Attention:
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Real Talk: How the Revised Stark and AKS Rules Will Impact Health Industry Compliance


Level: Advanced
Runtime: 92 minutes
Recorded Date: January 12, 2021
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Agenda

  • Introductions
  • Background on AKS and Stark
  • Minefield of risks in health care industry
  • OIG’s AKS and CMP law changes
  • CMS’s Stark Law changes
  • Implications
  • Fact patterns/hypotheticals
Runtime: 1 hour, 32 minutes
Recorded: January 12, 2021
For NY - Difficulty Level: Experienced attorneys only (non-transitional)

Description

In closing out 2020, the Department of Health and Human Services (HHS)'s Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid (CMS) published historic revisions to regulations governing the federal physician self-referral law (Stark Law), Anti-Kickback Statute (AKS), and beneficiary inducement Civil Monetary Penalties (CMP) laws. These long-awaited revisions attempt to tackle road blocks to care coordination and value-based services. But how will these changes impact health industry compliance? What new relationships or innovation in the industry do these revisions allow? What will these regulations continue to restrict? What are the best practices for compliance teams looking at setting up new "value based arrangements"? Will there be any unintended consequences of these rules? What implications, if any, will the new rules have for fraud, waste, and abuse investigations and enforcement actions?

Join representatives from the OIG and health care compliance attorneys, both in-house and outside counsel, as we take a practical, real-world look at how the revised Stark, AKS and CMP law regulations will impact the industry. This presentation will use real-word examples, hypotheticals and address potential government scrutiny and enforcement risk. The panel will also highlight "best practices" for health care industry compliance professionals in the brave new world of value-based care and coordination.

This program was recorded on January 12th, 2021.

Provided By

American Bar Association
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Panelists

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Amy Hooper Kearbey

Senior Counsel, Office of Counsel to the Inspector General
U.S. Department of Health & Human Services (HHS)

Amy H. Kearbey is a Senior Counsel, Office of Counsel to the Inspector General at the U.S. Department and Health & Human Services.

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Benjamin Harry Wallfisch

Senior Counsel, Industry Guidance Branch, Office of Counsel to the Inspector General
U.S. Dept. of Health & Human Services

Benjamin Harry Wallfisch is the Senior Counsel, Industry Guidance Branch, Office of Counsel to the Inspector General at the U.S. Department of Health & Human Services.

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Michael McGovern

Deputy General Counsel
Vault Health

Michael McGovern is the Deputy General Counsel at Vault Health, a telehealth company aiming to make better health outcomes more accessible and affordable for everyone. As the second legal hire, Michael has built, scaled and managed a legal department serving five distinct business lines in a heavily regulated environment, including the first at-home saliva-based PCR COVID-19 test, and a nationwide COVID-19 vaccination distribution business. In addition to his work on Vault’s commercial lines, Michael focuses on executive and total company compensation and benefits, and corporate risk identification and mitigation.

Prior to joining vault, Michael worked as an executive compensation, benefits and ERISA attorney at Jones Day, and before that at Fox Rothschild.

Michael earned a Bachelor’s degree in History from Johns Hopkins University and a J.D. from Northwestern University’s Pritzker School of Law.

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Rebecca Simone

Partner
Nixon Peabody LLP

Rebecca Simone represents for-profit and nonprofit health care services providers and entities.

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Harsh P. Parikh

Associate
Nixon Peabody LLP

Harsh works with managed care organizations, hospital systems, and other providers on a wide range of regulatory, reimbursement, and transactional matters. His practice encompasses federal and California fraud and abuse compliance, licenses and permits, Medicare and Medicaid (Medi-Cal) participation and reimbursement, False Claims Act internal and government investigations, and enforcement actions. Harsh also advises clients on health information technology, bioethics, privacy, security compliance, digital health, and telemedicine matters.


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