Health Care Fraud and Abuse Update: Exploring Physician Compensation and the "Big 3" Compliance Requirements

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Date: 03/12/25
Time: 2:00-3:30 PM ET

* Please Note: registration closes at 11:59 PM ET the day before the live event. No further registrations will be accepted once registration has been closed *

Live closed captions are available.

Overview: Compliance with the health care fraud and abuse laws focuses on three critical regulatory requirements: fair market value, commercial reasonableness, and the prohibition on “taking into account” the volume or value of a physician’s referrals. These regulatory requirements have been called the "Big 3."  

In this webinar, panelists discuss the current state of the "Big 3," including an overview of the regulatory requirements as they stand today, detail recent enforcement actions, and review developing best practices.

Learning Objectives: 

  • Identify the "Big 3" regulatory requirements of FMV, commercial reasonableness, and volume/value
  • Describe recent enforcement actions and lessons learned
  • Evaluate processes and documentation that support compliance with the "Big 3"

Speaker Information:

Rob Lenio, Director, Physician Compensation & Valuation, Gallagher

Elspeth Paul, Deputy General Counsel, Cedars Sinai Health

Timothy Norton, Vice President & Chief Legal Officer, Augusta Health

Michelle Ilitch, Vice President, Physician Partnerships, Henry Ford Health

Moderator Information:

Joseph Wolfe, Shareholder, Hall Render


Continuing Education:

CLE: IMPORTANT CHANGE REGARDING CLE CREDIT: We are now working with ABA CLE for our accreditation needs. To earn credits during a live webinar, attendees must be logged into the webinar for at least 75 minutes (of a 90-minute webinar) or 55 minutes (of a 60-minute webinar). Then, they will receive a personalized CLE affidavit from mcle-ahla@americanbar.org. Watch for this email within 7-10 business days. If you do not receive it, please check your spam or junk folders as these emails often end up there. Please note you will fill out one affidavit for the full event. Once you complete the affidavit, you will be able to download your certificate(s) of attendance, and certificates will be emailed to you from mcle-ahla@americanbar.org.

CPE: AHLA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Nashville, TN 37219-2417. Website: www.nasba.org. For further information, please visit our Continuing Education Page.

AHLA is seeking CPE credits for live webinars. The maximum number of credits available is 1.80.


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