DPC Practices: Formation Solutions

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DPC Practices: Formation
Options & Compliance
Solutions

James “Jim” Eischen, Jr., Esq.

Learning Objectives

• Analyze alternatives/options that private direct practices have regarding
plan integration versus out-of-network/opted out of Medicare, and
provide guidance how on best to weigh those alternatives.

• Overview the federal (and typically also state) laws that generally protect
privacy, and specifically apply to health information privacy, and explain
why engaging in solid HIPAA compliance remains both responsible and
necessary.

• Describe the current shifts in US healthcare regulation, and provide insight
into anticipated future regulatory changes based on the current political
climate and how those changes may impact/help DPC practices.

Activity Disclaimer

The material presented here is being made available by the DPC Summit Co-Organizers for educational purposes
only. This material is not intended to represent the only, nor necessarily best, methods or processes appropriate
for the practice models discussed. Rather, it is intended to present statements and opinions of the faculty that
may be helpful to others in similar situations.

Any performance data from any direct primary care practices cited herein is intended for purposes of illustration
only and should not be viewed as a recommendation of how to conduct your practice.

The DPC Summit Co-Organizers disclaim liability for damages or claims that might arise out of the use of the
materials presented herein, whether asserted by a physician or any other person. While the DPC Summit Co-
Organizers have attempted to ensure the accuracy of the data presented here, these materials may contain
information and/or opinions developed by others, and their inclusion here does not necessarily imply
endorsement by any of the DPC Summit Co-Organizers.

The DPC Summit Co-Organizers are not making any recommendation of how you should conduct your practice or
any guarantee regarding the financial viability of DPC conversion or practice.

Faculty Disclosure

It is the policy of the DPC Summit Co-Organizers that all individuals in a position to
control content disclose any relationships with commercial interests upon
nomination/invitation of participation. Disclosure documents are reviewed for potential
conflict of interest (COI), and if identified, conflicts are resolved prior to confirmation of
participation. Only those participants who had no conflict of interest or who agreed to
an identified resolution process prior to their participation were involved in this CME
activity.

All faculty in a position to control content for this session have indicated they have no
relevant financial relationships to disclose.

The content of this material/presentation in this CME activity will not include discussion
of unapproved or investigational uses of products or devices.

Integrating Business & Law
Into 21st Century US Private Direct
Practice Models

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James J. Eischen, Jr., Esq.

 Jim Eischen is a California attorney with nearly 30 years of experience representing commercial interests locally, nationally,
and internationally. His clients have included life science companies, national healthcare enterprises, medical
real estate
groups/physicians,
developers/managers, and telecommunications conglomerates. He has extensive experience managing all facets of business
representation, from formation to contractual relations and managing disputes and transitions.

software/IT companies, health plans,

institutions,

enterprises,

industrial

financial

 Since 2009, Jim has worked with clients in matters involving health care and privacy licensing and regulatory issues,
including Medicare compliance and physician compensation and private direct fee business modeling and compliance. Jim
has experience structuring physician practice purchase and employment structures, and assisting companies delivering
wellness products or programs, to ensure reimbursement and privacy compliance.

 Graduated from the University of California at Davis School of Law in 1987.

 Professional Memberships: Professional Memberships: Chair, ABA Tort Trial & Insurance Practice Section Medicine and
Law Committee, Vice-Chair, TIPS Health and Disability Insurance Law Committee, Dispute Resolution Committee, San
Diego County Bar Association Law & Medicine Section, Attorney-Client Relations Committee, American Academy of
Family Physicians healthcare compliance educator, American Academy of Private Physicians corporate secretary and chair of
the Legal Compliance Committee.

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Topics We Will Cover Today

• Private Direct Medicine Models: What’s Out There?

• Private Direct Medicine Model Formation: Quick Primer & Options

• The “Fork” In The Road: Plan Integration (or Disintegration)

• Practice Amenity Pricing (Please, Not Fee For Service Again!)

• Data Privacy 101: Compliance Solutions

• Business Dealings: Identifying Compliance Issues

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