Alston & Bird attorneys Rob Stone and Trey Stephens presented this webinar hosted by Alston & Bird. In less than six months, nearly 800 U.S. hospitals will be required to accept bundled payments covering all services for hip and knee replacement procedures thanks to a new proposal by the Centers for Medicare & Medicaid Services aimed at curbing costs in the insurance program for the elderly and disabled. For the first time, the program will put hospitals at risk for other providers’ expenses. To mitigate this risk, they will have to develop all new organizational infrastructure, regulatory awareness and contractual relationships.
Due to the accelerated runway for this program, it’s imperative that hospitals in applicable areas begin planning as soon as possible. They will need to create a solid contractual framework to implement this new program effectively and efficiently.
What’s more, this first mandatory test of an alternative reimbursement model is a sure sign that hospitals will increasingly be at risk for financial losses if they don’t meet certain targets—Medicare’s stated goal for this program is to generate $153 million in savings.
This will be the “new normal” for hospitals, with a completely different set of defined terms and regulations. The race is on for hospitals to understand these new concepts and implement them in time to avoid significant financial risks. Navigating the new legal framework and related requirements depends on understanding the altered relationships created by this program.
In this one-hour webinar, our speakers discussed the regulatory and contractual issues that will arise for hospitals and health systems in responding to CMS’s program, as well as:
• How do retrospective bundled payment programs work?
• What will be expected of hospitals in their new role as at-risk manager of other providers’ services?
• How to interpret and implement waivers related to certain payment rules and fraud and abuse requirements.
• How best to deploy internal and external resources: legal counsel, consultants and the hospital’s physician relations team.
This webinar was provided as a complimentary service to clients and friends of Alston & Bird. CLE credit was provided for Georgia, Texas, California, New York, Pennsylvania and Missouri. Additional states were available upon request.
To receive a copy of the presentation, please contact abby.forness@alston.com.
August 26, 2015
1pm-2pm EDT