In this presentation:

- Introduction

- Why Ancillary Services Transactions Are Being Done

- Conversion to Provider-Based or Under Arrangement

- An Illustration

- Some Medicare Vernacular

- Why Convert?

- Factual Scenario

- History and Purpose of Provider-Based Rules

- On-Campus v. Off-Campus

- Provider-Based Requirements Applicable to On-Campus AND Off-Campus Facilities or Organizations

- Additional Provider-Based Requirements Applicable ONLY to Off-Campus Facilities or Organizations

- Provider-Based Status for Joint Ventures

- What If a Joint Venture Will Be Involved?

- Under Arrangement

- Provider-Based v. Under Arrangement

- Provider-Based v. Under Arrangement: The Choice

- Supervision of Hospital (Provider) Outpatient Diagnostic Services

- Process for Conversion to Provider-Based or Under Arrangement

- Roll-Up

- Factual Scenario

- Roll-Up Considerations

- Process for Roll-Up

- Outright Acquisition of Ancillary Services Centers or of Joint Venture Ownership

- Factual Scenario

- Acquisition Considerations

- Process for Acquisition

- Co-Management and Other Relationships Between Hospitals and Physicians Involving Ancillary Services

- Why Consider Other Relationships Involving Ancillary Services?

- Examples of Relationships

- Think Like an Investment Banker

- Quality and Risk Implications

- Excerpt from Some Medicare Vernacular:

- Physician groups and independent diagnostic testing facilities (“IDTFs”) are considered to be “suppliers” by Medicare.

- Hospitals are considered to be “providers” by Medicare.