Two–Session Webinar: Final Anti-Kickback and Stark Rules: Value-Based Arrangements and Beyond, What California Providers Need to Know and
Provider Compliance: Information Blocking and Patient Access
June 30, 2021 12:00 - 2:00 p.m. PT
Please see the session-specific tabs for more detailed
While this members-only webinar is free for CSHA members, you must register to attend.
Final Anti-Kickback and Stark Rules: Value-Based Arrangements and Beyond, What California Providers Need to Know
Long-awaited changes to the federal physician self-referral law (the Stark law) and the federal anti-kickback statute finally went into effect in January. The new rules contain sweeping changes and tremendous opportunities for California providers to structure innovative new arrangements. Key developments include broad new exceptions and safe harbors for value based arrangements and easing regulatory compliance requirements in other areas. This webinar provides an overview of the new rules with a specific focus on applications for California providers (including medical foundations and IPAs) and interactions with California law (including PORA).
Ben Durie, Hooper Lundy & Bookman PC
Ben’s practice involves healthcare-related business transactions and general corporate representation for healthcare entities.
Representative matters include work with acute care hospitals in purchase and sale transactions (entire life cycle of transaction including due diligence, regulatory issues, document negotiation and state and federal approval process), work with healthcare facilities on a variety of regulatory, operational, corporate governance, tax exemption and fraud and abuse compliance matters (with particular emphasis on physician-hospital relationships), and work with healthcare facilities on self-disclosure obligations under the Stark Law and Anti-Kickback Statute.
Recently, Ben has focused on assisting clients with the implementation of alternative payment models (including ACOs, Clinically Integrated Networks, CMS Innovation Models) and structuring agreements between acute and post-acute providers. Ben speaks and publishes regularly on fraud and abuse matters and on regulatory issues implicated in health care transactions.
Charles Oppenheim, Hooper Lundy & Bookman PC
Charles B. Oppenheim is co-chair of the firm’s business department and received a 2015 Leading Lawyer Award from The Ambulatory M & A Advisor. His practice includes all aspects of transactional, operational and regulatory healthcare law, including mergers & acquisitions, affiliations, joint ventures and the formation of integrated delivery systems, including 1206(l) medical foundations. Among his clients are many of the largest health care companies and hospital systems in the United States.
A nationally-recognized expert on anti-kickback and Stark Law issues, Mr. Oppenheim co-authored the 2018 American Health Lawyers Association Monograph on Stark Law, the sixth edition of a treatise he first wrote in 1998, which publication was cited by the Fourth Circuit Court of Appeals in United States ex rel. Drakeford v. Tuomey, No. 13-2219, 2015 U.S. App. LEXIS 11460 (4th Cir. July 2, 2015). Ranked by clients and peers as a top California health care attorney, Chambers USA notes that Charles assists clients with transactional and regulatory issues and is well regarded for his expertise in Stark Law and anti-kickback matters. Sources describe him as “clearly a regulatory expert, with a very strong working knowledge of the landscape.” A client said, “He is a great expert in Stark Law.” And, “He is very responsive and knowledgeable. He gives very thought-out advice and has a very good feel for what the market practices are.” Another client hailed him as “a premier expert.”
Mr. Oppenheim provides counseling to a variety of healthcare provider clients, and has recognized expertise in healthcare gainsharing, pay-for-performance and clinical co-management agreements. He has served as an expert on anti-kickback and Stark Law issues in arbitration and litigation, in both civil and criminal proceedings. In addition, he creates and implements compliance programs, investigates compliance issues, responds to government enforcement actions, and negotiates settlements for many types of healthcare providers. He also has substantial experience assisting managed care entities and ACOs, including representing both health plans and providers in a variety of transactional and regulatory matters, and is Chair of the firm’s ACO Task Force. He is also a member of the firm’s Fraud & Abuse Practice Group.
Provider Compliance: Information Blocking and Patient Access
On May 1, 2020 the Office of the National Coordinator for Health Information Technology finalized its information blocking rule (Final Rule) aimed at ending certain practices that impede the secure exchange and use of electronic health information by patients, doctors and health care organizations. The November 2020 compliance date was pushed back to April 5, 2021 due to the COVID-19 pandemic. The discussion will provide an overview of existing patient access rights under state and federal law and how they relate to compliance with the Final Rule. The presenters will also discuss how the Final Rule applies to health care providers and tips for identifying and analyzing potential information blocking practices that impermissibly restrict access, exchange, and use of electronic health information (EHI). In doing so, the discussion will evaluate common operational challenges and summarize best practices for health care providers in complying with the Final Rule.
Lara Compton, Mintz, Levin, Cohn, Ferris, Glovsky and
Lara is a trusted advisor to clients ranging from traditional health care providers to disrupter digital health platforms as they navigate the practical and regulatory challenges of health care innovation. Her unique depth of knowledge across HIPAA privacy and other regulatory issues governing the use of data, state and federal fraud and abuse laws, business planning and operational issues has led colleagues to describe Lara as the “Swiss Army knife” of health care problem-solving.
Working at the intersection of health care and technology, Lara counsels telemedicine and other digital health clients on business plan strategy and implementation, state-specific telemedicine regulation, corporate practice of medicine, the scope of practice, fee splitting, anti-kickback, reimbursement, and other health care regulatory issues. Leveraging her prior in-house experience at two nonprofit health systems, she also advises health care providers on the incorporation of telehealth and other technology infrastructures, which has seen a vast uptick as a result of the COVID-19 pandemic.
Lara advises health care providers, clinical trials companies, ancillary providers, technology start-ups, HMOs, insurance companies, and large technology companies on HIPAA and other health data privacy and security regulations, including developing and implementing HIPAA compliance programs. She has also led significant HIPAA breach investigations, advising clients on risk management and mitigation efforts.
She has been rated among the “Top Health Care Lawyers” and “Top Women Lawyers” in California by Daily Journal as a result of her impressive track record of success. Debra is a Fellow of the Litigation Counsel of America, a trial lawyer honorary society composed of attorneys selected based upon excellence and accomplishment in litigation, and superior ethical reputation.
Kathryn F. Edgerton, Davis Wright Tremaine
Kathryn F. Edgerton concentrates her practice on advising hospitals, physician organizations, long-term and behavioral health providers, telemedicine providers, home health providers, medical spas, and other health-related organizations on the complex transactional and regulatory issues impacting the healthcare industry. She has a strong focus on compliance issues for addiction treatment providers and telemedicine providers and is known for her pragmatic guidance on a large range of operational issues.
Kathryn also regularly advises on HIPAA, HITECH, and state privacy and security laws and regulations, the Federal Anti-Kickback Statute, the physician self-referral and payments law (Stark Law), and other healthcare compliance matters. Kathryn is a Certified Information Privacy Professional in U.S. private-sector privacy laws and regulations (CIPP/US), and is Certified in Healthcare Privacy Compliance (CHPC) by the Compliance Certification Board.
Continuing Education Credit
The California Society for Healthcare Attorneys is a State Bar of California-approved MCLE provider and is authorized to provide 2 hours of MCLE credit for this program.
Registrant must complete post-event survey, attest to participation and, when required, provide a professional license number. CE certificates will be emailed approximately two weeks after survey completion.