Schedule

• Government policy pivots
• Update on dispute resolution/surprise billing
• Current state of AI in healthcare and things to watch for
• Health care employment law trends
• Current reimbursement challenges
• Emerging trends not previously considered

• Reimbursement systems applicable to Part A and B providers
• Beneficiary enrollment, coverage, and benefits
• Provider enrollment and certification
• Conditions of participation and payment
• Governance and structure: CMS, ROs (and the transition to the PEOG), and MACs
• How Parts A and B impact transactions
• Applicable regulations, agency guidance, and key compliance resources

• Session details will be available soon

Privacy is becoming one of the core areas for understanding in virtually all areas of health law. Privacy affects most health care policy issues, corporate transactions, business contracts, litigation, business strategy and a wide range of overall compliance issues. This session will provide a baseline for all health lawyers on key areas where health privacy law impacts the business of health care and the use of health information across our health care system.

• Fundamentals of the PSL (also known as the "Stark Law")
• Discuss when the law is implicated vs. when it is not
• Use hypotheticals to inform analysis
• Discuss different types of exceptions for ownership, compensation and services
• Explain when to use exceptions and best practices

• The Anti-Kickback Statute and Historic Case Law
• Anti-Kickback Statute Safe Harbors–what they are and how to “sail into” them
• The Anti-Kickback Statute in Action
• Minimizing Anti-Kickback Statute risks
• “AKS Plus” – EKRA
• Significant Enforcement and Case Law Trends

• This session aims to contrast the Physician Self-Referral Law and Anti-Kickback Statute from a policy and operational perspective
• Discussion of enforcement and implications of violating either law
• Evaluation of hypothetical arrangements and the analytical framework for determining whether either, both, or neither of the laws are implicated
• Specifically, we will compare the following differences between the Anti-Kickback Statute to the Stark Law
  • Intent vs. Strict Liability
  • Penalties
  • Safe Harbors vs. Exceptions
  • Voluntary Disclosure Processes

The False Claims Act (FCA) remains the government’s most powerful tool to combat health care fraud, waste, and abuse. This session is designed for attorneys and compliance professionals new to health care and offers a practical introduction to the FCA. We’ll cover:

• Core elements and key case law: Understand what constitutes a false claim, including recent developments in materiality, intent, and qui tam actions
• Enforcement trends: Review DOJ and OIG priorities, including current hot spots like Medicare Advantage, telehealth, and provider arrangements
• Compliance strategies: Learn how to structure compliance programs to prevent violations, respond to concerns, and mitigate enforcement risk

Attendees will walk away with a clear understanding of FCA fundamentals and actionable steps to strengthen their organization’s compliance posture.

• How to furnish healthcare 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 healthcare-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 the items discussed above)

• Legal practice is messy, but sometimes we come across intentional and unintentional ethical lapses
• How do we as lawyers respond to ethical issues, like mailing the other side’s clients ex parte or improper ex parte communications with judges
• How do we ensure that we continue to meet the standards for our profession to ensure that we remain fluent in new technologies/data tools and how to ensure proper technical support for complex cases
• How to navigate when clients are getting conflicting advice from other sources (or are shopping for the advice they want)
• How internal documentation can both protect attorneys and clients

• 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

• Session details will be available soon

This presentation will focus upon the core requirements for health care organizations to qualify for tax exemption under 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. We also will cover such adjacent issues as:

• 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)
• In addition, the discussion will address the increasing scrutiny of hospitals and health care organizations from Congress, the IRS, the media, and others–with attention to new 2025 proposed or adopted legislation, regulations, and administrative action modifying the tax-exemption standards

• 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

• Session details will be available soon

This course provides a comprehensive overview of physician agreements, including employment, independent contractor, and professional services engagements, emphasizing the critical components of labor and employment and health care regulatory compliance. Participants will gain insights into the structure of these agreements, ensuring they meet both organizational objectives and regulatory standards. Through practical examples and interactive discussions, attendees will learn to navigate the complexities of physician contracts, safeguarding their organizations from legal pitfalls while fostering a collaborative and compliant work environment. We will discuss: 

• Gain foundational knowledge of the components and purposes of physician engagement agreements within health care organizations
• Key labor and employment laws affecting physician contracts, including anti-discrimination statutes, wage and hour regulations, compensation arrangements, incentives, co-employment issues, restrictive covenants, and paths for advancement
• Critical health care regulations impacting physician agreements, such as HIPAA, Stark Law, Anti-Kickback Statute, professional liability, and Licensing and Credentialing
• Identify and mitigate potential legal risks associated with physician contracts through proactive planning and compliance measures
• Real-world examples and best practices to understand common challenges and solutions in physician engagement agreements

• Introduction to telehealth, digital health, and artificial intelligence in health care
• Telehealth, digital health, and AI industry regulators and applicable laws and executive orders
• Legal risk areas, including privacy, corporate practice of medicine, fraud and abuse, FDA regulation of medical devices, and medical malpractice
• Enforcement actions and trends (e.g., special fraud alerts, litigation involving AI algorithms and medical necessity determinations or healthcare staffing determinations)

• An overview of the Medicaid program and its program objectives
• Medicaid financing and governance
• Medicaid fee-for-service and Medicaid managed care
• The common “bones” of Medicaid programs and how they differ
• Recent changes in Medicaid through Congressional, agency, and judicial actions
• How to research Medicaid issues

This session is being proposed as the general session on health equity. It will include 15 minutes of upfront lecture to level-set on definitions and existing actions, followed by a fireside chat with attorneys in the field that have focused on health equity efforts throughout their careers. Speakers will share the following:

• A framework for health, health equity, and health justice; the role of social and structural drivers of health
• Current initiatives to advance health equity
• The impact of law and policy on health equity
• Collaboration and the roles of physicians and other health care professionals, hospitals/ health systems, and payors
• Concrete action steps for the legal community

• Different types of transaction structure for a health care deal (e.g., asset purchase versus stock purchase or merger)
• A framework for approaching due diligence in a health care transaction
• Regulatory and legal issues common to health care transactions (e.g., federal Anti-Kickback and Stark Laws; anti-trust issues; and tax-exempt issues)
• The importance of the concepts of “fair market value” and “commercial reasonableness” to a health care transaction
• Apply these strategies to a case study (physician-hospital integration), sample letter of intent, and sample due diligence checklist to understand how various factual scenarios could affect the transaction and to highlight diligence and transactional considerations

• Session details will be available soon

Panelists including both former and current Federal Trade Commission staff and managers from Mergers I and Mergers IV division, in-house counsel, and private practitioner active in health care M&A antitrust, will discuss antitrust considerations in the context of health care merger review and collaborations, including:

• Background on the applicable antitrust laws and substantive framework
• Federal and state enforcement agency trends such as merger guidelines, recent enforcement actions, and state notification requirements
• Key practical considerations when counseling on health care transactions or collaborations

• Compliance Program design and implementation considerations
• The Government's focus on Compliance Program effectiveness
• The Board's role in compliance
• Distinguishing the role of Legal and Compliance in compliance matters

• Corporate Practice of Medicine Overview
• Friendly PC Model Overview
• Types of Agreements
• Case Study (California and North Carolina)

This course provides a comprehensive overview of physician agreements, including employment, independent contractor, and professional services engagements, emphasizing the critical components of labor and employment and health care regulatory compliance. Participants will gain insights into the structure of these agreements, ensuring they meet both organizational objectives and regulatory standards. Through practical examples and interactive discussions, attendees will learn to navigate the complexities of physician contracts, safeguarding their organizations from legal pitfalls while fostering a collaborative and compliant work environment. We will discuss: 

• Gain foundational knowledge of the components and purposes of physician engagement agreements within health care organizations
• Key labor and employment laws affecting physician contracts, including anti-discrimination statutes, wage and hour regulations, compensation arrangements, incentives, co-employment issues, restrictive covenants, and paths for advancement
• Critical health care regulations impacting physician agreements, such as HIPAA, Stark Law, Anti-Kickback Statute, professional liability, and Licensing and Credentialing
• Identify and mitigate potential legal risks associated with physician contracts through proactive planning and compliance measures
• Real-world examples and best practices to understand common challenges and solutions in physician engagement agreements

• Introduction to telehealth, digital health, and artificial intelligence in health care
• Telehealth, digital health, and AI industry regulators and applicable laws and executive orders
• Legal risk areas, including privacy, corporate practice of medicine, fraud and abuse, FDA regulation of medical devices, and medical malpractice
• Enforcement actions and trends (e.g., special fraud alerts, litigation involving AI algorithms and medical necessity determinations or healthcare staffing determinations)

• Legal practice is messy, but sometimes we come across intentional and unintentional ethical lapses
• How do we as lawyers respond to ethical issues, like mailing the other side’s clients ex parte or improper ex parte communications with judges
• How do we ensure that we continue to meet the standards for our profession to ensure that we remain fluent in new technologies/data tools and how to ensure proper technical support for complex cases
• How to navigate when clients are getting conflicting advice from other sources (or are shopping for the advice they want)
• How internal documentation can both protect attorneys and clients

Panelists including both former and current Federal Trade Commission staff and managers from Mergers I and Mergers IV division, in-house counsel, and private practitioner active in health care M&A antitrust, will discuss antitrust considerations in the context of health care merger review and collaborations, including:

• Background on the applicable antitrust laws and substantive framework
• Federal and state enforcement agency trends such as merger guidelines, recent enforcement actions, and state notification requirements
• Key practical considerations when counseling on health care transactions or collaborations

• Compliance Program design and implementation considerations
• The Government's focus on Compliance Program effectiveness
• The Board's role in compliance
• Distinguishing the role of Legal and Compliance in compliance matters