Category Archives: Physician Contracting and Alignment

Concierge Medicine Agreements – Five Key Contract Clauses for Medical Practices

Summary: Concierge medicine agreements should clearly address membership benefits, refund and cancellation policies, Medicare-related disclosures, arbitration provisions, and fee-adjustment mechanisms to help medical practices manage legal risk and patient expectations. Concierge medicine, direct primary care, and membership-based medical practices can … Continue reading

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Hybrid Concierge Models – Why Popularity Comes With Compliance Risk

Hybrid concierge models are gaining traction for a simple reason: they give physicians a way to offer a more personalized patient experience without walking away from traditional insurance. Patients can opt into a membership tier for enhanced access and non-covered … Continue reading

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Concierge Medicine Legal Guide: Key Compliance and Business Issues for Physicians

What physicians need to know before launching or converting to a membership-based medical practice As concierge medicine becomes a more common membership-based medical practice model, physicians and practice groups are weighing its potential to improve patient access, reduce burnout, and … Continue reading

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Direct Primary Care (DPC) vs. Concierge Medicine: A Regulatory Comparison

In recent years, alternative primary care models like Direct Primary Care (DPC) and concierge medicine have grown in popularity as both patients and providers seek more personalized and accessible healthcare. While both models emphasize improved doctor-patient relationships and enhanced patient … Continue reading

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Physician Autonomy in the Value-Based Care Era: Legal and Operational Priorities for Health Care Providers

Topics: value-based care compliance, physician autonomy, health care provider legal issues, Stark Law compliance, Anti-Kickback Statute compliance, physician compensation arrangements, value-based care contracts, health care compliance counsel, medical staff governance, accountable care organizations, provider reimbursement strategy, health care fraud and … Continue reading

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ACO Primary Care Exclusivity Requirement – Not As Broad As Some Believe

By John Fisher, JD, CHC, CCEP Client Alert – MSSP ACO Participant Exclusivity Remains Narrow and Assignment-Based Updated July 10, 2026 Bottom line: MSSP exclusivity remains narrow and assignment-based. Organizations should focus compliance efforts on the TINs and claims that … Continue reading

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Block Leasing of Group Practice Facilities – Anti-Kickback Statute Risks

By John Fisher, JD, CHC, CCEP Client Alert – Healthcare Block Leasing, Anti-Kickback Statute Risks, and AKS Safe Harbor Compliance Healthcare block leasing arrangements—where a group practice, physician organization, or other healthcare provider leases defined blocks of space in a … Continue reading

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OIG Advisory Opinions on Gainsharing Arrangements Since 2018

By Fisher, JD, CHC, CCEP Client Alert: OIG Advisory Opinions on Gainsharing Arrangements Since 2018 Introduction to Gainsharing Arrangements As hospitals, health systems, and physician groups continue to pursue value-based care strategies, gainsharing arrangements remain an important—but highly regulated—tool for … Continue reading

Posted in Anesthesiologists, Clinical Integration, Fraud and Abuse, Health Care Contracting, Health Law Practice, Hospital Issues, Medicare and Medicaid, Medicare and Medicaid Reimbursement, Physician Contracting and Alignment, Physician Issues, Reimbursement & Payment Practices, Reimbursement Issues, Stark Law and Anti-Kickback Issues | Comments Off on OIG Advisory Opinions on Gainsharing Arrangements Since 2018

Podcast – Beyond Insurance: New Medicine

Episode 5 – Beyond Insurance: New Medicine Welcome to “Beyond Insurance: New Medicine,” the next episode in our Legal Pulse: Healthcare Edition series. In this installment, we delve into innovative approaches to healthcare delivery that move past traditional insurance frameworks. … Continue reading

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Podcast – Opting Out of Healthcare

Legal Pulse: Healthcare Edition Welcome to Legal Pulse: Healthcare Edition, the podcast where we explore the intersection of law and medicine to keep you informed on the latest developments and trends. Podcast – Opting Out of Healthcare Episode 4 – … Continue reading

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