j Clinically integrated networks, if properly structured <strong>and</strong><br />
operated, can avoid the regulatory <strong>and</strong> financial mistakes<br />
made by PHOs in the past<br />
j Existing clinically integrated networks, demonstrate how<br />
these organizations have promoted better care at lower<br />
cost, offering a compelling value proposition to payers in<br />
their markets<br />
j Contemporary governance structures <strong>and</strong> contractual provisions<br />
can address the competing interests of physicians<br />
who wish to preserve their independence with a hospital’s<br />
expectation of loyalty to the goals <strong>and</strong> objectives of the<br />
organization<br />
j The challenges <strong>and</strong> opportunities presented by clinically<br />
integrated networks when they seek to negotiate enhanced<br />
payment arrangements with payers in order to share in the<br />
value created by coordinated care<br />
j Apply these concepts <strong>and</strong> strategies to factual scenarios<br />
where physician employment is not an option or has been<br />
tried unsuccessfully<br />
B. Complex Fair Market Value/ Commercial<br />
Reasonableness Compensation Issues (repeat)<br />
3:00-4:00 pm<br />
P. Hospital Acquisition of <strong><strong>Physician</strong>s</strong> Groups<br />
William E. Berlin<br />
John P. Wieg<strong>and</strong><br />
j The structural divestiture remedy in Renown Health, contrast<br />
to recent AG conduct remedies in the MaineHealth<br />
<strong>and</strong> UCPA physician mergers<br />
j The effect of healthcare reform <strong>and</strong> changing market<br />
dynamics on merger activity, including the interplay with<br />
Accountable Care <strong>Organizations</strong> (ACOs) <strong>and</strong> their implementing<br />
regulations – do the goals <strong>and</strong> mechanisms of<br />
healthcare reform <strong>and</strong> market reality conflict with agency<br />
merger enforcement?<br />
j Unique market definition <strong>and</strong> market power issues in physician<br />
services markets – how useful is historical <strong>and</strong> often<br />
limited patient data? Is market concentration a reliable tool<br />
for determining whether the parties will exercise market<br />
Program Agenda<br />
11<br />
power, especially in consummated mergers? How should coordinated<br />
effects <strong>and</strong> vertical foreclosure issues be analyzed?<br />
j Practical issues in merger implementation <strong>and</strong> defending<br />
agency investigations: Payor communications, community<br />
commitments, hold separate agreements, CID compliance<br />
<strong>and</strong> document preservation <strong>and</strong> production<br />
j FTC <strong>and</strong> AG enforcers’ perspective on substantive analysis<br />
<strong>and</strong> remedies in hospital-physician mergers<br />
Q. OIG Enforcement Initiatives Relating to Hospitals<br />
S. Craig Holden<br />
Lewis Morris<br />
j Recent False Claim Act cases<br />
– Stark/Kickback cases<br />
– Short stay cases<br />
j OIG Audit initiatives<br />
j OIG Self‐Disclosure Protocol<br />
j M<strong>and</strong>atory repayment rules<br />
C. Employer <strong>and</strong> Employee Perspectives on the <strong>Physician</strong><br />
Employment Contract (repeat)<br />
D. Bundled Payments – Practicalities, Contractual <strong>and</strong><br />
Governance Issues (repeat)<br />
J. Legal Ethics: What Penn State <strong>and</strong> Lehman Brothers<br />
Can Teach <strong>Law</strong>yers about Conflict of Interest (repeat)<br />
4:15-5:15 pm<br />
R. Knowing When <strong>and</strong> How to Protect Quality Information<br />
in an Employed <strong>Physician</strong> World<br />
Catherine M. Ballard<br />
Barbara Harbor Evert<br />
j Effectively triaging quality concerns/professional behavior<br />
concerns with employed physicians in both the hospital <strong>and</strong><br />
office settings (e.g., quality of care, professional behavior,<br />
compliance, contract, etc.)<br />
j Conducting peer review of employed physicians in the nonhospital<br />
setting<br />
j Creating processes that permit sharing of protected peer<br />
review information beyond the entity employing the physicians<br />
to include other organizations within a system<br />
j Looking at the risks that need to be assessed if certain information<br />
is not shared within a system (or can be shared, but<br />
not peer review protected)<br />
j Creating processes that take advantage of a state peer review<br />
privilege, to the extent possible<br />
S. Strategies Behind Successfully Resolving Compliance<br />
Issues <strong>and</strong> Government Investigations<br />
Brian D. Roark<br />
Richard L. Shackelford<br />
j Disclosure strategies for complex overpayment issues<br />
j Disclosure strategies tailored to address issues unique to<br />
potential stark violations
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
j Relevant considerations for determining the historical lookback<br />
period<br />
j Privilege/work product concerns <strong>and</strong> pitfalls to avoid during<br />
the investigation of complex compliance issues<br />
j Factors to consider when deciding where to make a<br />
voluntary disclosure<br />
E. I’ll Have What She’s Having… Harry Hospital Meets<br />
Sally Specialist (repeat)<br />
H. <strong>Physician</strong> Compensation: Legal <strong>and</strong> Valuation Trends<br />
Today, Tomorrow <strong>and</strong> Beyond (repeat)<br />
K. A Practitioner’s Toolkit for Addressing “Technical”<br />
Violations of the Stark <strong>Law</strong> (repeat)<br />
O. Clinically Integrated Networks: The PHOs of the<br />
21st Century (repeat)<br />
5:15-6:30 pm<br />
Networking Reception, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests are<br />
welcome to attend)<br />
6:30-7:30 pm<br />
Fair Market Value Affinity Group Happy Hour<br />
(attendees <strong>and</strong> faculty are welcome to attend; please see page<br />
20 for a descriptinons <strong>and</strong> sign-up on the registration form<br />
pages 21-22)<br />
7:00 pm<br />
Young Professionals Networking Dinners<br />
(Sign-up at the AHLA Resource Center Table)<br />
Wednesday, February 13, 2013<br />
7:30 am-3:25 pm<br />
Registration <strong>and</strong> Information<br />
7:30-8:30 am<br />
Continental Breakfast, sponsored by HORNE LLP<br />
(attendees, faculty, <strong>and</strong> registered spouses <strong>and</strong> guests<br />
welcome)<br />
7:30-8:30 am<br />
Fair Market Value Affinity Group Breakfast<br />
(attendees <strong>and</strong> faculty are welcome to attend; please see page<br />
20 for a descriptions <strong>and</strong> sign-up on the registration form on<br />
pages 21-22)<br />
CONCURRENT SESSIONS<br />
8:30-9:30 am<br />
T. Health Reform Fatigue: Which Health Reform Models<br />
Have the Strongest Chance of Success? (not repeated)<br />
James C. Pyles<br />
j The objectives that any healthcare delivery model will have<br />
to achieve in order to succeed <strong>and</strong> which models st<strong>and</strong> the<br />
best chance of achieving those objectives<br />
j Which models provide the best return on investment now<br />
<strong>and</strong> in the future<br />
U. Reimbursement Rules that Could Trip Up Hospital<br />
Attorneys<br />
Cynthia F. Wisner<br />
j The 3 day rule <strong>and</strong> in particular its application to joint ventures<br />
that the hospital manages<br />
j The provider-based rule <strong>and</strong> the problems with system<br />
signage<br />
j The physician supervision rule <strong>and</strong> the effect on hospitals<br />
departments not located on the hospital campus -- appropriate<br />
levels of supervision for individual hospital outpatient<br />
therapeutic services<br />
j The 340b drug pricing program <strong>and</strong> the effect on the pharmacy<br />
of enhanced scrutiny<br />
j Changes in reference lab billing for lab services to inpatients<br />
j Patient freedom of choice <strong>and</strong> Important Message from<br />
Medicare obligations of hospitals<br />
j The locums tenems rule <strong>and</strong> the limits on billing for coverage<br />
j Anesthesia for preventive services – Medicare free screenings<br />
j The use of physician extenders <strong>and</strong> the effects on scheduling<br />
j Practical steps that hospital counsel can recommend to<br />
ensure that reimbursement is not lost<br />
V. Analysis of the New “Omnibus” HIPAA/HITECH<br />
Regulations<br />
Marilyn Lamar<br />
Patricia A. Markus<br />
j Security breach notification<br />
j Enforcement<br />
j Marketing <strong>and</strong> sale of PHI<br />
j Other topics (depending on content of omnibus rule)<br />
j Guidance in transitioning from the current rules to the<br />
new rule<br />
j How business associates are affected<br />
j Any impact on providers seeking meaningful use incentives<br />
j If the rule isn’t out by the time of the program, the speakers<br />
will address an alternative topic related to HIPAA privacy<br />
<strong>and</strong> security<br />
W. If You Can’t Monitor It, Don’t Execute It: Ways to<br />
Develop Compliant Agreements that Are Commercially<br />
Reasonable <strong>and</strong> Consistent with FMV<br />
Curtis H. Bernstein<br />
Jill H. Gordon<br />
j When to use income, market <strong>and</strong> asset valuations<br />
j Can goodwill be valued?<br />
j Application of strategic value<br />
j <strong>Physician</strong> compensation impact on practice value<br />
j Should a billing audit be part of valuation process?<br />
12
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Program Agenda<br />
j Impact ancillary revenue has on valuation (<strong>and</strong> on<br />
physician’s post-acquisition compensation)<br />
j Is it Commercially reasonable to incur losses on physician<br />
practices post-acquisition?<br />
9:40-10:40 am<br />
X. Best Practices for Achieving Complex Patient<br />
Discharges (not repeated)<br />
Mary Daymont<br />
Alice M. MacDermott<br />
j Legal framework for discharge planning<br />
j Role of in-house <strong>and</strong> outside legal counsel in discharge<br />
planning<br />
j Legal strategies to h<strong>and</strong>ling difficult discharges<br />
j Best practices to mitigate legal <strong>and</strong> financial risks<br />
– Interdisciplinary team approach<br />
– Focus on clinical planning<br />
– Early escalation<br />
– Communication<br />
– Cultural sensitivity<br />
j Addressing non-supportive team dynamics<br />
Y. Non-Profit/For-Profit Joint Ventures – Structuring <strong>and</strong><br />
Valuing the Deal<br />
Eliot Jeter<br />
James M. Pinna<br />
j Non-profit / for-profit joint venture trends<br />
– Post-acute, rehab, surgery centers, imaging, oncology,<br />
urgent care<br />
– Operational <strong>and</strong> financial considerations<br />
j Regulatory <strong>and</strong> compliance issues<br />
– Stark, Anti-Kickback, tax exemption, antitrust, licensure,<br />
reimbursement<br />
j Hypothetical transaction structure<br />
– Legal <strong>and</strong> regulatory structure<br />
– Business valuations<br />
– Service agreement valuations<br />
– Interrelation of pre- <strong>and</strong> post- transaction structure<br />
on valuations<br />
j Service agreement valuations<br />
j Interrelation of pre- <strong>and</strong> post- transaction structure<br />
on valuations<br />
A. Why Quality of Care Should Matter to You: FCA<br />
Enforcement in 2013 <strong>and</strong> Beyond (repeat)<br />
P. Hospital Acquisition of <strong><strong>Physician</strong>s</strong> Groups (repeat)<br />
j Recent NLRB reports <strong>and</strong> rulings on employer social media<br />
policies <strong>and</strong> other protected activity<br />
j Social media policy language for compliance with recent<br />
NLRB rulings<br />
j The current vigorous HIPAA enforcement environment<br />
j HIPAA compliance risks for providers when employees disclose<br />
patient information via social networks (key pertinent<br />
HIPAA Rules)<br />
j Practical steps that provider should take to minimize potential<br />
sanctions if a HIPAA violation occurs<br />
G. Consolidation in a Rapidly Changing Industry: Navigating<br />
Options, Antitrust <strong>and</strong> Other Obstacles (repeat)<br />
M. The Top 10 Conflicts of Interest Developments<br />
Healthcare <strong>Law</strong>yers Need to Know About (repeat)<br />
S. Strategies Behind Successfully Resolving Compliance<br />
Issues <strong>and</strong> Government Investigations (repeat)<br />
11:50 am-1:05 pm<br />
Lunch on your own or attend a Practice Group Luncheon:<br />
Health Information <strong>and</strong> Technology or Healthcare<br />
Liability <strong>and</strong> Litigation (additional fee; limited attendance;<br />
pre-registration required; see page 20 for the descriptions<br />
<strong>and</strong> pages 21-22 to register)<br />
CONCURRENT SESSIONS<br />
1:15-2:15 pm<br />
R. Knowing When <strong>and</strong> How to Protect Quality Information<br />
in an Employed <strong>Physician</strong> World (repeat)<br />
Q. OIG Enforcement Initiatives Relating to Hospitals (repeat)<br />
U. Reimbursement Rules that Could Trip Up Hospital<br />
Attorneys (repeat)<br />
V. Analysis of the New “Omnibus” HIPAA/HITECH<br />
Regulations (repeat)<br />
2:25-3:25 pm<br />
N. How Health Reform Has Reduced Fraud Enforcement<br />
Risk for Hospitals <strong>and</strong> Systems (repeat)<br />
W. If You Can’t Monitor It, Don’t Execute It: Ways to<br />
Develop Compliant Agreements that Are Commercially<br />
Reasonable <strong>and</strong> Consistent with FMV (repeat)<br />
10:50-11:50 am<br />
Z. Social Media Compliance Challenges: From HIPAA<br />
to the NLRA (not repeated)<br />
Kimberly W. Daniel<br />
Sara S. Rorer<br />
j The application of the National Labor Relations Act to nonunionized<br />
employers<br />
13<br />
Y. Non-Profit/For-Profit Joint Ventures – Structuring <strong>and</strong><br />
Valuing the Deal (repeat)<br />
Adjournment
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Planning Committee<br />
S. Allan Adelman, Esq.,<br />
Program Co-Chair<br />
Adelman Sheff & Smith LLC<br />
Annapolis, MD<br />
Lisa Gilden, Esq.,<br />
Program Co-Chair<br />
Vice President <strong>and</strong> General Counsel<br />
Catholic Health Association<br />
Washington, DC<br />
Louise M. Joy, Esq.<br />
Joy & Young LLP<br />
Austin, TX<br />
Richard L. Shackelford, Esq.<br />
King & Spalding LLP<br />
Atlanta, GA<br />
Robert A. Wade, Esq.<br />
Krieg DeVault LLP<br />
Mishawaka, IN<br />
Cynthia F. Wisner, Esq.<br />
Associate Counsel<br />
Trinity Health<br />
Farmington Hills, MI<br />
Catherine M. Ballard, Esq.<br />
Bricker & Eckler LLP<br />
Columbus, OH<br />
William E. Berlin, Esq.<br />
OBER | KALER<br />
Washington, DC<br />
Curtis H. Bernstein, CPA/ABV, ASA, CVA, MBA<br />
Altegra Health<br />
Los Angeles, CA<br />
Philip M. Bluestein, Esq.<br />
<strong>Law</strong> Office of Philip M. Bluestein<br />
Boulder, CO<br />
Kristin M. Bohl, Esq.<br />
Adelman Sheff & Smith LLC<br />
Annapolis, MD<br />
George B. Breen, Esq.<br />
Epstein Becker & Green PC<br />
Washington, DC<br />
Elizabeth B. Carder-Thompson, Esq.<br />
Reed Smith LLP<br />
Washington, DC<br />
Patrick S. Coffey, Esq.<br />
Locke Lord Bissell & Liddell LLP<br />
Chicago, IL<br />
Kevin A. Cornish<br />
Navigant<br />
Phoenix, AZ<br />
Kimberly W. Daniel, Esq.<br />
Hancock Daniel Johnson & Nagle PC<br />
Glen Allen, VA<br />
Mary Daymont, Esq.<br />
Executive Director of Clinical Resource Management<br />
Children’s National Medical Center<br />
Washington, DC<br />
Hospitals Program Faculty<br />
Jeffrey Dickstein, Esq.<br />
AUSA<br />
Department of Justice<br />
Miami, FL<br />
David A. Ettinger, Esq.<br />
Honigman Miller Schwartz <strong>and</strong> Cohn LLP<br />
Detroit, MI<br />
Barbara Harbor Evert, MD<br />
Vice President Medical Affairs<br />
Ohio Health<br />
Dublin Methodist Hospital <strong>and</strong> Grady<br />
Memorial Hospital<br />
Columbus, OH<br />
Lori A. Foley<br />
PYA<br />
Atlanta, GA<br />
Jill H. Gordon, Esq.<br />
Nixon Peabody LLP<br />
Los Angeles, CA<br />
Lynn Gordon, Esq.<br />
Ungaretti & Harris LLP<br />
Chicago, IL<br />
Alice G. Gosfield, Esq.<br />
Alice G. Gosfield & Associates PC<br />
Philadelphia, PA<br />
Judd A. Harwood, Esq.<br />
Bradley Arant Boult Cummings LLP<br />
Birmingham, AL<br />
Martha S. Henley, Esq.<br />
Operations Counsel<br />
Community Health Systems<br />
Franklin, TN<br />
S. Craig Holden, Esq.<br />
OBER | KALER<br />
Baltimore, MD<br />
Robert G. Homchick, Esq.<br />
Davis Wright Tremaine LLP<br />
Seattle, WA<br />
William W. Horton, Esq.<br />
Johnston Barton Proctor & Rose LLP<br />
Birmingham, AL<br />
Eliott Jeter<br />
VMG Health<br />
Dallas, TX<br />
Marilyn Lamar, Esq.<br />
Liss & Lamar PC<br />
Oak Brook, IL<br />
Alice M. MacDermott, Esq.<br />
Vice President, Associate General Counsel<br />
Health Alliance Plan<br />
Detroit, MI<br />
Patricia A. Markus, Esq.<br />
Smith Moore Leatherwood LLP<br />
Raleigh, NC<br />
Kimberly A. Mobley, Esq.<br />
Sullivan Cotter <strong>and</strong> Associates, Inc.<br />
Southfield, MI<br />
14<br />
Lewis Morris, Esq.<br />
Adelman Sheff & Smith LLC<br />
Annapolis, MD<br />
Peter A. Pavarini, Esq.<br />
Squire S<strong>and</strong>ers LLP<br />
Columbus, OH<br />
James M. Pinna, Esq.<br />
Hunton & Williams LLP<br />
Richmond, VA<br />
James C. Pyles, Esq.<br />
Powers Pyles Sutter & Verville PC<br />
Washington, DC<br />
Gregory S. Radinsky, JD, MBA<br />
Vice President, Chief Corporate Compliance Officer<br />
North Shore Long Isl<strong>and</strong> Jewish Health System<br />
Great Neck, NY<br />
Cynthia Y. Reisz, Esq.<br />
Bass Berry & Sims PLC<br />
Nashville, TN<br />
Brian D. Roark, Esq.<br />
Bass Berry & Sims PLC<br />
Nashville, TN<br />
Sara S. Rorer, Esq.<br />
Taft Stettinius & Hollister LLP<br />
Cincinnati, OH<br />
Michael F. Schaff, Esq.<br />
Wilentz Goldman & Spitzer PA<br />
Woodbridge, NJ<br />
Jack S. Schroder, Jr., Esq.<br />
Ret. Alston & Bird LLP<br />
Big Canoe, GA<br />
Jeff Sconyers, Esq.<br />
Senior Vice President <strong>and</strong> General Counsel<br />
Seattle Children’s Hospital<br />
Seattle, WA<br />
Robert D. Stone, Esq.<br />
Alston & Bird LLP<br />
Atlanta, GA<br />
Melissa S. Szabad, Esq.<br />
McGuire Woods LLP<br />
Chicago, IL<br />
Martha J. Talley, JD<br />
Chief, Industry Guidance Branch<br />
US Department of Health <strong>and</strong> Human Services<br />
Office of the Inspector General<br />
Washington, DC<br />
Claire M. Turcotte, Esq.<br />
Bricker & Eckler LLP<br />
West Chester, OH<br />
Linda A. Wawzenski, Esq.<br />
Assistant US Attorney <strong>and</strong> Deputy Chief of<br />
Civil Division<br />
United States Attorney’s Office, Northern<br />
District of Illinois<br />
Chicago, IL<br />
John P. Wieg<strong>and</strong>, Esq.<br />
Staff Attorney<br />
Federal Trade Commission<br />
San Francisco, CA
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Monday, February 11, 2013<br />
Programs at a Glance<br />
7:30 am-<br />
5:15 pm<br />
8:30-<br />
9:45 am<br />
Registration <strong>and</strong> Information<br />
General Session<br />
8:30-8:45 am<br />
Welcome <strong>and</strong> Introduction<br />
Rosati, Reisz<br />
8:45-9:45 am<br />
Keynote Address<br />
DeConti<br />
10:00-<br />
11:00 am<br />
A Marketing Compliance Primer for<br />
Healthcare Providers<br />
The MSO’s Prognosis after the ACA: A<br />
Viable Integration Tool?<br />
The Evolution of HIPAA: Impact of<br />
HITECH <strong>and</strong> Increased HIPAA<br />
Enforcement on <strong>Physician</strong> Practices<br />
Grizzle<br />
Pelliccioni<br />
Anderson<br />
Grey<br />
Short Kirk<br />
Rostolsky<br />
11:15 am-<br />
12:15 pm<br />
Audits <strong>and</strong> Appeals: Pre- <strong>and</strong><br />
Post-Audit Strategies<br />
(not repeated)<br />
How to Determine Commercial<br />
Reasonableness of Hospital-<strong>Physician</strong><br />
Compensation Arrangements<br />
Staying the Course: Maintaining a<br />
<strong>Physician</strong> Group Practice in Today’s<br />
Healthcare Environment<br />
Cohen<br />
Goldstone<br />
Johnson<br />
Melvin<br />
Barry<br />
Grant<br />
12:15-<br />
1:35 pm<br />
Lunch on your own or attend a Practice Group Luncheon:<br />
Antitrust; <strong>Physician</strong> <strong>Organizations</strong>, sponsored by PYA; or Labor <strong>and</strong> Employment<br />
(additional fee; limited attendance; pre-registration required; see page 19 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
1:45-<br />
2:45 pm<br />
Building a Practice Acquisition <strong>and</strong><br />
Employment Strategies that St<strong>and</strong> the<br />
Test of Time in a Changing Regulatory<br />
Environment<br />
Caught between Scylla <strong>and</strong> Charybdis:<br />
Reconciling Incentive Payments for<br />
Value with Government Concerns<br />
about Clinical Quality <strong>and</strong><br />
Overutilization<br />
Reimbursement: Getting <strong><strong>Physician</strong>s</strong><br />
Paid<br />
Carnahan<br />
Lewis<br />
Murphy<br />
Toppin<br />
Selesnick<br />
3:00-<br />
4:00 pm<br />
A 12-Step Program to Better<br />
Compliance: A Practical Approach<br />
The Evolution of HIPAA: Impact of<br />
HITECH <strong>and</strong> Increased HIPAA<br />
Enforcement on <strong>Physician</strong> Practices<br />
(repeat)<br />
Reimbursement: Getting<br />
<strong><strong>Physician</strong>s</strong> Paid<br />
(repeat)<br />
Kass<br />
Looney<br />
Short Kirk<br />
Rostolsky<br />
Selesnick<br />
4:15-<br />
5:15 pm<br />
A Marketing Compliance Primer for<br />
Healthcare Providers<br />
(repeat)<br />
Grizzle<br />
Pelliccioni<br />
How to Determine Commercial<br />
Reasonableness of Hospital-<strong>Physician</strong><br />
Compensation Arrangements<br />
(repeat)<br />
Goldstone<br />
Johnson<br />
Melvin<br />
Building a Practice Acquisition <strong>and</strong><br />
Employment Strategies that St<strong>and</strong> the<br />
Test of Time in a Changing Regulatory<br />
Environment<br />
(repeat)<br />
Carnahan<br />
Lewis<br />
5:15-<br />
6:15 pm<br />
6:15-<br />
7:15 pm<br />
Networking Reception, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
Celebrating Diversity <strong>and</strong> Inclusiveness Reception, sponsored by AHLA’s Advisory Council on Diversity<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
15
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Tuesday, February 12, 2013<br />
Please Note: The session in the dark shaded boxes are included on the agendas of both the <strong><strong>Physician</strong>s</strong> <strong>Law</strong> <strong>Institute</strong> <strong>and</strong> the<br />
Hospitals <strong>Law</strong> <strong>Institute</strong>. Other sessions are on the program indicated.<br />
7:00 am-<br />
5:15 pm<br />
7:00-<br />
8:00 am<br />
8:00-<br />
9:45 am<br />
Registration <strong>and</strong> Information<br />
Continental Breakfast, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
General Session<br />
8:00-8:15 am<br />
Welcome <strong>and</strong> Introduction<br />
Rosati, Gilden<br />
8:15-9:45 am<br />
Top Legal Developments for Hospitals <strong>and</strong> <strong><strong>Physician</strong>s</strong><br />
Carder-Thompson, Schroder<br />
10:15-<br />
11:15 am<br />
(<strong><strong>Physician</strong>s</strong> Only)<br />
A 12-Step<br />
Program to Better<br />
Compliance: A<br />
Practical<br />
Approach<br />
(repeat)<br />
Kass<br />
Looney<br />
Why Quality of<br />
Care Should<br />
Matter to You:<br />
FCA Enforcement<br />
in 2013 <strong>and</strong><br />
Beyond<br />
Breen<br />
Cornish<br />
Dickstein<br />
Complex Fair<br />
Market Value/<br />
Commercial<br />
Reasonableness<br />
Compensation<br />
Issues<br />
Wade<br />
You Say<br />
Tomato: Employer<br />
<strong>and</strong> Employee<br />
Perspectives on<br />
the <strong>Physician</strong><br />
Employment<br />
Contract<br />
Bluestein<br />
Henley<br />
Bundled Payments<br />
– Practicalities,<br />
Contractual <strong>and</strong><br />
Governance Issues<br />
Gosfield<br />
I’ll Have What<br />
She’s Having…<br />
Harry Hospital<br />
Meets Sally<br />
Specialist<br />
Homchick<br />
Reisz<br />
11:25 am-<br />
12:25 pm<br />
(<strong><strong>Physician</strong>s</strong> Only)<br />
Caught<br />
between Scylla<br />
<strong>and</strong> Charybdis:<br />
Reconciling<br />
Incentive<br />
Payments for<br />
Value with<br />
Government<br />
Concerns about<br />
Clinical Quality<br />
<strong>and</strong> Overutilization<br />
(repeat)<br />
(Hospitals Only)<br />
Consolidation in<br />
a Rapidly<br />
Changing Industry:<br />
Navigating<br />
Options,<br />
Antitrust <strong>and</strong><br />
Other Obstacles<br />
Buyer Beware!<br />
The Value of Due<br />
Diligence in<br />
Hospital-<strong>Physician</strong><br />
Transactions<br />
(not repeated)<br />
<strong>Physician</strong><br />
Compensation:<br />
Legal <strong>and</strong><br />
Valuation Trends<br />
Today, Tomorrow<br />
<strong>and</strong> Beyond<br />
Legal Ethics: What<br />
Penn State <strong>and</strong><br />
Lehman Brothers<br />
Can Teach<br />
Healthcare<br />
<strong>Law</strong>yers about<br />
Conflicts of Interest<br />
A Practitioner’s<br />
Toolkit for<br />
Addressing<br />
“Technical”<br />
Violations of<br />
the Stark <strong>Law</strong><br />
Murphy<br />
Toppin<br />
Ettinger<br />
L. Gordon<br />
Foley<br />
Harwood<br />
Mobley<br />
Turcotte<br />
Horton<br />
Sconyers<br />
Bohl<br />
Stone<br />
12:25-<br />
1:35 pm<br />
Lunch on your own or attend a Practice Group Luncheon: Medical Staff, Credentialing, <strong>and</strong> Peer Review, sponsored by<br />
MDReview or Hospitals <strong>and</strong> Health Systems/In-House Counsel/Enterprise Risk Management Task Force<br />
(joint luncheon), sponsored by Health Capital Consultants LLC<br />
(additional fee; limited attendance; pre-registration required; see page 19 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
1:45-<br />
2:45 pm<br />
(<strong><strong>Physician</strong>s</strong> Only)<br />
The MSO’s<br />
Prognosis after<br />
the ACA: A<br />
Viable Integration<br />
Tool?<br />
(repeat)<br />
(Hospitals Only)<br />
The Top 10<br />
Conflicts of<br />
Interest Developments<br />
Healthcare<br />
<strong>Law</strong>yers Need to<br />
Know About<br />
<strong>Physician</strong> <strong>and</strong><br />
Hospital<br />
Investment in<br />
Ambulatory<br />
Surgery Centers<br />
(not repeated)<br />
How Health<br />
Reform Has<br />
Reduced Fraud<br />
Enforcement Risk<br />
for Hospitals <strong>and</strong><br />
Systems<br />
Clinically Integrated<br />
Networks: The<br />
PHOs of the 21st<br />
Century<br />
Complex Fair<br />
Market Value/<br />
Commercial<br />
Reasonableness<br />
Compensation<br />
Issues<br />
(repeat)<br />
Anderson<br />
Grey<br />
Radinsky<br />
Szabad<br />
Talley<br />
Coffey<br />
Wawzenski<br />
Pavarini<br />
Schaff<br />
Wade<br />
16
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Tuesday, February 12, 2013 (continued)<br />
3:00-<br />
4:00 pm<br />
(<strong><strong>Physician</strong>s</strong> Only)<br />
Staying the<br />
Course:<br />
Maintaining a<br />
<strong>Physician</strong> Group<br />
Practice in<br />
Today’s Healthcare<br />
Environment<br />
(repeat)<br />
(Hospitals Only)<br />
Hospital<br />
Acquisition<br />
of <strong><strong>Physician</strong>s</strong><br />
Groups<br />
(Hospitals Only)<br />
OIG Enforcement<br />
Initiatives<br />
Relating to<br />
Hospitals<br />
Legal Ethics:<br />
What Penn State<br />
<strong>and</strong> Lehman<br />
Brothers Can<br />
Teach Healthcare<br />
<strong>Law</strong>yers about<br />
Conflicts of<br />
Interest<br />
(repeat)<br />
Employer <strong>and</strong><br />
Employee<br />
Perspectives on the<br />
<strong>Physician</strong><br />
Employment<br />
Contract<br />
(repeat)<br />
Bundled<br />
Payments –<br />
Practicalities,<br />
Contractual<br />
<strong>and</strong><br />
Governance<br />
Issues<br />
(repeat)<br />
Barry<br />
Grant<br />
Berlin<br />
Wieg<strong>and</strong><br />
Holden<br />
Morris<br />
Horton<br />
Sconyers<br />
Bluestein<br />
Henley<br />
Gosfield<br />
4:15-<br />
5:15 pm<br />
(Hospitals Only)<br />
Knowing When<br />
<strong>and</strong> How to<br />
Protect Quality<br />
Information in an<br />
Employed<br />
<strong>Physician</strong> World<br />
(Hospitals Only)<br />
Strategies Behind<br />
Successfully<br />
Resolving<br />
Compliance<br />
Issues <strong>and</strong><br />
Government<br />
Investigations<br />
Clinically Integrated<br />
Networks:<br />
The PHOs of the<br />
21st Century<br />
(repeat)<br />
A Practitioner’s<br />
Toolkit for<br />
Addressing<br />
“Technical”<br />
Violations of the<br />
Stark <strong>Law</strong><br />
(repeat)<br />
I’ll Have What<br />
She’s Having…<br />
Harry Hospital<br />
Meets Sally<br />
Specialist<br />
(repeat)<br />
<strong>Physician</strong><br />
Compensation:<br />
Legal <strong>and</strong><br />
Valuation<br />
Trends Today,<br />
Tomorrow <strong>and</strong><br />
Beyond<br />
(repeat)<br />
Ballard<br />
Evert<br />
Roark<br />
Shackelford<br />
Pavarini<br />
Schaff<br />
Bohl<br />
Stone<br />
Homchick<br />
Reisz<br />
Mobley<br />
Turcotte<br />
5:15-<br />
6:30 pm<br />
6:30-<br />
7:30 pm<br />
Networking Reception, sponsored by HORNE LLP<br />
(attendees, faculty <strong>and</strong> registered spouses <strong>and</strong> guests are welcome to attend)<br />
Fair Market Value Affinity Group Happy Hour<br />
(attendees <strong>and</strong> faculty are welcome to attend; see page 20 for the description <strong>and</strong><br />
sign-up on the registration form on pages 21-22)<br />
7:00 pm Young Professionals Networking Dinners<br />
(Sign-up at the AHLA Resource Center Table)<br />
17
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Wednesday, February 13, 2013<br />
7:30 am-<br />
3:25 pm<br />
7:30-<br />
8:30 am<br />
Registration <strong>and</strong> Information<br />
Continental Breakfast sponsored by HORNE LLP<br />
(attendees, faculty, <strong>and</strong> registered spouses <strong>and</strong> guests welcome)<br />
Fair Market Value Affinity Group Breakfast<br />
(attendees <strong>and</strong> faculty are welcome to attend; see page 20 for the description<br />
<strong>and</strong> sign-up on the registration form on pages 21-22)<br />
8:30-<br />
9:30 am<br />
Health Reform Fatigue:<br />
Which Health Reform<br />
Models Have the Strongest<br />
Chance of Success?<br />
(not repeated)<br />
Reimbursement Rules that<br />
Could Trip Up Hospital<br />
Attorneys<br />
Analysis of the New<br />
“Omnibus” HIPAA/<br />
HITECH Regulations<br />
If You Can’t Monitor It,<br />
Don’t Execute It: Ways to<br />
Develop Compliant Agreements<br />
that Are Commercially<br />
Reasonable <strong>and</strong> Consistent<br />
with FMV<br />
Pyles<br />
Wisner<br />
Lamar<br />
Markus<br />
Bernstein<br />
J. Gordon<br />
9:40-<br />
10:40 am<br />
Best Practices for<br />
Achieving Complex Patient<br />
Discharges<br />
(not repeated)<br />
Non-Profit/For-Profit Joint<br />
Ventures – Structuring <strong>and</strong><br />
Valuing the Deal<br />
Why Quality of Care<br />
Should Matter to You:<br />
FCA Enforcement in 2013<br />
<strong>and</strong> Beyond<br />
(repeat)<br />
Hospital Acquisition of<br />
<strong><strong>Physician</strong>s</strong> Groups<br />
(repeat)<br />
Daymont<br />
MacDermott<br />
Jeter<br />
Pinna<br />
Breen<br />
Cornish<br />
Dickstein<br />
Berlin<br />
Wieg<strong>and</strong><br />
10:50-<br />
11:50 am<br />
Social Media Compliance<br />
Challenges: From HIPAA<br />
to the NLRA<br />
(not repeated)<br />
Consolidation in a Rapidly<br />
Changing Industry: Navigating<br />
Options, Antitrust <strong>and</strong> Other<br />
Obstacles<br />
(repeat)<br />
The Top 10 Conflicts of<br />
Interest Developments<br />
Healthcare <strong>Law</strong>yers Need<br />
to Know About<br />
(repeat)<br />
Strategies Behind<br />
Successfully Resolving<br />
Compliance Issues <strong>and</strong><br />
Government Investigations<br />
(repeat)<br />
Daniel<br />
Rorer<br />
Ettinger<br />
L. Gordon<br />
Radinsky<br />
Roark<br />
Shackelford<br />
11:50<br />
am-<br />
1:05 pm<br />
Lunch on your own or attend a Practice Group Luncheon:<br />
Health Information <strong>and</strong> Technology or Healthcare Liability <strong>and</strong> Litigation<br />
(additional fee; limited attendance; pre-registration required; see page 20 for the descriptions <strong>and</strong> pages 21-22 to register)<br />
1:15-<br />
2:15 pm<br />
Knowing When <strong>and</strong> How<br />
to Protect Quality<br />
Information in an<br />
Employed <strong>Physician</strong> World<br />
(repeat)<br />
OIG Enforcement Initiatives<br />
Relating to Hospitals<br />
(repeat)<br />
Reimbursement Rules that<br />
Could Trip Up Hospital<br />
Attorneys<br />
(repeat)<br />
Analysis of the New<br />
“Omnibus” HIPAA/HITECH<br />
Regulations<br />
(repeat)<br />
Ballard<br />
Evert<br />
Holden<br />
Morris<br />
Wisner<br />
Lamar<br />
Markus<br />
2:25-<br />
3:25 pm<br />
How Health Reform Has Reduced<br />
Fraud Enforcement Risk for Hospitals<br />
<strong>and</strong> Systems<br />
(repeat)<br />
If You Can’t Monitor It, Don’t Execute<br />
It: Ways to Develop Compliant<br />
Agreements that Are Commercially<br />
Reasonable <strong>and</strong> Consistent with FMV<br />
(repeat)<br />
Non-Profit/For-Profit Joint Ventures<br />
– Structuring <strong>and</strong> Valuing the Deal<br />
(repeat)<br />
Coffey<br />
Wawzenski<br />
Bernstein<br />
J. Gordon<br />
Jeter<br />
Pinna<br />
18
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Practice Group Luncheon Presentations<br />
February 11, 2013<br />
Antitrust<br />
Review of Antitrust Enforcement of Hospital-<strong>Physician</strong><br />
Transactions<br />
David A. Argue, PhD<br />
Economists Incorporated, Washington, DC<br />
Douglas C. Ross, Esq.<br />
Davis Wright Tremaine LLP, Seattle, WA<br />
Christine L. White, Esq.<br />
Federal Trade Commission, New York, NY<br />
<strong>Physician</strong> practice consolidations have been the subject of increased<br />
federal <strong>and</strong> state scrutiny, as well as at least one recently<br />
filed private antitrust action. Several transactions have been<br />
blocked by antitrust enforcers, <strong>and</strong> some parties have entered into<br />
consent agreements to resolve antitrust concerns. The private case<br />
is currently in litigation. Drawing on these cases, our panelists<br />
will identify factors that may impact the risk of antitrust scrutiny<br />
(including both antitrust red flags <strong>and</strong> procompetitive justifications<br />
for a transaction) as well as potential means of minimizing or<br />
resolving those concerns.<br />
The panelists will provide specific examples <strong>and</strong> illustrations based<br />
on actions such as:<br />
j Federal enforcement actions: Renown Health’s acquisition of<br />
Sierra Nevada Cardiology Associates <strong>and</strong> Reno Heart <strong><strong>Physician</strong>s</strong>;<br />
<strong>and</strong> Providence Health System’s proposed acquisition of<br />
Northwest Cardiology <strong>and</strong> Spokane Cardiology)<br />
j State enforcement actions: Urology of Central Pennsylvania;<br />
MaineHealth; <strong>and</strong> Atrius Health/Fallon Clinic<br />
j Private actions: St. Luke’s Health System’s proposed acquisition<br />
of Saltzer Medical Group<br />
<strong>Physician</strong> <strong>Organizations</strong>, sponsored by PYA<br />
Roundtable Discussion of Recent Issues Affecting <strong><strong>Physician</strong>s</strong><br />
Ann M. Bittinger, Esq. (Moderator)<br />
Bittinger <strong>Law</strong> Firm, Jacksonville, FL<br />
Rick L. Hindm<strong>and</strong>, Esq.<br />
McDonald Hopkins LLC, Chicago, IL<br />
Julie E. Kass, Esq.<br />
OBER|KALER, Baltimore, MD<br />
Alyson M. Leone, Esq.<br />
Wilentz Goldman & Spitzer PA, Woodbridge, NJ<br />
David T. Lewis, Esq.<br />
Life Point Hospitals, Brentwood, TN<br />
Sidney S. Welch, Esq.<br />
Arnall Golden Gregory LLP, Atlanta, GA<br />
Join the <strong><strong>Physician</strong>s</strong> Organization Practice Group for an interactive<br />
discussion of hot topics for lawyers who represent physicians. The<br />
topics will include:<br />
j Ways in which physicians are participating in ACOs<br />
j Fraud <strong>and</strong> Abuse <strong>and</strong> enforcement update<br />
j <strong>Physician</strong> quality reporting update<br />
j OIG guidance on on-call arrangements<br />
j US vs All Children's<br />
Labor <strong>and</strong> Employment<br />
The “Other” Reform; Implications <strong>and</strong> Realities of Immigration<br />
Reform for Health Care <strong>Organizations</strong><br />
Kristen A. Harris, Esq.<br />
Rubman & Harris LLC, Chicago, IL<br />
Gregory Siskind, Esq.<br />
Siskind Susser, Memphis, TN<br />
Immigration reform will impact healthcare organizations both as<br />
employers <strong>and</strong> as providers. This presentation will explore the effect<br />
of recent <strong>and</strong> pending immigration reform measures upon the<br />
healthcare industry. The presenters will review changes to healthcare<br />
organizations as visa sponsors for healthcare professionals <strong>and</strong><br />
as employers subject to immigration compliance measures (I-9s, E-<br />
Verify, <strong>and</strong> new enforcement initiatives). The presentation will also<br />
analyze the eligibility of immigrants for various healthcare benefits,<br />
<strong>and</strong> will review healthcare immigration implications resulting from<br />
other new legislative measures, such as the Affordable Care Act<br />
<strong>and</strong> budget negotiations.<br />
February 12, 2013<br />
Medical Staff, Credentialing, <strong>and</strong> Peer Review,<br />
sponsored by MDReview<br />
Implementing “Systemness” into Health System Consolidation<br />
Amy L. Marquardt, Esq.<br />
Vice President <strong>and</strong> General Counsel Hospitals<br />
Sisters Health System, Clear Lake, IL<br />
Increased hospital <strong>and</strong> health system consolidation has emphasized<br />
the varied challenges of unifying medical staff cultures <strong>and</strong><br />
the ever-growing web of system-wide services lines <strong>and</strong> hospital<br />
credentialing, privileging <strong>and</strong> quality activities. Many of these<br />
activities are becoming more centralized as health systems search<br />
for greater st<strong>and</strong>ardization, efficiency <strong>and</strong> cost reduction. This luncheon<br />
presentation will use h<strong>and</strong>s-on experience from an in-house<br />
perspective to discuss the many challenges, opportunities <strong>and</strong> lessons<br />
learned when integrating services lines <strong>and</strong> multiple medical<br />
staffs into a health system, including:<br />
j Considerations <strong>and</strong> lessons learned when merging medical staff<br />
governance <strong>and</strong> leadership perspectives<br />
j Making system-wide service lines work<br />
j The relationship between health system activities <strong>and</strong> traditional<br />
medical staff roles, qualifications <strong>and</strong> st<strong>and</strong>ards<br />
j Considering state peer review laws when centralizing service<br />
line, credentialing, privileging <strong>and</strong> peer review activities<br />
Hospitals <strong>and</strong> Health Systems, In-House Counsel <strong>and</strong> the<br />
Enterprise Risk Management Task Force (joint luncheon),<br />
sponsored by Health Capital Consultants LLC<br />
High Reliability Healthcare - The Science of Safety<br />
Kerry M. Johnson<br />
Healthcare Performance Improvement LLC, Virginia Beach, VA<br />
Errors, delays <strong>and</strong> waste are the results of low performing cultures<br />
<strong>and</strong> poorly designed systems. High Reliability <strong>Organizations</strong> manage<br />
to have fewer than their fair share of accidents even under very<br />
complex <strong>and</strong> challenging conditions. High reliability is the study<br />
of human performance in complex systems <strong>and</strong> includes: systems<br />
19
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Practice Group Luncheon Presentations<br />
thinking, analysis of serious safety events, techniques <strong>and</strong> methods<br />
to minimize the probability of errors, techniques to minimize waste<br />
in processes <strong>and</strong> tactics to move people to a culture where patient<br />
safety is an un-comprisable core value of your operations. This<br />
lecture will explore how high reliability organizations can optimize<br />
outcomes <strong>and</strong> how hundreds of healthcare organizations are using<br />
these strategies to improve quality outcomes <strong>and</strong> reduce preventable<br />
serious patient harm events by over 90% in three years.<br />
February 13, 2013<br />
Health Information <strong>and</strong> Technology<br />
HIPAA Security Risk Assessment<br />
Chris Bowen MBA, CIPP/US, CIPP/IT<br />
ClearDATA.net, Phoenix, AZ<br />
Brad M. Rostolsky, Esq.<br />
Reed Smith LLP, Philadelphia, PA<br />
Seth M. Wolf<br />
University Hospitals Health System<br />
Shaker Heights, OH<br />
Hospital <strong>and</strong> health system counsel often face many technical <strong>and</strong><br />
operational issues with HIPAA Security rule compliance, including<br />
meeting the risk assessment <strong>and</strong> compliance documentation<br />
st<strong>and</strong>ards under the rule. Establishing <strong>and</strong> documenting a risk<br />
assessment <strong>and</strong> correcting any deficiencies is now required as a<br />
core objective under the Medicare <strong>and</strong> Medicaid EHR Incentive<br />
Program, <strong>and</strong> hospitals <strong>and</strong> eligible professionals must attest to this<br />
objective. Join our Health Information <strong>and</strong> Technology panel to get<br />
an overview of the relevant security st<strong>and</strong>ards, the technical <strong>and</strong><br />
operational issues involved in conducting a security risk assessment,<br />
<strong>and</strong> an in-house perspective on operational issues, including<br />
setting expectations when working with IT professionals <strong>and</strong><br />
consultants <strong>and</strong> establishing compliance documentation.<br />
Healthcare Liability <strong>and</strong> Litigation<br />
Unlocking the Secrets of Our Healthcare Insurance System<br />
<strong>and</strong> Healthcare Coverage Crisis<br />
Philip M. Sprinkle, II, Esq.<br />
Balch & Bingham LLP, Atlanta, GA<br />
An historical analysis <strong>and</strong> perspective of the evolution of our<br />
healthcare system <strong>and</strong> our healthcare finance system with a discussion<br />
of the challenges the future holds for both.<br />
Other Practice Group Activities<br />
Hospitals <strong>and</strong> Health Systems Practice Group<br />
Fair Market Value Affinity Group Happy Hour<br />
Tuesday, February 12<br />
6:30-7:30 pm<br />
The Hospital <strong>and</strong> Health Systems Practice Group’s Fair Market<br />
Value Affinity Group (FMV AG) is pleased to invite in-house<br />
attendees to a networking reception at Blue Sage, located in<br />
the JW Marriott Desert Ridge Resort, where drinks <strong>and</strong> hors d<br />
’oeuvres will be a Dutch treat. Make plans to join us <strong>and</strong> get to<br />
know members <strong>and</strong> the leaders of the FMV AG <strong>and</strong> Hospitals <strong>and</strong><br />
Health Systems Practice Group (HHS PG). Sign up on the registration<br />
form on pages 21-22. For questions regarding the Fair Market<br />
Value Affinity Group, feel free to contact Chair Greg Anderson<br />
greg.<strong>and</strong>erson@horne-llp.com<br />
Hospitals <strong>and</strong> Health Systems Practice Group<br />
Fair Market Value Affinity Group Breakfast<br />
Wednesday, February 13<br />
7:30-8:30 am<br />
FMV <strong>and</strong> Commercial Reasonableness – The Year in Review<br />
<strong>and</strong> a Look Ahead<br />
Joe Wolfe<br />
Daryl Johnson<br />
Join us for breakfast <strong>and</strong> a panel discussion of recent developments<br />
that may affect attorney <strong>and</strong> valuator perspectives<br />
of FMV <strong>and</strong> commercial reasonableness. Topics will include<br />
recent settlements, court decisions, OIG opinions, <strong>and</strong> changes<br />
in the marketplace. Attendees <strong>and</strong> faculty are welcome. Space<br />
is limited. Please sign-up on the registration form if you’d like to<br />
attend.<br />
20
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Registration Form 3<br />
To register: Remit payment <strong>and</strong> completed registration form by mail to the <strong>American</strong> Health <strong>Law</strong>yers Association • P.O. Box 79340 • Baltimore,<br />
MD 21279-0340 or fax with credit card information to (202) 775-2482. To register by phone call (202) 833-1100, prompt #2. If any program is<br />
over-subscribed, only AHLA members will be placed on a waiting list. On-site registrations will be accepted on a space-available basis only.<br />
Name:_____________________________________________________________ Member ID #:_____________________________________________<br />
First Name for Badge (if different than above):_____________________________________________________________________________________<br />
Title:________________________________________________________________________________________________________________________<br />
Organization:_________________________________________________________________________________________________________________<br />
Address:_____________________________________________________________________________________________________________________<br />
City:________________________________________________________ State:________________ ZIP+ 4:____________________________________<br />
Telephone: (______)_____________________________________________ Fax: (______)__________________________________________________<br />
E-Mail:______________________________________________________________________________________________________________________<br />
Spouse/Guest ________________________________________________________________________________________________________________<br />
REGISTRATION INFORMATION<br />
N Please Register Me for the <strong><strong>Physician</strong>s</strong> Program Only<br />
Postmarked <strong>and</strong> paid by January 21, 2013:<br />
AHLA/NAMSS Members: N $745 Non-Members: N $970<br />
N $670 each additional member registering from same organization at same time on the same check<br />
or credit card payment<br />
Postmarked <strong>and</strong> paid between January 22 <strong>and</strong> February 6, 2013:<br />
AHLA/NAMSS Members: N $870 Non-Members: N $1095<br />
N $795 each additional member registering from same organization at same time on the same check<br />
or credit card payment<br />
N Please Register Me for the Hospitals Program Only<br />
Postmarked <strong>and</strong> paid by January 21, 2013:<br />
AHLA/NAMSS Members: N $775 Non-Members: N $1000<br />
N $700 each additional member registering from same organization at same time on the same check<br />
or credit card payment<br />
Postmarked <strong>and</strong> paid between January 22 <strong>and</strong> February 6, 2013:<br />
AHLA/NAMSS Members: N $900 Non-Members: N $1125<br />
N $825 each additional member registering from same organization at same time on the same check<br />
or credit card payment<br />
Printed<br />
Course Materials<br />
All attendees will receive an<br />
electronic version of the full set of<br />
course materials for the program.<br />
If you would like to purchase a<br />
binder, please indicate that below:<br />
I am registering for the<br />
<strong><strong>Physician</strong>s</strong> Program <strong>and</strong><br />
would like to purchase a<br />
binder for $65<br />
I am registering for the<br />
Hospitals Program <strong>and</strong><br />
would like to purchase a<br />
binder for $65<br />
I am registering for the<br />
<strong><strong>Physician</strong>s</strong> <strong>and</strong> Hospitals<br />
Programs <strong>and</strong> would like to<br />
purchase both binders for $95<br />
N Please Register Me for Both the <strong><strong>Physician</strong>s</strong> <strong>and</strong> the Hospitals Programs<br />
Postmarked <strong>and</strong> paid by January 21, 2013:<br />
AHLA/NAMSS Members: N $1140 Non-Members: N $1360<br />
N $1060 each additional member registering from same organization at same time on the same check or credit card payment<br />
Postmarked <strong>and</strong> paid between January 22 <strong>and</strong> February 6, 2013:<br />
AHLA/NAMSS Members: N $1260 Non-Members: N $1480<br />
N $1180 each additional member registering from same organization at same time on the same check or credit card payment<br />
21<br />
(Continued, next page)
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Registration Information<br />
N I plan to attend the Celebrating Diversity <strong>and</strong> Inclusiveness reception, Tuesday, February 12<br />
N I plan to attend the HHS PG Fair Market Falue Affinity Group Happy Hour, Tuesday, February 12<br />
N I plan to attend the HHS PG Fair Market Value Breakfast, Wednesday, February 13<br />
I will require: N Audio N Visual N Mobility N Other assistance______________________________<br />
N I have special dietary needs<br />
REGISTRATION INFORMATION<br />
Please fill in applicable amount: (Sorry! Registrations cannot be processed unless accompanied by payment.)<br />
$______________ Registration Fee<br />
$______________ Printed Course Materials N $65 <strong><strong>Physician</strong>s</strong> binder N $65 Hospitals binder N $95 <strong><strong>Physician</strong>s</strong>/Hospitals binders<br />
Practice Group Luncheons ($40 for sponsoring PG members; $55 for non-members)<br />
$______________ N <strong>Physician</strong> <strong>Organizations</strong> – February 11<br />
– OR –<br />
N Antitrust – February 11<br />
– OR –<br />
N Labor <strong>and</strong> Employment – February 11<br />
$______________ N Medical Staff, Credentialing, <strong>and</strong> Peer Review – February 12<br />
– OR –<br />
N Hospitals <strong>and</strong> Health Systems <strong>and</strong> In-House Counsel <strong>and</strong> Enterprise Risk Management Task Force (Joint Luncheon) – February 12<br />
$______________ N Health Information <strong>and</strong> Technology – February 13<br />
– OR –<br />
N Healthcare Liability <strong>and</strong> Litigation – February 13<br />
$______________ Spouse/Guest Fee ($30)<br />
$______________ Membership Dues (Date admitted to the bar/graduated: N N/ N N/ N N)<br />
$______________ Total Enclosed<br />
N Check enclosed (Make checks payable to <strong>American</strong> Health <strong>Law</strong>yers Association)<br />
Bill my credit card: N Á N Ò N Å N ¸ N Diners Club<br />
Number: Exp. Date: N N/N N<br />
Name of Cardholder:__________________________________________________________________________________________________________<br />
Signature of Cardholder:_______________________________________________________________________________________________________<br />
ZIP Code of Cardholder’s Billing Address ________________________________________________________________________________________<br />
Please Note: Should your credit card total be miscalculated, AHLA will charge your credit card for the correct amount. To receive a refund of the<br />
registration fee paid minus $125, cancellation notice must be received in writing by February 4, 2013. If you are registered for both programs <strong>and</strong><br />
cancel your registration for one of the programs, you will not be charged the $125 administration fee.<br />
Fed ID No. 23-7333380<br />
22
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong> <strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong>/<br />
Hospitals <strong>and</strong> Health Systems <strong>Law</strong> <strong>Institute</strong><br />
Program Information<br />
Dates: February 11-13, 2013<br />
Place:<br />
JW Marriott Desert Ridge Resort & Spa<br />
5350 East Marriott Drive<br />
Phoenix, AZ 85054<br />
Reservations: (800) 835-6206<br />
<strong><strong>Physician</strong>s</strong> Program Only<br />
$745 For the first AHLA/NAMSS Member<br />
$670 For each additional AHLA/NAMSS Member<br />
$970 Non-Members<br />
Hospitals Program Only<br />
$775 For the first AHLA/NAMSS Member<br />
$700 For each additional AHLA/NAMSS Member<br />
$1000 Non-Members<br />
<strong><strong>Physician</strong>s</strong> <strong>and</strong> Hospitals Programs Dual Registration<br />
$1140 For the first AHLA/NAMSS Member<br />
$1060 For each additional AHLA/NAMSS Member<br />
$1360 Non-Members<br />
Registration Fees increase $125 on January 21<br />
If you have indicated an incorrect amount due to errors in addition<br />
or not being eligible for a specific rate, AHLA will charge the correct<br />
amount to the credit card you have supplied.<br />
Discounted Registration Fees: In-house counsel, government<br />
employees, academicians, solo practitioners <strong>and</strong> students: please call<br />
(202) 833-1100, prompt #2 for special discounted registration fees.<br />
Spouse/Guest Fee: For an additional $30 spouses <strong>and</strong> adult guests<br />
can register to attend the reception(s) <strong>and</strong> the breakfast(s). Please sign<br />
up on the registration form on pages 21-22.<br />
Continuing Education: Participants will be given continuing education<br />
forms at the program. Forms must be completed <strong>and</strong> returned<br />
to AHLA staff to receive credit. AHLA is an approved sponsor of<br />
continuing legal education credits in most states. The <strong><strong>Physician</strong>s</strong><br />
seminar will be worth approximately 12.5 continuing education credits<br />
(including 1.0 ethics credit) based on a 60-minute hour <strong>and</strong> 15.0 credits<br />
(including 1.2 ethics credits) based on a 50-minute hour. The Hospitals<br />
seminar will be worth approximately 11.5 continuing education credits<br />
(including 1.0 ethics credits) based on a 60-minute hour <strong>and</strong> 13.8 credits<br />
(including 1.2 ethics credits) based on a 50-minute hour.<br />
AHLA is registered with the National Association of State Boards of Accountancy<br />
(NASBA) as a sponsor of continuing professional education<br />
on the National Registry of CPE Sponsors. State boards of accoun tancy<br />
have final authority on the acceptance of individual courses for CPE<br />
credit. Complaints regarding registered sponsors may be addressed to<br />
the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite<br />
700, Nashville, TN 37219-2417. Web site: www.nasba.org. The <strong><strong>Physician</strong>s</strong><br />
program will be worth approximately 15.0 CPE credits <strong>and</strong> Hospitals<br />
program will be worth approximately 13.0 CPE credits.<br />
There are no prerequisites or advanced preparations required to<br />
register for this group live program. Those seeking accounting credits<br />
should be familiar with the basic concepts of law <strong>and</strong> terminology associated<br />
with representing physicians <strong>and</strong> hospitals in order to obtain<br />
the full educational benefit of these programs. Sessions are intermediate<br />
to advanced unless otherwise noted.<br />
Membership: Dues are $185 for those admitted to the Bar/graduated<br />
from college within the last four years; $305 for those admitted/<br />
graduated between four <strong>and</strong> eight years ago; <strong>and</strong> $350 for those admitted/graduated<br />
eight or more years ago. Dues are $100 for government<br />
employees <strong>and</strong> full-time academicians; $80 for paralegals, $160 for<br />
public interest professionals <strong>and</strong> $25 for full-time law school students.<br />
Include the applicable membership fee with your registration form<br />
<strong>and</strong> take advantage of the program registration fee for members.<br />
Cancellations/Substitutions: Cancellations must be received in<br />
writing no later than February 4, 2013. Refunds will not be issued<br />
for cancellations received after this date. Registration fees, less a $125<br />
administrative fee, will be refunded approximately 3-4 weeks following<br />
the program. If you wish to send a substitute or need more information<br />
regarding refund, complaint <strong>and</strong> program cancellation policies, please<br />
call the Member Service Center at (202) 833-1100, prompt #5. Please<br />
note that registration fees are based on the AHLA membership status of<br />
the individual who actually attends the program.<br />
Special Needs: If you have needs requiring special assistance or<br />
accommodations, including special dietary needs, or have questions<br />
about accessibility issues at the program, contact our special<br />
needs coordinator, Valerie Eshleman at (202) 833-0784 or<br />
veshleman@healthlawyers.org.<br />
Travel: Association Travel Concepts (ATC) has negotiated discounts with<br />
United, <strong>American</strong>, Enterprise <strong>and</strong> Hertz Rental Car to bring you special<br />
airfares <strong>and</strong> car rental rates lower than those available to the public. Discounts<br />
of 4-15% apply to travel on February 8-13, 2013. Some restrictions<br />
may apply <strong>and</strong> a service fee may apply. ATC will also search for the lowest<br />
available fare on any airline.<br />
ASSOCIATION TRAVEL CONCEPTS<br />
1-800-458-9383<br />
email: reservations@atcmeetings.com<br />
www.atcmeetings.com<br />
(follow the Member Travel links)<br />
Fax: (858) 362-3153<br />
ATC is available for reservations from 8:30 am until<br />
8:00 pm Eastern, Monday through Friday.<br />
23
1620 Eye Street, NW<br />
6th Floor<br />
Washington, DC 20006-4010<br />
<strong><strong>Physician</strong>s</strong> <strong>and</strong> <strong>Physician</strong><br />
<strong>Organizations</strong> <strong>Law</strong> <strong>Institute</strong><br />
February 11–12, 2013<br />
Hospitals <strong>and</strong> Health<br />
Systems <strong>Law</strong> <strong>Institute</strong><br />
February 12–13, 2013<br />
JW Marriott Desert<br />
Ridge Resort & Spa<br />
Phoenix, AZ<br />
For updates <strong>and</strong> to register, go to<br />
www.healthlawyers.org/programs<br />
Presorted<br />
First-Class Mail<br />
U.S. Postage Paid<br />
Suburban, MD<br />
Permit No. 4841