Let’s [Virtually] Talk Compliance | A Foley & PYA Master Class

PYA and Foley & Lardner hosted the third annual “Let’s ‘Virtually’ Talk Compliance” master class on Friday, January 22nd. The panel of presenters included health care attorneys, certified public accountants and valuators, and health care advisors. Panelists included Foley & Lardner attorneys Jackie Acosta, Chanley Howell, Jana Kolarik, and Roger Strode and PYA experts Angie Caldwell, Lori Foley, Barry Mathis, and Valerie Rock. Below are a few major takeaways from the day’s discussion.

Please reach out to us if you have any questions.

Session #1: IT Risks and Compliance Amid COVID-19

When it comes to cyber threats to privacy and security, stick to the basics:

Complete a Security Risk Analysis and take action on prioritized concerns.
Implement Behavioral Based End Point Protection.
Implement Multi Factor Authentication.
Assume you will be impacted at some point and prepare to respond.
Educate, Educate, Educate and test your staff’s response to email phishing attempts. Consider a reward program for anyone who identifies and helps prevent an actual attack.

Session #2: Unintended Consequences of Due Diligence

Pre-transaction due diligence is important to the buyer and the seller to evaluate culture and identify areas of risk.
Sellers are better positioned when they have identified, addressed and acknowledged areas of concern—and may work into the negotiation process—instead of being in a recovery position if the seller identifies issues during due diligence. Issues identified through due diligence can delay closing the deal and may negatively impact the purchase price.
Issues found in diligence can be handled through escrows and special indemnities if not remedied prior to closing. Some deals include representations and warranties insurance to address items discovered after closing.

Session #3: Telemedicine: Trendy or Here to Stay?

Section 1834m of the Social Security Act is the law that impacts telemedicine coverage for Medicare beneficiaries. The geographic and location waivers in effect during the Public Health Emergency will no longer be in effect after the pandemic. This means that the accessibility of telehealth to Medicare patients will again be restricted to rural areas and will be required to be performed in a facility. Until Congress acts to revise this law, the future of telemedicine expansion is at risk.
The Consolidated Appropriations Act allows for the funding of certain telecommunications infrastructure development in support of telemedicine technologies. This action may foretell Congress’ future intentions to make telehealth a more permanent part of the medical service delivery model.
Regardless of federal waivers applicable for Medicare reimbursement, health care providers must still adhere to licensure and telehealth practice standard requirements at the state level.
Many states have enacted temporary waivers (via legislation, governor executive orders, and/or professional board rules) of such licensure and telehealth practice standard requirements to allow for digital health and telemedicine technologies to reach patients during the public health emergency.

Session #4: Physician Compensation: Hot Topics

After much anticipation, CMS revised and clarified the Stark Law Regulations. Effective January 19, 2021, the revised Stark Law contains clarified definitions, formalization of the “Big 3” concept (fair market value, commercial reasonableness, and volume or value standard), introduced value-based care exceptions, introduced an new exception for limited remuneration to a physician, introduced a new cybersecurity technology and related services exception, and provided several other important revisions/clarifications to existing exceptions and definitions.
The revised Stark Law Regulations also included an update to the group practices provisions with a later effective date of January 1, 2022 to give entities time to revise their arrangements.
The OIG also revised and clarified the Anti-kickback Statute safe harbors, also effective January 19, 2021. The OIG added value-based arrangement safe harbors that are more narrowly drawn and prohibit certain entities from relying on the safe harbor (e.g., DMEPOS, laboratory companies, etc.).
The OIG regulations also provide for new safe harbors (patient engagement and support, CMS-sponsored models, cybersecurity technology and services, ACO Beneficiary Incentive Program, telehealth for in-home dialysis) and modified safe harbors related to personal services and management contracts, local transportation, EHR, and warranties.
The 2021 Medicare Physician Fee Schedule may bring operational challenges to physician practices. The 2021 Medicare Physician Fee Schedule includes Medicare reimbursement changes, RVU changes, and work RVU changes that may significantly impact physician compensation.
Based on the MPFS changes, now is a good time to review (i) contract provisions allowing changes to contract terms and compensation due to payer reimbursement changes, (ii) physician practice financial impacts, and (iii) internal documentation surrounding commercial reasonableness.

You can listen to this program in its entirety for free, and download slides from each of the session, by clicking here. Be sure to also check out the following Let’s Talk Compliance additional resources:

We are working on developing future Let’s Talk Compliance events, so stay tuned for dates and details!

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Foley & Lardner has been providing health care law and business consultative services for more than 45 years. Our team of more than 150 attorneys regularly provides innovative, leading-edge counsel to the entire spectrum of the healthcare industry. With offices throughout the United States, Foley’s Health Care Industry Team is consistently ranked as one of the top healthcare law firms nationally and regionally by Chambers USA and U.S. News. Foley remains at the forefront of health policy and law, advocating the interests of our health care clients in legislatures, administrative agencies, courts and boardrooms across the country.

PYA is a professional services firm with specialized expertise in healthcare consulting and certified public accounting. PYA’s multi-disciplinary Healthcare division serves hospitals, health systems, clinically integrated networks, physician groups, and specialty practices. Our healthcare services are structured around three main pillars: Strategy & Integration, Valuation (business, compensation, machinery and equipment, and litigation support), and Compliance. PYA consistently ranks as a Top 20 healthcare consulting firm and a Top 100 accounting firm in the U.S. Drawing upon the expansive depth of knowledge and breadth of experience of more than 300 professionals across offices in Atlanta, Kansas City, Knoxville, Nashville, and Tampa, and address the specific needs of a client base that spans 50 states.