Physicians and Physician Organizations Law Institute - American ...

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Physicians and Physician Organizations Law Institute Planning Committee Cynthia Y. Reisz, Esq., Program Chair Bass Berry & Sims PLC Nashville, TN David J. Hyman, Esq. Doerner Saunders Daniel & Anderson LLP Tulsa, OK Kim Harvey Looney, Esq. Waller Lansden Dortch & Davis LLP Nashville, TN Donald “Rocky” P. Wilcox, Esq. General Counsel Texas Medical Association Austin, TX Gregory D. Anderson, CPA/ABV, CVA HORNE LLP Hattiesburg, MD R. Michael Barry, Esq. Arnall Golden Gregory LLP Atlanta, GA Philip M. Bluestein, Esq. Law Office of Philip M. Bluestein Boulder, CO Kristin M. Bohl, Esq. Adelman Sheff & Smith LLC Annapolis, MD George B. Breen, Esq. Epstein Becker & Green PC Washington, DC Elizabeth B. Carder-Thompson, Esq. Reed Smith LLP Washington, DC Christopher T. Carnahan Carnahan Group, Inc. Tampa, FL Patrick S. Coffey, Esq. Locke Lord Bissell & Liddell LLP Chicago, IL Frank Cohen, Esq. The Frank Cohen Group LLC Clearwater, FL Kevin A. Cornish Navigant Phoenix, AZ Robert K. DeConti, Esq. Assistant Inspector General for Legal Affairs Office of the Inspector General US Department of Health and Human Services Washington, DC Physicians Program Faculty Jeffrey Dickstein, Esq. AUSA US Department of Justice Miami, FL Lori A. Foley PYA Atlanta, GA Marc D. Goldstone, Esq. Vice President and Associate General Counsel Community Health Systems Franklin, TN Alice G. Gosfield, Esq. Alice G. Gosfield & Associates PC Philadelphia, PA Barbara Grant PYA Atlanta, GA Emily B. Grey, Esq. Breazeale Sachse & Wilson LLP Baton Rouge, LA Anna M. Grizzle, Esq. Bass Berry & Sims PLC Nashville, TN Judd A. Harwood, Esq. Bradley Arant Boult Cummings LLP Birmingham, AL Martha S. Henley, Esq. Operations Counsel Community Health Systems Franklin, TN Robert G. Homchick, Esq. Davis Wright Tremaine LLP Seattle, WA William W. Horton, Esq. Johnston Barton Proctor & Rose LLP Birmingham, AL Daryl P. Johnson, MACC, AVA HealthCare Appraisers, Inc. Delray Beach, FL Julie E. Kass, Esq. OBER | KALER Baltimore, MD Kimberly Short Kirk, Esq. Moore & Van Allen PLLC Charlotte, NC David T. Lewis, Esq. Vice President and Associate General Counsel Lifepoint Hospitals Brentwood, TN Daniel H. Melvin, Esq. McDermott Will & Emery LLP Chicago, IL 8 Kimberly A. Mobley, Esq. Sullivan Cotter and Associates, Inc. Southfield, MI Daniel F. Murphy, Esq. Bradley Arant Boult Cummings LLP Birmingham, AL Peter A. Pavarini, Esq. Squire Sanders LLP Columbus, OH Lori S. Richardson Pelliccioni, JD, PhD Chief Risk Officer and Chief Compliance Officer Simplex Healthcare, Inc. Beverly Hills, CA Brad M. Rostolsky, Esq. Reed Smith LLP Philadelphia, PA Michael F. Schaff, Esq. Wilentz Goldman & Spitzer PA Woodbridge, NJ Jack S. Schroder, Jr., Esq. Ret. Alston & Bird LLP Big Canoe, GA Jeff Sconyers, Esq. Senior Vice President and General Counsel Seattle Children’s Hospital Seattle, WA Andrew H. Selesnick, Esq. Michelman & Robinson LLP Encino, CA Robert D. Stone, Esq. Alston & Bird LLP Atlanta, GA Melissa S. Szabad, Esq. McGuire Woods LLP Chicago, IL Martha J. Talley, JD Chief, Industry Guidance Branch Office of Inspector General US Department of Health and Juman Services Washington, DC Bruce J. Toppin, Esq. Vice President and General Counsel North Mississippi Health Services Tupelo, MS Claire M. Turcotte, Esq. Bricker & Eckler LLP West Chester, OH Robert A. Wade, Esq. Krieg DeVault LLP Mishawaka, IN Linda A. Wawzenski, Esq. Assistant US Attorney and Deputy Chief of Civil Division United States Attorney’s Office, Northern District of Illinois Chicago, IL
Hospitals and Health Systems Law Institute Tuesday, February 12, 2013 7:00 am-5:15 pm Registration and Information 7:00-8:00 am Continental Breakfast, sponsored by HORNE LLP (attendees, faculty and registered spouses and guests welcome) GENERAL SESSION 8:00-8:15 am Welcome and Introduction Kristen B. Rosati, AHLA President-Elect Lisa J. Gilden, Hospitals Program Co-Chair 8:15-9:45 am Top Legal Developments for Hospitals and Physicians Elizabeth B. Carder-Thompson Jack S. Schroder, Jr. CONCURRENT SESSIONS 10:15-11:15 am A. Why Quality of Care Should Matter to You: FCA Enforcement in 2013 and Beyond George B. Breen Kevin A. Cornish Jeffrey Dickstein j The government’s theory of FCA liability in “quality of care” and “worthless services” cases against hospitals and against individual physicians j Challenging the government’s effort to utilize the False Claims Act as a mechanism to enforce quality standards j What providers and hospitals can do proactively, to try to stave off this enforcement effort and how compliance programs should be adapted to address this risk area B. Complex Fair Market Value/ Commercial Reasonableness Compensation Issues Robert A. Wade j Compensation stacking j How to apply benchmark data j When is it safe to exceed the benchmark data range? j Call compensation issues j How to apply commercial reasonableness to compensation arrangements – including shifting of business risk j Productivity compensation issues j Mid-level provider supervision compensation j Stipends for hospital-based services (ER, Anesthesiology, Hospitalist, Radiology) j Real estate – what is a defensible market assessment and how to apply j Time share leasing arrangements – how to develop and manage compliant arrangements Program Agenda C. You Say Tomato: Employer and Employee Perspectives on the Physician Employment Contract Philip M. Bluestein Martha S. Henley j Generic/standard physician employment contract j Contentious issues from the employer’s and employee’s counsels perspective j Non-competition and non-solicitation provisions j Medical records – ownership, disclosure, appropriate access to and use of during and post-employment j Government audits and recapture of funds from employed physicians j Intellectual property j Issues surrounding moonlighting and other outside employment opportunities j Meaningful use j Compensation structures j Offsetting compensation for funds owed j Malpractice claims, settlement and tail insurance and more D. Bundled Payments – Practicalities, Contractual and Governance Issues Alice G. Gosfield j Defining terms: Bundles vs episodes vs. gainsharing, etc j What do we really know about bundled payment? Experiences to date j Principles of bundling: Triggering, breaking, ending j How bundles affect governance and contracting j Governance among participating providers: Avoiding food fights: sueprmajorities, adding, terminating participants j Dispute resolution E. I’ll Have What She’s Having… Harry Hospital Meets Sally Specialist Robert G. Homchick Cynthia Y. Reisz j Integration options and the factors driving how and to what degree hospitals and specialists are coming together j Use of hypotheticals to explore: – Professional Services Agreements in combination with Management Services Agreements – Innovative models facilitating Hospital or Physician Network participation in or ownership of traditional Physician practices 9
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