Schedule

• What is post-acute care? Understanding the continuum from acute to long-term services
• Current and future demographics and state of the industries including industry history and current trends
• Alphabet soup: Key acronyms and entities in post-acute and long-term care
• Federal and state licensure, certification and oversight in this space
• Payment systems prevalent in long term care (Medicare, Medicaid, HCBS, private pay, managed care)
• Post-acute and long-term care provider types (facility-based and home-based)
• Survey processes across care settings (e.g., SNFs, HHAs, ALFs, etc.)
• Primary trends/ How to issue spot legal challenges

Health care lawyers often stand at the intersection of organizational obligations and individual professional duties. These obligations and duties can collide when compliance concerns arise, or a government entity launches an investigation or serves a subpoena. This session will examine the ethical challenges that emerge when advising facilities, executives, and licensed providers who may themselves have independent reporting obligations or even be potential whistleblowers. In this session, we will address:

• Approaches for advising employees and physicians who may have personal reporting duties as licensed professions or may be potential whistleblowers
• Conflicts of interest that arise during internal investigations and strategies for navigating those conflicts
• Managing representation boundaries and ethical risks in response to government subpoenas and investigations
• Key professional responsibility principles that guide lawyers in these situations, including organizational representation, conflict of interest and interactions with unrepresented individuals

This session explores the essential components of cultivating a robust culture of compliance within health care organizations. Attendees will learn practical strategies for leadership engagement, staff training, and policy development that promote ethical behavior and regulatory adherence. We will discuss real-world challenges such as resistance to change, communication gaps and maintaining compliance amidst evolving regulations. Through case studies and interactive discussion, participants will gain insights into creating an environment where compliance is ingrained in organizational values, ultimately reducing risk and enhancing patient trust.

• Overview of Industry: Understand industry segments (mental health, substance use disorder, intellectual and developmental disability, etc.) and care settings
• Defining Legislation of Last Decade: Review the laws that have shaped the behavioral health landscape in recent years, including the Mental Health Parity and Addiction Equity Act; Comprehensive Addiction and Recovery Act; SUPPORT for Patients and Community Act; and others
• Unique Legal Issues: Gain awareness of laws that specifically impact behavioral health providers, including stringent and overlapping privacy laws; all-payer fraud and abuse laws; and nuanced state involuntary commitment laws
• Hot Legal Topics: Explore current hot-button issues in behavioral health, including Medication-Assisted Treatment for opioid use disorder; tech-and telemedicine-enabled behavioral health; and private equity investment

This presentation will explore the core requirements for health care organizations to qualify for exemption from federal income taxation. The principal focus will be Code Section 501(c)(3), including the mandate to be operated for charitable purposes and the prohibitions against private inurement, substantial lobbying, and political campaigning. In addition, the discussion will cover adjacent topics like:

• Distinguishing between public charities and private foundations
• Preventing improper benefits to third parties
• Applying the rules governing unrelated business income tax
• Helping hospitals comply with their obligations under Code Section 501(r)

The presentation also will discuss other categories of tax exemption within the health care sector–such as 501(c)(4) social welfare organizations, 501(c)(6) associations, and 501(c)(2) real estate holding companies–as well as the standards for joint ventures between tax-exempt and taxable entities. Finally, the presentation will address the increasing scrutiny of hospitals and health care organizations from Congress, the IRS, the media, and others–with attention to recently-proposed and enacted legislation, regulations, and administrative action affecting tax-exempt organizations.

Panelists from the Federal Trade Commission, in-house counsel, and private practice will discuss ten antitrust issues that health law practitioners should be prepared to recognize and navigate, including:

• Core antitrust laws and concepts and how they apply across the health care industry
• Key antitrust considerations arising in transactions, competitor collaborations, contracting practices, information sharing, and other common health care activities
• Federal and state enforcement priorities and emerging areas of antitrust scrutiny
• Practical guidance for spotting antitrust red flags, asking the right questions, and knowing when to involve antitrust counsel

• Purpose and role of organized medical staffs within health systems and hospitals
• Applicable statutes, regulations, and accreditation requirements for hospital medical staffs
• Underlying legal, business, and operational issues for hospital medical staffs
• Emerging issues and areas of emphasis, including:
  • Medical Staff/employed physician considerations
  • Integrating non-physician Advanced Practice Professionals
  • Peer review and Information sharing
  • Evolving role of Medical Staffs on quality
  • Trends in Medical Staff governance and oversight
  • Drafting tips and sample language for medical staff governing documents

• Types of Affiliations:
  • Employment
  • Joint Ventures
  • PSAs
  • Service Line Management
• As we discuss each model, we will address potential points of conflict, including the following:
  • Valuation of the practice
  • Fraud and abuse issues/concerns
  • Decision making and operational oversight
  • State law issues including CPOM and fee-splitting

• How to furnish health care items and services: Overview of licensure requirements
  • Individual providers (e.g., MDs, DMDs, NPs, etc.)
  • Entities (e.g., group practices)
  • Facilities (e.g., ASCs, hospitals)
  • Item- and/or service-specific requirements (e.g., x-ray, DMEPOS, in-office surgery, pharmacy)
• How to bill for the furnishing of health care items and services: Overview of Medicare and Medicaid enrollment requirements
  • Introduction, including brief overview of essential terminology
  • Medicare initial enrollment requirements
  • Medicaid initial enrollment requirements
• How to remain eligible to furnish and bill for health care-related items and services: Overview of continuing obligations
  • Reporting changes of information
  • Reporting changes of ownership
  • Maintaining compliance with licensure and enrollment standards (e.g., surveys, background screenings, revalidations/renewals, etc.)
• Case study (incorporating all of the items discussed above)

Attendees will hear from in-house and outside counsel on the following topics, with each translated into practical takeaways for advising clients on telehealth matters:

• The state and federal legal and regulatory framework governing telehealth
• Professional licensure and scope-of-practice issues, including multistate licensure challenges and relevant compacts/exceptions counsel should know when advising clients on telehealth issues
• Remote prescribing rules, including controlled substance and DEA considerations that frequently arise in telehealth engagements
• Credentialing by proxy and the corporate practice of medicine doctrine as they apply to structuring telehealth delivery and staffing arrangements
• Reimbursement principles and key fraud and abuse risk areas specific to telehealth

This session explores the essential components of cultivating a robust culture of compliance within health care organizations. Attendees will learn practical strategies for leadership engagement, staff training, and policy development that promote ethical behavior and regulatory adherence. We will discuss real-world challenges such as resistance to change, communication gaps and maintaining compliance amidst evolving regulations. Through case studies and interactive discussion, participants will gain insights into creating an environment where compliance is ingrained in organizational values, ultimately reducing risk and enhancing patient trust.

This presentation will cover key regulatory issues that occur during health care transactions with private equity sponsors, particularly around evolving corporate practice of medicine enforcement and state antitrust and transaction oversight issues. By the end of the session, participants will understand how regulatory approvals impact timing to close and be prepared to engage with clients, identify legal risks, and provide comprehensive legal advice in this specialized area. The areas to be covered include the following:

• Basic Transaction Structures. The typical private equity investment model and basic transaction structures will be reviewed for familiarity with types of transactions occurring with private equity sponsors
• Treatment of the Transaction as a Change of Information, a Change of Ownership, or Both. Instruction will be provided regarding how to review and analyze CHOI and CHOW requirements for licenses, permits and payor enrollment status, together with case studies
• The Impact of the Corporate Practice of Medicine on Transaction Structure and Operations. An introduction to corporate practice of medicine (CPOM) restrictions will be provided together with helpful strategies for understanding the risks and structuring considerations in CPOM states
• Fraud and Abuse Risks. The implications of common private equity deal structures under the Anti-Kickback Statute, the Stark Law, and other fraud and abuse laws will be discussed, with practical guidance for identifying and mitigating risks
• Federal Antitrust Law and State Transaction Oversight. Federal and state antitrust law considerations including baby-HSR and state material transaction laws will be reviewed along with discussion of evolving transaction notification and approval processes

• Types of Affiliations:
  • Employment
  • Joint Ventures
  • PSAs
  • Service Line Management
• As we discuss each model, we will address potential points of conflict, including the following:
  • Valuation of the practice
  • Fraud and abuse issues/concerns
  • Decision making and operational oversight
  • State law issues including CPOM and fee-splitting

Health care lawyers often stand at the intersection of organizational obligations and individual professional duties. These obligations and duties can collide when compliance concerns arise, or a government entity launches an investigation or serves a subpoena. This session will examine the ethical challenges that emerge when advising facilities, executives, and licensed providers who may themselves have independent reporting obligations or even be potential whistleblowers. In this session, we will address:

• Approaches for advising employees and physicians who may have personal reporting duties as licensed professions or may be potential whistleblowers
• Conflicts of interest that arise during internal investigations and strategies for navigating those conflicts
• Managing representation boundaries and ethical risks in response to government subpoenas and investigations
• Key professional responsibility principles that guide lawyers in these situations, including organizational representation, conflict of interest and interactions with unrepresented individuals

Panelists from the Federal Trade Commission, in-house counsel, and private practice will discuss ten antitrust issues that health law practitioners should be prepared to recognize and navigate, including:

• Core antitrust laws and concepts and how they apply across the health care industry
• Key antitrust considerations arising in transactions, competitor collaborations, contracting practices, information sharing, and other common health care activities
• Federal and state enforcement priorities and emerging areas of antitrust scrutiny
• Practical guidance for spotting antitrust red flags, asking the right questions, and knowing when to involve antitrust counsel

Attendees will hear from in-house and outside counsel on the following topics, with each translated into practical takeaways for advising clients on telehealth matters:

• The state and federal legal and regulatory framework governing telehealth
• Professional licensure and scope-of-practice issues, including multistate licensure challenges and relevant compacts/exceptions counsel should know when advising clients on telehealth issues
• Remote prescribing rules, including controlled substance and DEA considerations that frequently arise in telehealth engagements
• Credentialing by proxy and the corporate practice of medicine doctrine as they apply to structuring telehealth delivery and staffing arrangements
• Reimbursement principles and key fraud and abuse risk areas specific to telehealth