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Program Description
Halifax Medical Center recently entered into a record-breaking $85 million settlement with the U.S. Department of Justice to resolve allegations it violated the False Claims Act by entering into employment agreements with medical oncologists and neurosurgeons that violated the Stark Law.
This case, following on the heels of Tuomey’s $237 million judgment for similar Stark violations serve as cautionary tales for hospitals across the country as they continue to pursue integration arrangements with referring physicians.
Kathy McNamara, CPA, was the government’s expert witness in both the Tuomeyand Halifax cases. In this webinar, Ms. McNamara will discuss her findings relating to the fair market value and commercial reasonableness of Halifax’s employment arrangements with its neurosurgeons.
Learning Objectives
After completing this webinar, attendees will be able to:
- Recall the case background and specific issues which led to Ms. McNamara’s findings
- Summarize Ms. McNamara’s positions taken in the case
- List methodologies Ms. McNamara used to assess the value of the employment arrangements
- Associate lessons learned and best practices related to fair market value and commercial reasonableness
Who Should Attend
Valuators, business developers, attorneys, hospital executives
Moderator(s)
Richard Romero, MBA, CVA, CHFP, PAHM
Mr. Richard Romero has over 20 years’ experience assessing the financial performance of various entities. Mr. Romero’s practice focuses on valuation and litigation support. His previous experience includes strategic and operational consulting, bankruptcy and turnaround, valuation, litigation support, expert witness services, compliance and employment-related matters. Mr. Romero has experience in the valuation of a variety of healthcare entities and contractual relationships.
Prior experience also includes his leading the healthcare forensic and dispute-consulting practice for one of the eighth largest public accounting firms in the U.S. He was a member of the healthcare practices at nationally known consulting firms. He has presented nationally and been published on topics involving healthcare, litigation, and valuation. Mr. Romero maintains memberships in several professional healthcare organizations and currently serves on the advisory committee for the Healthcare Practice Group of the National Association of Certified Valuators and Analysts (NACVA). Mr. Romero has a master of business administration degree from the University of Florida and a bachelor of science degree from University of Tampa. His professional designations include Certified Valuation Analyst (CVA), Certified Healthcare Financial Professional (CHFP), and Professional, Academy for Healthcare Management (PAHM).
Presenter(s)
Kathy McNamara, CPA
Ms. Kathy McNamara nearly 30 years experience in healthcare and business consulting. She has extensive organizational, financial and regulatory knowledge in the healthcare industry. She has participated in audits of third party payers and is familiar with Medicare and Medicaid reimbursement for various health care providers including hospitals, home health agencies, nursing homes, physicians, FQHC’s and rural health clinics. She has dealt extensively with the Department of Justice in Medicare fraud issues.
Her knowledge base makes her qualified to provide guidance on a range of regulatory topics, such as Medicare reimbursement, Medicaid reimbursement, Anti-kickback and Stark I and II.
Further, Ms. McNamara has been found by United States District Courts to be qualified to testify as an expert on the fair market value and commercial reasonableness of healthcare relationships numerous times. Ms. McNamara has performed hundreds of fair market valuations and commercial reasonableness analyses in the Stark Law and Anti-Kickback Statute context.
Ms. McNama has been an expert witness on the following cases which involved fair market value issues.
- U.S. ex rel. Baklid-Kunz v. Halifax Med. Center et al. (M.D. Fla.)
- U.S. ex rel. Drakeford v. Tuomey Healthcare System (D.S.C.)
- U.S. v. Campbell (D.N.J.)
- U.S. ex rel. Pogue v. Diabetes Treatment Center of America (M.D. Tenn.)
- U.S. v. Bourseau et al. (S.D. Cal.)
- U.S. ex rel. Kaczmarczyk, et al. v. SCCI Health Services Corp. et al. (S.D. Tex.)
- U.S. ex rel. Gale v. Omnicare Corporation (N.D. Ohio)
- U.S. ex rel. Heesch v. Diagnostic Physicians Group, PC et. al.
Prior to joining Myers & Stauffer, she worked for 5 years as the treasurer of a national health care company specializing in home health care, private duty nursing, supplemental staffing and hospital medical documentation services. She was responsible for establishing accounting and tracking processes to ensure an accurate Medicare cost report. From 1981 through 1985, Kathy worked for a national accounting firm as a senior in its audit department.
CPE Credit |
Richard Romero, MBA, CVA, CHFP, PAHM
Kathy McNamara, CPA
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