In-Person Schedule

• Trends, practices, and practical guidance for parties involved in disputes between physicians/health systems and payers, with a focus on navigating the provider/hospital services agreements
• How the evolving regulatory landscape impacts and is reshaping managed care disputes
• The growing role of AI in reimbursement disputes and what it means for strategy and outcomes
• A framework for determining whether arbitration or court is the most effective forum for a given dispute
• How value-based arrangements are being interpreted and litigated in managed care disputes, including emerging theories, risks, and strategic considerations
• The key legal issues that drive provider-payer conflicts and the tools available to strengthen negotiation leverage and legal positions

• The state of non-competes for health care Professionals and what's to be made of the FTC's stern letters to Payors?
• All these new State Notification Laws...What should parties do?
• Is the Big Beautiful Bill accelerating the consolidation of providers?
• Are PE's and Payors cherry-picking practice groups regardless of the competitive impact?
• Where do the States stand on consolidation vs. access to care?
• The dangers of using AI and other information sharing tools under new federal scrutiny and auditing systems

• The valuation shell game, or which valuation/valuator will we rely on?
• You promised them what? How to undo a promise made by an operator?
• But the boss said so. How to avoid being the messenger who is on the wrong end of the crossbow.
• I may or may not have those documents. Dealing with issues of attorney-client veracity.
• E-discovery? What's that? I delete my texts every day, anyway.

• The recent increase in government investigations and other internal challenges related to hospital–physician alignment and medical staff oversight, emphasizing the necessity for hospitals to actively monitor and ensure compliance with established policies and plans
• Recognize that practices once considered high priority for hospital compliance related to employed and affiliated physicians may have become routine or overlooked, potentially resulting in vulnerabilities that trigger regulatory scrutiny, settlements, or corporate integrity agreements
• Essential components of effective compliance programs and internal policies for hospitals, including initial valuation requirements, compliant transaction structures, consistent monitoring of physician employees and medical staff, annual compliance training, routine compensation assessments, and robust conflict-of-interest, speaker program, meal, and gift policies
• Practical strategies for engaging between inside and outside counsel, compliance officers, administrators, and employed and medical staff physicians in collaborative discussions, aligning compliance efforts with business objectives—such as recruitment and retention—while maintaining vigilant oversight and ensuring ongoing adherence to compliance standards post-agreement

• The valuation shell game, or which valuation/valuator will we rely on?
• You promised them what? How to undo a promise made by an operator?
• But the boss said so. How to avoid being the messenger who is on the wrong end of the crossbow.
• I may or may not have those documents. Dealing with issues of attorney-client veracity.
• E-discovery? What's that? I delete my texts every day, anyway.

• The organizational structure and function of the NLRB
• The key changes implemented since January 2025
• Potential shifts in legal precedents and enforcement focus expected under the new administration
• The impact of NLRB decisions and enforcement priorities on employers, employees, and unions

• Trends, practices, and practical guidance for parties involved in disputes between physicians/health systems and payers, with a focus on navigating the provider/hospital services agreements
• How the evolving regulatory landscape impacts and is reshaping managed care disputes
• The growing role of AI in reimbursement disputes and what it means for strategy and outcomes
• A framework for determining whether arbitration or court is the most effective forum for a given dispute
• How value-based arrangements are being interpreted and litigated in managed care disputes, including emerging theories, risks, and strategic considerations
• The key legal issues that drive provider-payer conflicts and the tools available to strengthen negotiation leverage and legal positions

• Case Study 1: Why Compliance Matters Beyond HRSA Audits: Examples of arrangements requiring review under general health care laws and regulations, in addition to the 340B Statues
• Case Study 2: System 340B Strategies: Tips on working with consultants, hospital leadership and outside counsel on enrollment and conversions
• Case Study 3: Recent Developments: Maintaining an open line of communication with hospital leadership and pharmacy about recent changes in rebate model guidance and other drug pricing trends"

• The state of non-competes for health care Professionals and what's to be made of the FTC's stern letters to Payors?
• All these new State Notification Laws...What should parties do?
• Is the Big Beautiful Bill accelerating the consolidation of providers?
• Are PE's and Payors cherry-picking practice groups regardless of the competitive impact?
• Where do the States stand on consolidation vs. access to care?
• The dangers of using AI and other information sharing tools under new federal scrutiny and auditing systems

• What to think through as providers approach these projects and transactions, including real estate, financing, and compliance considerations
• Negotiating and navigating the potential pain points in the documents for these projects and deals
• Tips on working with and developing consensus among internal stakeholders, joint venture partners, developers, and other transaction parties
• Advice on getting joint venture projects and transactions approved and across the finish line

• The recent increase in government investigations and other internal challenges related to hospital–physician alignment and medical staff oversight, emphasizing the necessity for hospitals to actively monitor and ensure compliance with established policies and plans
• Recognize that practices once considered high priority for hospital compliance related to employed and affiliated physicians may have become routine or overlooked, potentially resulting in vulnerabilities that trigger regulatory scrutiny, settlements, or corporate integrity agreements
• Essential components of effective compliance programs and internal policies for hospitals, including initial valuation requirements, compliant transaction structures, consistent monitoring of physician employees and medical staff, annual compliance training, routine compensation assessments, and robust conflict-of-interest, speaker program, meal, and gift policies
• Practical strategies for engaging between inside and outside counsel, compliance officers, administrators, and employed and medical staff physicians in collaborative discussions, aligning compliance efforts with business objectives—such as recruitment and retention—while maintaining vigilant oversight and ensuring ongoing adherence to compliance standards post-agreement

Physician compensation arrangements are a focal point for compliance risk, especially in today's heightened regulatory environment. This session will provide practical, legally sound strategies for conducting both internal and external fair market value (FMV) reviews, and for structuring compliant professional service agreements, medical directorship agreements, and other physician compensation models. Using real-world examples, the session will explore how academic medical centers (AMCs), hospitals, and physician groups can proactively identify and address risk while preserving operational flexibility and physician engagement.

• Conducting Effective FMV Reviews–Step-by-step process for internal self-assessments versus engaging an external valuation firm, and when each is appropriate. We will also discuss hybrid approaches, including use of both self-assessment and external review during the same review to reduce cost while maintaining independent, third-party involvement
• Navigating Legal and Regulatory Risks–Stark Law, Anti-Kickback Statute, IRS rules, and state laws considerations when structuring physician compensation arrangements, including review of relevant case law
• Reviewing Professional Service Agreements (PSAs)–Common pitfalls, red flags, and negotiation points from the institutional and physician perspectives
• Medical Directorship Agreements–Ensuring duties are clearly defined, compensation is supportable, and documentation is audit-ready
• Beyond Salary: Incentives and Productivity Models–Structuring quality-based and productivity incentives to withstand legal and FMV scrutiny
• Practical Compliance Tips–Policies, documentation practices, and board/committee oversight strategies to support defensibility in compensation arrangements

In-house counsel are often the gatekeepers at preventing, discouraging, investigating and disclosing corporate misconduct. This session will utilize a fact pattern scenario involving alleged violations of the Stark law and False Claims Act to examine an attorney's role in preventing, discouraging, investigating and disclosing corporate misconduct and the potential attorney ethics rules that are implicated in this role. We will examine multiple professional rules of Conduct, including:

• ABA Model Rule 1.13–Organization as Client
• ABA Model Rule 1.16–Declining or Terminating Representation
• ABA Model Rule 1.6–Confidentiality
• Counsel "going up the ladder" when the client ignores the advice
• Options for counsel when the client refuses to follow legal advice

• How employer/employee direct subscription models combined with plan/Medicare-covered preventive services (e.g., RPM, FFC) can collectively shift healthcare away from fee-for-service misalignments and toward improved outcomes with employer ROI (reduced absenteeism, increased talent retention, improved workplace wellness)
• Shared benefits of transparent pricing, stable revenues, reduced fee-for-service burdens, and stronger patient–provider connection with adoption of the executive health practice structure but implementing longevity/lifestyle modification/health education resources
• Compliant integration of direct care with plan reimbursed services to meet ERISA, IRC, Stark, AKS, CPOM, Medicare/Medicaid and FMV compliance requirements
• Evaluate and contrast ROI for individual patient, general population, and private enterprise investment in direct care/subscription practice models integrated with plans and broaded in scope beyond traditional executive health models
• Dispel myths that practices must choose between cash-pay and plan reimbursed models by telling the historical hidden history of how routine exams evolved into executive/corporate health with federal statutory protections nearly 100% unknown by US health care attorneys and consultants
• Recent OIG alerts on improper concierge practice marketing and RPM as signals and guideposts for evolved and effective/compliant, high-value updated practice model design

• The organizational structure and function of the NLRB
• The key changes implemented since January 2025
• Potential shifts in legal precedents and enforcement focus expected under the new administration
• The impact of NLRB decisions and enforcement priorities on employers, employees, and unions

• The value-based enterprise framework in the context the Stark Law and Anti-Kickback Statute and how it has been leveraged by various health care organizations
• Work through 3-4 real world examples of VBEs and evaluate related successes, challenges, compliance and other considerations
• Focus and practical issues in meeting applicable Stark Law exceptions and Anti-Kickback Statute safe harbors, and other regulations
• Best practices for pursuing and implementing VBEs based on lessons learned
• The role of VBEs in the future, particularly in light of financial headwinds and other market dynamics

• What to think through as providers approach these projects and transactions, including real estate, financing, and compliance considerations
• Negotiating and navigating the potential pain points in the documents for these projects and deals
• Tips on working with and developing consensus among internal stakeholders, joint venture partners, developers, and other transaction parties
• Advice on getting joint venture projects and transactions approved and across the finish line