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Legal and Regulatory Considerations: Selected Issues

Title: Legal and Regulatory Considerations: Selected Issues
with Connie Raffa, JD, LLM

CE/CME Offered:

CE/CME Credit Available: Nurse, Physician, and Non-Physician Healthcare Professional CE credit


Member Price: $105.00
Non-Member Price: $210.00

Payment Options:

Add to Cart without CE/CME
Add to Cart with Nurse CE
Add to Cart with Physician CME credit
Add to Cart with Non-Physician Healthcare Professional Certificate

Length: 1.0 hours
This session was originally presented at NHPCO’s 2015 Virtual Event 'Creating the Future of Palliative Care.' The emphasis of the Affordable Care Act is to provide efficient high quality care that lowers health care costs and includes an interdisciplinary approach with patient participation.  Palliative Care Programs (PCPs) address these goals and can be found in different settings: Physician Part B Groups, Home Health Agencies; contract arrangements between Hospices and Hospitals or LTCFs; Nurse Liaisons, contracts with Managed Care Organizations; ACOs and Medical Homes.  This session will describe the various ways to structure a PCP: the available Medicare and Medicaid reimbursement streams and the legal issues that must be examined and complied with to do this right.  Additional topics will include compliance with state license laws, the corporate practice of medicine, anti-kickbacks, physician self-referrals, patient inducement, fee splitting laws, cost report rules and available Medicare and Medicaid reimbursement rules.


  • Describe six ways of structuring a PCP
  • Discuss the current revenue streams available to PCPs depending on how they are structured
  • Identify the eight laws and regulatory pitfalls that must be analyzed and met in order to create a PCP that is compliant

Connie Raffa, JD, LLM
Connie Raffa was a partner with Arent Fox LLP, and founder of their Health Group in NY and was recognized in Chambers USA, Legal 500 and Super Lawyers as a national expert in hospice and palliative care. Her areas of expertise included regulatory and reimbursement issues, fraud and abuse investigations, OIG, OMIG, MFCU, DOJ, MIC, RAC,& ZPIC audits, medical reviews, compliance programs, survey and certification, managed care, administrative, arbitration and Federal litigation. Connie served 15 years with the U.S Dept. of Health and Human Services, Office of the General Counsel and Office of the Inspector General. She was a prosecutor in the New York County District Attorney's Office, the basis for the Law and Order TV show, and represented providers for 20 years. A frequent lecturer and author, Connie's work appeared in Caring, NHPCO's NewsLine, Journal of Health Care Compliance, NY'S Bar Association Health Law Journal, and her hospice work was featured in a lead front-page article in the Wall Street Journal. Connie's health care clients included hospital systems, palliative care programs, home health agencies, hospices, physicians and nursing homes. She served on the Board of the Hospice & Palliative Care Association of New York State and on NHPCO's Public Policy and Regulatory Committees. Connie was the recipient of many awards CMS, Office of General Counsel, Hospice and Palliative Care Association of NY, and from clients. Connie died in 2016 following a short illness, while under the care of hospice.

Disclosure: Planners: Barbara L. Bouton, MA, FT, and Jennifer Kennedy, MA, BSN, RN, have no relevant financial relationships to disclose.

Faculty: Connie Raffa, JD, LLM has no relevant financial relationships to disclose.

Completion: In order to complete this online activity, participants must view the course in its entirety, correctly answer all case studies and quiz/test questions (as appropriate) and complete the evaluation. You will have access to the course for 90 days from the date of purchase.
CE/CME Info:

Nurse: NHPCO is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
NHPCO designates this enduring material for a maximum of 1.0 contact hours. Nurses should claim only the contact hours commensurate with the extent of their participation in the activity. Accredited status by ANCC refers only to continuing nursing education and does not imply endorsement of any commercial product discussed in conjunction with this activity.


Physician: The National Hospice and Palliative Care Organization is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

NHPCO designates this enduring material for a maximum of 1.0 AMA PRA Category 1 credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Certificate of Participation for Non-physician Healthcare Professionals: 
For participants* whose disciplines are other than counselor, nurse, physician, and social worker, you may request a Certificate of Participation for Non-physician Healthcare Professionals to submit to your accrediting bodies/licensing boards for continuing education credit. This certificate will indicate the Webinar was certified for AMA PRA Category 1 Credit(s) TM. It is the responsibility of participants to submit the certificates to their accrediting bodies/licensing boards for approval. Unfortunately, NHPCO cannot guarantee its acceptance. To receive this certificate, you must complete all CE/CME requirements and indicate your desire to receive this certificate on the evaluation form. *including bereavement professionals, finance professionals, physician assistants, spiritual care givers, etc.

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