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

ACHE Qualifying Education Credit 

This activity is eligible for 1 ACHE Qualifying Education credit toward earning or maintaining your FACHE credential. 

Credits must be self-reported at My ACHE upon completion of this activity.