How to Audit-Proof Your Physician Contracts

Why Should You Attend:

In today’s heavily scrutinized healthcare industry, it is imperative that all financial arrangements with physicians who may serve as a referral source to the organization are structured to comply with a number of legal requirements. In addition, a physician contract management program should incorporate a number of internal controls to ensure the efficiency and effectiveness of your financial relationships with physicians.

This program will enable you to walk through your physician contracts with the mind set of an auditor looking for proof. Attendees will learn how to ensure you have a physician contract management process that can hold up to any scrutiny.

Areas Covered in the Webinar:

• Learn how to conduct a self audit of your physician contracts.
• Understand the key legal implications of Stark and Federal Anti-Kickback statutes.
• Learn how to incorporate the “Show me” principle in your physician contract process to ensure you can hold up under audit scrutiny.
• How and why HIPAA, EMTALA, and other legal requirements should be considered as part of this process.
• How to perform necessary periodic reviews on your physician contracts.

Who Will Benefit:

This webinar will provide valuable assistance to any healthcare provider engaged in contracting for the services of physicians who also serve as referral sources to the provider. Workforce personnel who should attend include:

• Compliance director
• Internal auditor
• Legal officer
• CFO
• Physician affiliation director
• Administrator

Instructor Profile:

Kevin McPoyle, CPA, is the director of internal audit and compliance with Kennedy Health System in New Jersey. He is a healthcare audit and compliance specialist with over 20 years’ experience assisting healthcare providers, both large and small, with developing systems to ensure compliance, revenue integrity, and operational efficiency.\. He has presented at numerous conferences and seminars and he is the past president of the Metropolitan Philadelphia Chapter of the Healthcare Financial Management Association where he led extensive efforts to design and deliver exceptional professional education for the industry.

Topic Background:

Hospital and physician alignment strategies are in full throttle in most organizations today. While employment of physicians is popular, there remain many relationships that will not work that way and so professional services agreements are necessary. Many considerations must be made for these arrangements to be compliant with Stark Law and the Anti-Kickback Statute. Additional considerations may be needed for IRS tax exempt requirements, state regulations, and other legal requirements such as those imposed by HIPAA and EMTALA. Legal departments spend countless hours reviewing and approving these arrangements, but how do you know that the agreements have been placed into operations in such a way that a regulatory auditor would not find reason to raise any questions about compliance? Despite all the best intentions to do things right, hospitals are often the subjects of fraud investigations because they lack the ability to “show” that they covered all of the compliance bases.

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