Physician Services Agreement (PSA) is alternative employment model relationship between hospitals and physician groups. In a Professional Service Agreement, the exchange is physician services for money. We have had success in negotiating employment and PSA relationships both for hospitals and physicians. MANAGEMENT SERVICES AGREEMENT . This Agreement constitutes the entire agreement between the parties with respect to the management of the Health Services Corporation and supersedes any and all prior or contemporaneous agreements, either oral or written, between the parties hereto, with respect thereto. PSAs are used to contract for hospital-based services (e.g., hospitalists, intensivists, an… PDF; Size: 35 KB. Physician groups that contract with hospitals or other facilities to provide services “under arrangement” must ensure that any referrals within the group satisfy Stark requirements. (42 USC § 1395dd; 42 CFR § 411.353). FIN 0002 July 1, 2004 Page 5 of 6 a. The physicians depend on the hospital for most of their referrals, and the hospital depends on the physicians to run the department. endstream endobj 357 0 obj <>/Metadata 115 0 R/Pages 354 0 R/StructTreeRoot 278 0 R/Type/Catalog/ViewerPreferences<>>> endobj 358 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 359 0 obj <>stream with the terms of this Agreement. �hic>���˜� ��+f�f�{��ظ *�&$Q�.Jp��c�Mlt��%�DO��媡XL��w�u&�\Qceh׆���F���'u8��$�8��]r�EjA�c�6*"4�{��D _������$(J��j(�����5�:�������R� �Ga�7�&�� ©2021 Material Change. Defined in Section 2.1 of this Agreement. Examples include medical director agreements, professional services agreements, exclusive service agreements, building and equipment lease agreements, management service agreements, contract-based joint ventures, and myriad others. This sample is an agreement between physician and hospital regarding employment. hޔVmO9����Չ��+UH �+jSP�A%UK�${lv�]�����I ����ό�y�Ya4�DC2��%,ӌp�����,�0�Q�r�4+�pJ $���"\� ҄[�ȇ�9�Q^��=�Z7Ӽ��aQ8;'��;�{�A��f�^�ޡf��b1s�������w0��z�ZO�������n޺�ՠ����S��z~\�F�q��������(n�Ɨ�)�v�*Oe���'W�'����$o�ο�0�,8���[״Ÿ�Y��J7�iԄ�0���&��ġ�k�zm�����9����qF��A���Zw�{bP�8�˺��i�F���'8�^8�s�}��K���0��ڠn�p��1L����J�B5��'4Ђ�9��/x�����ڻt�8����m��8���p���pm���-N��w�����m����& 3330 Cumberland Boulevard, Suite 200 It's also a testament to the need for new physician services in that particular community. ─Benefit – for whom? %%EOF certain clinical services from distance via electronic communications to patients physically located at OS (Contracted Services). h�bbd``b`� $ �m@����$X�����H?�� �f� $�� �>d�D �������3�xF҈��� t� 7 Note: If the physician group perfor… The graph below shows what percent of hospital-based contracts have payments for call coverage, medical direction, or a stipend to cover broader obligations. ─Protection? Income protection is crucial. This more integrated model places physicians and hospital administrators as “partners” in the management and oversight roles for the distinct grouping of services. Defined in first paragraph of this Agreement. As … The Exchange: Services for Money The co-management model (Table 1) has historically helped hospitals and health systems develop collaboration with their physicians. A growing trend in physician-hospital alignment is related to professional services agreements (“PSA”). These provisions shall not prohibit collection of payments for non-covered services or co-payments due in accordance with the terms of the applicable Benefit Program. KW��Wp��t�q���w�K�a���!��������7����+�l��ʝ�gѴ>� physician personal services agreements in full compliance with all federal and state statutes and regulations, including Stark and Antikickback. PHO Physician Professional Services Agreement THIS PHO PHYSICIAN PROFESSIONAL SERVICES AGREEMENT (the “Agreement”) is made and entered into effective as of _____ (the “Commencement Date”), by and between Northeast Louisiana Physician Hospital Organization, Inc., a Louisiana for profit corporation (hereinafter referred to as “PHO”, and Part of the hospital's role in physician recruiting is to provide independent physicians with an income guarantee, which serves as an inducement to attract an incoming physician. 4. All Rights Reserved. Hospital-Physician Leasing Arrangements: If You’ve Seen One, You’ve Seen One. A PSA is generally defined as a financial relationship between a physician practice and a hospital in which the physician practice remains an autonomous entity but the physicians are compensated by the hospital at fair market value compensation for their professional services. The … Physician’s work hours shall be determined in the reasonable discretion by Hospital but shall not be less than forty (40) clinical hours per week, of which Physician shall be available to provide professional services at Hospital or any site designated by Hospital. In either the employment model or the PSA the hospital typically purchases the physicians’ assets. Background Perspective Purpose of an agreement ─Are the parties on the same page? By now most hospitals are acutely aware that the Office of Inspector General (OIG) has been focusing enforcement to various types of arrangements involving physicians due to an enhanced opportunity for abuse in this area. Medical Management Associates: Hospital Physician Alignment Services. Under a PSA, a physician or medical group remains independent (i.e., not employed by the hospital) and provides professional services in the hospital or at a hospital clinic. ��rº�1�� ���l���/^����vW�HE���. 0 4. Hospital-based physicians usually provide the physician services within a particular hospital department, for example, radiology, emergency medicine, anesthesiology and more. Details. To satisfy Stark’s “group practice” safe harbors, a physician group that wishes to contract with a physician on an independent contractor basis must contract directly with the physician, not a group. 387 0 obj <>stream Under CCMAs, hospitals will focus on a particular service line, which may cover inpatient, outpatient, ancillary, and/or other services, and enter into an agreement (s) with physicians (either individual physicians, medical groups, or a physician-owned management entity) to work with hospital leadership to develop, manage, and improve the quality and efficiency of such service line. Download. Each side, however, wants to shift less profitable work to the other, for example, administrative work and supervision of staff. For purposes of this Agreement, each physician affiliated with DS providing or anticipated to provide Contracted Services is a Physician (collectively Physicians). Under Stark, if a hospital has a financial relationship with a physician, the physician may not refer patients to the hospital for certain designated health services 1 payable by Medicare or Medicaid unless the arrangement fits within a regulatory safe harbor. I understand I can withdraw this agreement at any time. Stark Personal Services Exception . Professional Services Agreements Have been powerful tools To staff existing hospital service or develop new hospital specialty facility To convert existing group sites to hospital licensed facilities paid at hospital outpatient payment rates Integrate and align hospital and group to improve quality, efficiency and operations of hospital’s An income guarantee ensures that the physician will earn a certain amount of income per month after practice expenses. Unlike an employment model where the hospital enters into an employment relationship, in the PSA the physicians continue to operate under their own corporate structure, but contract with the hospital to provide medical services to their patients. 375 0 obj <>/Filter/FlateDecode/ID[<49ABADFF0123444987268897C7D5A41E>]/Index[356 32]/Info 355 0 R/Length 94/Prev 640166/Root 357 0 R/Size 388/Type/XRef/W[1 2 1]>>stream Leasing arrangements between hospitals and physicians can be a very complex regulatory and enforcement area. This agreement applies to any provider services I may obtain from Mercy providers at a clinic Relativity Employment vs. 356 0 obj <> endobj %PDF-1.5 %���� And, when communicated and structured appropriately, this model establishes trust and buy-in from all parties. (The hospital is the practice’s sole or primary source of revenue.) This agreement includes duties and responsibilities of the physicians once or after they get the employment. Regardless of the type of entity involved or nomenclature used, all the parties need to be on the same page before entering into such a relationship, or it will not go well. Physician Services AgreementsServices Agreements Senior Pediatric Resident RetreatSenior Pediatric Resident Retreat August 30, 2011 Bloomington, Indiana Isaac M. Willett Baker & Daniels LLP. Professional Service Agreements Basics A traditional PSA, a contract drafted between a hospital and a physician practice, is composed of the following elements: The hospital contracts with the physicians for their services at a fair market value rate. Separation agreements should also detail the returning of employer-owned property, the need to complete patient records, and patient notification. A separation agreement is in the best interest of both the physician and the employer, regardless of who initiates the termination of the contract. Medical Management Associates, Inc. Professional Services Agreements: A Physician-Hospital Integration Model Structuring Contracts and Complying With Stark Law and Anti-Kickback Statute Today’s faculty features: 1pm Eastern | 12pm Central | 11am Mountain | 10am Pacific The audio portion of the conference may be accessed via the telephone or by using your computer's speakers. Physician and Hospital Services Agreement 1.Annual Consent for Services: I agree to the services that may be performed by a Mercy physician or non-physician provider (“provider”) or facility. … �d۴�t��K&-��>DBapQ�S�:|"f��O�k��#VP�y� May 24, 2017 By: Lisa M. Cribben, Francis P. Egan. This is a medical simple service agreement template for a physician who is being hired to provide medical services to a community or physician group. The benefit of the PSA is that the physicians maintain some autonomy as it relates to their income distribution model and benefit structure. PSAs provide hospitals and health systems a convenient and highly flexible mechanism to obtain services from physicians and achieve care coordination, access, and alignment goals. Physician and Practice shall make available to authorized agents of the Secretary of Health and Human Services (or other governmental authority) this Agreement, any amendments to this Agreement, and any books, documents or records belonging to Physician or Practice and any related entity that may be necessary to verify the nature and extent of any payments made to Physician or Practice hereunder. h�b```a``�������A���2�@�!�pƀ���T7����r,.��3}[���f4W;'�A�����XAB5Pm&�\+ -�R`���Y�1�g�d�eja��t���D��mܬ켌l�1�u�L�K/3�%>d`�^uW��[@����]��R�Û!�� Ϣ*� In addition to physicians in service lines, hospitals sign comanagement agreements with orthopedists, cardiologists, and urologists to run ASCs and other facilities owned by the hospital. Physician Services Agreement (PSA) is alternative employment model relationship between hospitals and physician groups. THIS MANAGEMENT SERVICES AGREEMENT (the “Agreement”) is entered into as of this 25 th day of April, 2003, by and among PAINCARE ACQUISITION COMPANY V, INC., a Florida corporation (“Manager”), INDUSTRIAL & SPORT REHABILITATION, LTD., an Illinois corporation (“Company”), ASSOCIATED PHYSICIAN GROUP, LTD, an Illinois professional … Hospital. endstream endobj startxref Structuring legally compliant hospital-physician leases and establishing fair market value (FMV) rental rates can be challenging. A PSA is a staffing arrangement between a hospital and a non-employed physician that can take several forms. At the heart of most contracts is a single exchange. Hospital-Based Physicians. File Format. Contracted Services provided pursuant to this Agreement. This includes a blank space for any exhibits that either party wishes to add on to the main agreement. In some cases, the hospital bills and collects for all services and pays the physician a flat rate for performing the underlying service. Often, compensation consists of base fees and bonuses based on achievement of measurable clinical … Agreements with these physicians cover clinical coverage and administrative services for all patients in the hospital requiring that service. Atlanta, Georgia 30339. Services.Both the hospital and the physician group must pay attention to the definition of “Services.” The physician group wants to provide all physician services within the department, because that’s where the money is. MMA: Hospital Physician Alignment Services Also, there is arguably an easier unwind should the relationship with the hospital fail. Hospital Services. Expenses and compensation, termination by the hospital, medical records and histories, confidential information, insurance and notices are included. Unlike an employment model where the hospital enters into an employment relationship, in the PSA the physicians continue to operate under their own corporate structure, but contract with the hospital to provide medical services to their patients. This agreement is generally referred to as a Partnership Agreement, Shareholders’ Agreement, Members’ Agreement or Operating Agreement, depending on the type of entity through which the physicians render services. Where an entity and a physician have a personal services arrangement, the remuneration paid to the physician will not trigger Stark if: HHSC Policy No. Contracts between physicians and hospitals take many forms to address many relationships. PROFESSIONAL SERVICE AGREEMENT Consistent with a national trend, many Idaho hospitals are acquiring physician practices and then entering into a direct financial relationship with post-acquisition physicians formally associated with the practice. 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