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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

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