Did you know the OIG now has a Quality CIA webpage? This speaks to the fact that quality itself is a basis for fraud liability. There are two separate bases for liability: (1) actual quality process deficiencies; and (2) fraud in reporting quality to the multiple agencies, state and federal, which require it, or for which providers volunteer as in the PQRS program for physicians in Medicare. This highly focused half hour of lecture with 15 minutes for questions will offer to hospitals and their compliance officers and physician practice groups a much better understanding of looming pitfalls which can be avoided with attention.

With health reform now moving inexorably forward, the implications of value-based payments, bundled payments, and reorganized care delivery - particularly for physicians - must be confronted. We are offering three highly focused, shorter teleconferences to address high level issues in three types of increasingly important transactions. (More details below)

1. Leasing The Practice to The Hospital (Sept. 11, 2012)
2. Co-management From The Physician's Perspective (Sept. 18, 2012)
3. Governance and Contractual Issues in Bundled Payment (Sept. 25, 2012)

Hospitals and health systems seeking to engage in these transactions with physicians will want to understand the positions we would take on the physicians' behalves. Each program will be one half hour of practical, real world guidance based on real transactions, with a brief five to ten minutes of Q & A. There is a substantive handout for each program which can act as a checklist for each transaction. To make these programs even more focused, we will solicit questions from attendees in advance. Each program will be $300 for either the live teleconference or the MP3 recording. All attendees get the handout. We are offering a significantly discounted price of $750 for those who purchase three, regardless of format -- live or MP3, with handout.
All programs are at 12 PM ET, 11 AM CT, 10 AM MT, 9 AM PT.

Register here for:

> MP3 Only

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1. Leasing The Practice To The Hospital: Pros, Cons and Practicalities
(Sept. 11, 2012)
Models other than employment can achieve significant alignment between hospitals and physicians. A professional services agreement which, in effect, leases the practice to the hospital is close to full integration without employment, and far easier to terminate. It can and should include more than wRVU payments. Learn what these transactions actually look like.

Register here for:
> MP3 Only

• Pros and cons
• Payment models
• Going provider-based: pros and cons
• Preserving productivity and improving quality
• Exclusivity: when and when not
• Restrictive Covenants
• Non-CPT Payments for What
• Approaches to paying overhead
• Accommodating changes in the practice during the term

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2. A Physician's Perspective on Co-Management: Opportunities and Pitfalls
(Sept. 18, 2012)
Co-management gets physicians far more intimately involved in the operation of a hospital service line, with the goal of increasing quality and value. It engages the physicians in improving the hospital's position and realizing financial reward for doing so.

Register here for:
> MP3 Only

• What's different from medical directorships
• One group or more: is an entity necessary?
• Who can participate?
• Payment for time or results?
• Payment issues from the hospital
• Measurement issues
• The importance of valuation
• Fixing accountability at the locus of control
• Are restrictive covenants necessary?

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3. Governance and Contractual Issues Within Bundled Payment: The Physician Perspective (Sept. 25, 2012)
Medicare has launched its Bundled Care for Payment Improvement Initiative and many commercial payors are initiating bundled payment options. There are a range of issues that arise in the governance of these programs as well as in the contracts among providers that make them real. By definition they involve more than one type of provider in the 'bundle'. That is the point. Controversies will arise. This session is not about the contract with the payor, which actually is a simpler proposition in many ways.

Register here for:

> MP3 Only

• Governance: One man one vote or by group
• Which stakeholders on the board?
• What types of issues need supermajorities
• Defining the bundle, breaking the bundle
• Bundled budget versus bundled payment
• Where will the money land and who will distribute?
• Bases for payment allocation: avoiding foodfights
• Adding and terminating participants
• Dispute resolution issues
• Clinical integration: the sine qua non

Register here for:

> MP3 Only

Credit Card Only

Health reform changed the landscape for Stark compliant compensation in groups. Claims submitted by non-compliant groups are now subject to whistleblower complaints of false claims. There are many myths about the requirements as they pertain to profit sharing, productivity bonuses and incident-to billing. This teleconference will explain the rules, debunk the myths and offer new information about how leading edge groups are increasingly moving to make their internal compensation models consistent with external demands for improved quality and value. Health systems and hospitals which now employ large numbers of physicians should pay particular attention to these issues.

REGISTRATION CLOSED. If you would like to order a recording of this audioconference with Q and A and handouts, click here-- $325 for a downloadable MP3. Credit Card only.

[Teleconference account holders, login to purchase.]

This focused, one hour teleconference will offer 45 minutes of presentation and 15 minutes of Q & A addressing:

• How the Stark definition of a group practice matters and when it doesn't
• Understanding productivity versus profit sharing
• Incident-to versus shared visits: what's the difference?
• Myths debunked
• The hospital employment wrinkles
• What leading edge organizations are doing
• Lessons learned

REGISTRATION CLOSED. If you would like to order a recording of this audioconference with Q and A and handouts, click here-- $325 for a downloadable MP3. Credit Card only.

[Teleconference account holders, login to purchase.]

This focused, one hour teleconference, with a handout including an outline and a list of resources, will offer 45 minutes of presentation and 15 minutes of Q & A addressing:

• What is a breach and how to avoid one
• What if the breach is by a Business Associate
• Doing a basic risk assessment
• Who needs to be told what and by when
• When to get legal help

In health reform, Congress has given CMS and its contractors even more authority to make physician enrollment in Medicare difficult. What is little understood, however, are the pitfalls of not maintaining enrollment effectively. The system requires reporting to Medicare within defined timeframes such changes as engaging a new billing company, a new administrator or that a physician's assistant has left the practice! In this teleconference, Alice Gosfield and Daniel Shay will (1) elucidate what is new, (2) present typical problematic scenarios, and (3) provide real-life guidance on maintaining enrollment effectively. This is a "must listen" to avoid having your Medicare billing privileges suspended for avoidable administrative failures and worse yet, false claims liability for improper statements made.

REGISTRATION CLOSED. If you would like to pre-order a recording of this audioconference with Q and A and handouts, click here-- $325 for a downloadable MP3. Credit Card only.

[Teleconference account holders, login to purchase.]

This focused, one hour teleconference, with a handout including an outline and a list of resources, will offer 45 minutes of presentation and 15 minutes of Q & A addressing:

• What health reform added to an already tedious process
• Getting in the door
• What needs to be reported and when once you are in
• Typical mistakes and how to avoid them
• Appeal rights and their limits

• The difference between bundled payment and bundled budgets
• Where Potentially Avoidable Complications fit in health reform
• How PROMETHEUS Evidence-informed case rates® are constructed
• How the PROMETHEUS Payment model can sustain the patient-centered medical home
• The pilot sites and how they differ
• How PROMETHEUS Payment fosters clinical collaboration
• The role of provider impetus to change

Purchase a recording of this audioconference with Q and A and the handouts that were distributed --- $325 for a downloadable MP3. Credit Card only.

[Teleconference account holders, login to purchase.]

IMPORTANT: Your access is limited to 24 hours after you sign up. So, you can download the recording and the handouts to your desktop or other device and save them for your convenience or wait until you want to listen to purchase.

Payment and Quality Challenges and Opportunities for Physicians and Hospitals

• What will really be so different?
• The new payment opportunities without payment reform
• The payment pressures on hospitals and what that will create
• Where hospitals and physicians will find common cause
• The real story on the ‘shared savings’ Accountable Care Organization provisions
• The demonstration projects: bundled payments, episode grouper, chronic care, medical homes and more
• What the changes in Medicaid payment and measurement might mean

Purchase a recording of this audioconference with Q and A and the handouts that were distributed --- $325 for a downloadable MP3. Credit Card only.

[Teleconference account holders, login to purchase.]

Fraud and Abuse in Health Reform

• What the changed intent standard for antikickback means
• The new obligation to report overpayments in 60 days
• The Stark in-office ancillary services disclosure requirement
• Enhanced screening of providers and suppliers
• Expansion of false claims liability
• Special DME and home health certification rules
• Expanded government agency sharing of data…and more

Que FERA, FERA: The Need for Upgraded Compliance Programs

With the budget crisis and health reform, the government will be increasingly focused on recouping overpayments from providers and enforcing the fraud and abuse laws. The Fraud Enforcement and Recovery Act of 2009 (FERA) makes their jobs easier. It also expands the targets for whistleblowers. This law turns mere overpayments--including under the Stark regulations -- into false claims. In addition, the government has made it clear that there are new forms of fraud and abuse hidden in Medicare and Medicaid claims. All compliance programs should be revisited to take these changes into account. Anyone without a compliance program had best wake up and create one! This teleconference is intended to provide a practical understanding of these changes.

Purchase a recording of this audioconference with Q and A and the handouts that were distributed --- $325 for a downloadable MP3. Credit Card only. [Teleconference account holders, login to purchase.] IMPORTANT: Your access is limited to 24 hours after you sign up. So, you can download the recording and the handouts to your desktop or other device and save them for your convenience or wait until you want to listen to purchase.

This focused, one hour teleconference, with a 10 page handout including an outline and a list of resources, will offer 45 minutes of presentation and 15 minutes of Q & A addressing:

• How the current context is different
• What FERA did and how it affects providers
• Reverse false claims
• Quality fraud
• Quality reporting fraud
• The new pitfalls under Stark
• Critical compliance program questions