HEA1804 - Managing FMV & Commercial Reasonableness Risk for Health System Practice Losses

Losses on physician practices present a significant compliance risk for health systems based on government enforcement trends. Such losses are generally considered to be “red flags” for FMV and commercial reasonableness (“CR”). Since losses on physician practices are common, most health systems face significant enforcement risk for FMV and CR issues. This session will discuss these enforcement trends and analyze the unique reasons why most health systems lose money on their practices. It will also provide a framework for health systems to address the enforcement risk emerging from their practice losses.

Learning Objectives:
• Learn about enforcement trends involving practice losses
• Understand the causes of practice losses in health system practices
• Develop an enterprise risk management approach to address practice losses