The Legal Challenges of Multi-Provider Alternative Payment Models: Minimizing the Risks of the Volume-to-Value Transition
Alternatives to fee-for-service (FFS) have proliferated in recent years as government, insurers and employers seek to increase value in the health care system. Since the passage of the Affordable Care Act (ACA), both federal and state policies have promoted the adoption of alternative payment models (APMs), providing financial incentives for groups of providers to improve care quality while containing costs. According to a recent study, there were 744 Accountable Care Organizations (ACOs) operating as of March 2015, giving evidence to the growing momentum behind the transition from volume to value.
All U.S. payers – including Medicare, Medicaid and private insurers – are increasingly moving to value-based contracting with health care providers. Hospitals and physicians must establish integrated networks to engage in alternative payment arrangements, whether with government health care agencies or private payers. These hospital-physician integration efforts, however, raise unique regulatory compliance challenges that differ substantially from those faced in the traditional FFS environment.
In a new webinar, Manatt provides insights into the growth of APMs, sharing examples of new models across Medicare, Medicaid and the private sector. The program takes an in-depth look at how both government and private payers are implementing APMs and the regulations that are raising the incentives to drive provider participation. It then explores the fraud and abuse and antitrust issues and implications around value-based contracting arrangements between hospitals and physicians, the options available to protect these arrangements, and the structuring and compliance strategies for minimizing risks.
Educational Objectives:
• Understand the types of payment models and their growth across Medicare, state Medicaid programs and the private sector.
• Find out how states are building APMs into Medicaid payment methodologies and how private payers are adopting APMs.
• Learn how the Medicare and CHIP Reauthorization Act (MACRA) of 2015 will increase incentives for provider participation in APMs.
• Examine how the Stark Law, Anti-Kickback Statute (AKS) and the Gainsharing Civil Monetary Penalty Law are implicated by value-based contracting arrangements between hospitals and physicians.
• Discover which exceptions, safe harbors and waivers can potentially protect these arrangements.
• Explore how collaborations between hospitals and physicians implicate antitrust laws.
• Discuss structuring and compliance strategies for mitigating legal risks.
Speakers:
Mr. Robert Belfort is a partner in the health care practice of Manatt, Phelps & Phillips, LLP and has over 20 years of experience representing health care organizations on regulatory compliance and transactional matters.
Ms. Lisl Dunlop is a partner in the firm’s New York office and a member of the Litigation Division. She advises leading U.S. and multinational companies in an array of industries – in particular in the media, technology and health care sectors – on a broad range of antitrust counseling, antitrust litigation and transactional matters.
Ms. Jocelyn Guyer is a managing director with Manatt Health, an interdisciplinary policy and business advisory division of Manatt, Phelps & Phillips, LLP. Ms. Guyer provides policy expertise, strategic advice and technical support to states, foundations, and a broad array of other clients on implementation of the Affordable Care Act, Medicaid and the Children’s Health Insurance Program.
FREE!
Mr. Robert Belfort is a partner in the health care practice of Manatt, Phelps & Phillips, LLP and has over 20 years of experience representing health care organizations on regulatory compliance and transactional matters.
Ms. Lisl Dunlop is a partner in the firm’s New York office and a member of the Litigation Division. She advises leading U.S. and multinational companies in an array of industries – in particular in the media, technology and health care sectors – on a broad range of antitrust counseling, antitrust litigation and transactional matters.
Ms. Jocelyn Guyer is a managing director with Manatt Health, an interdisciplinary policy and business advisory division of Manatt, Phelps & Phillips, LLP. Ms. Guyer provides policy expertise, strategic advice and technical support to states, foundations, and a broad array of other clients on implementation of the Affordable Care Act, Medicaid and the Children’s Health Insurance Program.
Ms. Lisl Dunlop is a partner in the firm’s New York office and a member of the Litigation Division. She advises leading U.S. and multinational companies in an array of industries – in particular in the media, technology and health care sectors – on a broad range of antitrust counseling, antitrust litigation and transactional matters.
Ms. Jocelyn Guyer is a managing director with Manatt Health, an interdisciplinary policy and business advisory division of Manatt, Phelps & Phillips, LLP. Ms. Guyer provides policy expertise, strategic advice and technical support to states, foundations, and a broad array of other clients on implementation of the Affordable Care Act, Medicaid and the Children’s Health Insurance Program.
FREE!
Total Credits: 1.50 units
Online
April 19, 2016, 10:00 am to 11:30 am PT
For further information see:
http://www.bna.com/bring-own-device-m57982065702/?elqTrackId=a016bb75021d44ebb6c740208eee6497&elq=184053797c22422d86941c54ec60ec1d&elqaid=4671&elqat=1&elqCampaignId=2771
No comments:
Post a Comment