Health system executives are often interested in understanding the movement of patients in, through and out of their system and want a detailed view of the volume and value of the services being consumed. While many in the legal community start with the dim view that the executive's interest in this topic is solely motivated by a desire to incentivize referring physicians, this information is often mission-critical data used in care coordination, strategic planning and operational efficiencies.

Tracking referral patterns, measuring patient outmigration and creating financial reporting that directly show the value of a physician's referral activity within the healthcare system can substantially elevate risk to the organization, but there are ways to mitigate those risks. Spending the time to construct some reasonable guardrails around what information is created and which individuals have access to it can significantly reduce the risk of violating Stark Law and Anti-Kickback Statute (AKS) regulations while still giving executives and administrators the information they need to make informed, rational business decisions.

This webinar will provide a comprehensive overview of the relevant provisions of Stark and Anti-Kickback laws to help executives understand what is legally prohibited and where risk of violating these laws becomes elevated.

Learning Objectives:

• Recognize Stark and Anti-Kickback law restrictions on the use of referral and downstream revenue data.
• Examine a compliant process to gather data on patient referrals and physician utilization.
• Evaluate conversations about patient referrals with referring providers to mitigate legal risks.

Faculty:

Adam White, JD, FACHE, Assistant General Counsel, Children's Nebraska

Continuing Education Credit

ACHE Qualifying Education Credit

This webinar is eligible for 1 ACHE Qualifying Education credit. ACHE Qualifying Education credits will be automatically updated in your My ACHE account upon completion of the recording.

Interprofessional Continuing Education Credit

In support of improving patient care, the American College of Healthcare Executives is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), and the American Academy of PAs (AAPA) to provide continuing education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive a maximum of 1 Interprofessional Continuing Education (IPCE) credit for learning and change. For further information about Joint Accreditation credits and certificates, please click here.

Physician Continuing Medical Education

The American College of Healthcare Executives (ACHE) designates this live activity for a maximum of 1 AMA PRA Category 1 Credits^™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The American College of Healthcare Executives designates this live activity for a maximum of 1 contact hours of continuing nursing education.

Continuing Pharmacy Education

The American College of Healthcare Executives designates this knowledge-based activity for a maximum 1 contact hours of continuing pharmacy education credit. 

Continuing Social Work Education

The American College of Healthcare Executives designates this knowledge-based activity for a maximum 1 contact hours of continuing social work education credit.

Continuing Education for Dietitians

The American College of Healthcare Executives designates this knowledge-based activity for a maximum 1 contact hours of continuing education credit for Registered Dietitians and Dietetic Technicians, Registered. RDs and DTRs should enter activities offered by jointly accredited providers as type 102 on Professional Development Portfolio (PDP) activity logs. CPEUs awarded must be commensurate with participation in the activity.

Physician Associate/Physician Assistant Continuing Education

The American College of Healthcare Executives has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for a maximum of 1 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.