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Fundamentals of Health Law 2022

Schedule

This program will be formatted as a traditional two and a half day in-person program - we are excited for attendees to connect and network in person. The program will begin on Wednesday, November 9 at 11:30 am and end on Friday, November 11 at 3:15 pm. Visit on Continuing Education Information page for the number of credits available. 

AHLA is committed to providing a safe and healthy environment for program participants and staff. AHLA has adopted preventative measures to reduce the potential spread of the COVID-19 virus, including proof of vaccine or a negative PCR test, and is following guidance provided by the US Centers for Disease Control and local authorities. Attendees are also expected to do their part and abide by AHLA’s Duty of Care.


Faculty Information

 


Wednesday, November 9, 2022

11:30 am-5:15 pm

Registration and Check-In
Register Early! Come to AHLA Registration area to print out your badge. We'll need your proof of vaccine or negative PCR test on the Clear Health App.

 
12:30-5:15 pm GENERAL SESSION

12:30-12:45 pm
Welcome and Introduction
Thomas Shorter, AHLA President
Michael Paulhus, Program Chair

12:45-1:30 pm
1. Health Law in 2022 and Beyond: Top Trends, Challenges, and Opportunities​
Anthea R. Daniels

Post-pandemic world
Digital health and the role of technology
Health care data, privacy & security
Governance
Compliance
Fraud and Abuse
Mergers and Acquisitions
Ancillary Providers
Health Care Disruptors
ACOs, Health Plans, and Risk

1:30-2:45 pm
2. Fundamentals of Medicare Parts A and B
Allison R. Hollender
Felicia Y. Sze

This session will cover Parts A and B of the Medicare program to give attendees a detailed overview of what Parts A and B are and what they need to know to advise their clients and work with the Medicare Program:

Medicare governance and structure: CMS and Medicare Contractors
What is Medicare Part A & B, including how it works for beneficiaries and providers/suppliers
Part A & B coverage and reimbursement
Conditions of Participation and Payment
How to maintain participation and get paid
Medicare enrollment and certification
How to do it
How to keep it updated
Medicare’s Impact on healthcare transactions
CHOW/asset purchase v. CHOI/equity transfer
How to assist providers when addressing Medicare questions
Where to research
What regulatory agencies are available to help
How to interpret guidance
How ending the COVID waivers will impact Parts A and B

3:00-4:00 pm
3. Fundamentals of Medicare Parts C and D
Stephanie Godfrey
David E. Kopans

Insurance and managed care
A comparison of "Original" Medicare to the Medicare Advantage and Prescription Drug Benefit programs
Different aspects of these programs, including bid submissions, eligibility, cost sharing, benefits and provider contracting
An introduction to operational considerations, including appeals, compliance programs, and star ratings

4:15-5:15 pm
4. Medicaid Fundamentals: Examining America's Most Essential Health Care Program
Caroline L. Farrell
Jeff J. Wurzburg

A brief history of the Medicaid program and its program objectives
The statutory requirements for Medicaid programs
The ongoing and critical impact of the Medicaid program during the COVID-19 pandemic
Different state approaches to Medicaid
The future of the Medicaid program

 
5:15-6:15 pm
Networking Reception
This event is included in the program registration. Attendees, faculty, and registered spouses and guests are welcome
 


Thursday, November 10, 2022

7:00 am-5:45 pm

Registration and Check-In
If you haven’t already checked in, come to the AHLA Registration area to print out your badge. We'll need your proof of vaccine or negative PCR test on the Clear Health App.

 
7:00-8:00 am

Continental Breakfast
Open Table Networking with AHLA Leaders and Speakers.
Find a table with a topic you are interested in or practice setting.

This event is included in the program registration. Attendees, faculty, and registered spouses and guests welcome.

 
8:00-10:30 am GENERAL SESSION

8:00-9:00 am
5. Health Equity in Action
L. Kate Mitchell
John A. Rich
Asha B. Scielzo

A framework for health, health equity, and health justice; the role of social determinants of health
Key drivers of health inequity, including structural discrimination
The impact of law and policy on health equity
Addressing racism and advocating for health justice
Interdisciplinary collaboration, including medical-legal partnerships
Health system strategy; partnering for healthy communities

9:15-10:30 am
6. The ABCs of the PSL: A Primer on the Physician Self-Referral Law
Nicholas F. Alarif
Julia Tamulis

An introduction to the Physician Self-Referral Law (PSL), including its legislative and regulatory history
Key terminology of the PSL
Exceptions to the PSL’s prohibitions and how to use them effectively
PSL precautions and practitioner tips

 
11:00 am-12:15 pm Extended Sessions

7. Hitting Fastballs: Tips for Advising High-Growth Health Care Startups
(not repeated)

Michelle C. McGovern
Lee Nutini

There's a natural tension between tech startup culture (move fast, break things) and health care (proceed with caution through myriad regulatory hurdles). In-house counsel at health care startups / digital health have to learn to work within this tension and set both the business and patients up for success. In-house counsel have to learn to actually hit fastballs thrown at them–to work with speed and accuracy. This session will address:

  • Laying out the common problems high-growth health care startups face and how to tackle them with efficiency
  • Differences between large and small in-house legal teams, and developing judgment when you are the only lawyer in the room
  • Methods for providing actionable advice in "gray areas" (anticipating where laws will go and making risk calls)
  • How to explain health care concepts to start-up teams
  • Tips for handling privileges in a remote-work or hybrid-work culture
 

8. Innovative Arrangements for Physician Alignment
Annapoorani Bhat
Jeanna P. Gunville

This session will cover the alphabet soup of arrangements that are available to physicians and physician groups to work hand in hand with health systems and other participants across the health care spectrum, including private equity firms. The speakers will elaborate upon such agreements that are designed to create alignment among providers to achieve common goals and provide incentives to facilitate high quality patient care. We will review potential physician alignment transaction structures and discuss the legal and valuation considerations that apply, specifically:

  • A primer on types of arrangements between physicians and participants in the health care continuum
  • Timely, innovative operating structures including value-based care arrangements, as well as tried and tested structures such as integrated networks, Accountable Care Organizations, Management Services Organizations, and Independent Practice Associations
  • Essential transaction documents to create alignment, including professional services agreements, administrative services agreements, management services agreements, and network participation agreements
  • How to address key legal and business considerations
  • Lawyer 101 regarding valuation methodologies, understanding the valuation report, and drafting to accommodate anticipated changes to operations and re-valuation timelines
  • Case studies that highlight best practices
 

9. Compliance Programs–Design, Effectiveness and Governance
Abigail Wong Grisby
Leia C. Olsen

  • The 7 elements of an effective Compliance Program
  • Compliance Program effectiveness from the eyes of government enforcement agencies
  • The Board's role in compliance
  • Risks of failing to have an effective Compliance Program
  • Provide key takeaways
 
12:15-1:30 pm

Lunch on your own or attend the Networking Lunch:
Candid Conversations: Building and Deepening Partnerships Between In-House and Outside Counsel

Jennifer C. Hutchens, Michael E. Paulhus; A. Joel Richlin, Thomas Spellman

This is not included in the program registration; there is an additional fee of $65; limited attendance; and pre-registration is required. Continuing Education Credits are not available.

Join us for an interactive and candid conversation between in-house and outside counsel for practical tips about how you can team up to build and deepen effective partnerships. 

Our conversation will highlight some best practices for setting up relationships across organizations and between professionals (e.g., outside and in-house counsel) for success and to drive better client results.
We’ll also share our experiences and strategies for having difficult conversations and navigating conflicts (e.g., other-centered problem solving and use of the Platinum Rule).
We look forward to hearing from you about your own experiences as well!

 
1:45-2:45 pm

10. It’s a Private Equity World, We’re All Just Living in It: Legal Ethics on Representing Health Care Investors and Portfolio Companies​
(not repeated)

Anjali B. Dooley
Amandeep S. Sidhu

  • Difference between the Investor (PE/VC firm) and the Company/Organization it wants to invest in...scenarios will be added, who's who in the legal
  • Ethics re: Representing the Board of Directors of the Company and CEO of the company
  • Ethics re: Disclosures to potential PE/VC Investors whether you are in-house or outside counsel representing the Company
  • Ethics of when the Investor or Company says "Make this Deal Happen"
  • Note: (Above subject to change/added to slightly)
 

11. Fundamentals of Effective Health Care Contract Negotiations
Jennifer C. Hutchens
Thomas Spellman

  • The importance of negotiations in health care contracts
  • A framework for approaching health care contract negotiations, including negotiation techniques
  • Strategies for understanding the client and the counterparty, and discuss how to approach deal leverage
  • Impart health care legal, regulatory, and operational considerations that may inform negotiations
  • Apply the learnings to a case study (physician-private equity integration) to explain how real-life contract “deal points” can be effectively negotiated
 

12. Health Care Privacy for Health Lawyers
Kirk J. Nahra

Privacy is becoming one of the core areas for understanding in virtually all areas of health law. Privacy affects most health care policy issues, corporate transactions, business contracts, litigation, business strategy and a wide range of overall compliance issues. This session will provide a baseline for all health lawyers on key areas where health privacy law impacts the business of health care and the use of health information across our health care system.

 
2:45-3:15 pm
Break
 
3:15-4:15 pm

13. Before it Becomes a Law, Your Role in Policy Development​
(not repeated)

Priya J. Bathija
Melissa Myers

During this session, speakers will provide an overview of the key drivers for health policy in the United States, including increasing health care costs. They will then dive into the policy process and provide case studies for how attorneys may impact policy at the federal level throughout their careers. Speakers will then cover a year in review of current health policy issues, challenges and considerations facing stakeholders in the health care ecosystem, including hospitals, health systems and physicians.

  • The key drivers for health policy in the United States
  • The basics of the policy process and key ways in which attorneys can influence policy on behalf of their clients
  • Key health policy issues and considerations currently in play and the impact they have on hospitals, health systems, and physicians
 

14. Fundamentals of Public Health
(not repeated)

Montrece M. Ransom
Brian A. Smith

  • How government structures shape public health infrastructure and legal preparedness
  • How health care attorneys can advance health outcomes and equity by complying with public health laws
  • Fundamental and developing areas of public health law, including public health emergency powers, public health surveillance, legal epidemiology, and racism as a public health issue 
  • Examples of changes in state public health authority since COVID-19
  • Judicial decisions and common law changes to public health authority at federal and state levels
  • An actionable framework
 

15. Telehealth Fundamentals
Jacob J. Harper

  • Telehealth. Telemedicine. Virtual care. Whatever the name, technology-enhanced remote care services are a critical component of the future of health care
  • Nearly all health care stakeholders are engaged in or considering some type of telehealth care delivery
  • Telehealth involves a constantly evolving framework of federal and state laws that present a unique set of legal and regulatory challenges
  • The fundamental legal issues related to telehealth, including defining telehealth and related care modalities
  • The relevant areas of law and the governmental players regulating virtual care services
  • Dissect some of the recent federal enforcement actions related to “telefraud”
 
4:15-4:45 pm
Break
 
4:45-5:45 pm

16. Good Behavior: What Every Health Lawyer Needs to Know About Behavioral Health​
(not repeated)

Michaela D. Poizner

  • What does “behavioral health” include? Take a tour of the industry segments, care settings and provider landscape
  • What is the defining legislation shaping the behavioral health community? Learn about must-know laws governing behavioral health stakeholders
  • What legal challenges are unique to behavioral health providers? Get an overview of fraud and abuse, privacy, and other laws that apply specifically to mental health and substance use disorder treatment providers
  • What’s hot in behavioral health? Get familiar with trends in behavioral health transactions (private equity!), the influence of digital health (telemedicine!), and changing reimbursement models (value-based payment!)
 

17. Long Term and Post Acute Care 101
(not repeated)
Randall R. Fearnow
Emily M. Solum

  • Licensure and certification
  • Enforcement issues for skilled nursing, assisted living, home health, and hospice
  • Funding mechanisms for post-acute care
  • Independent and other non-skilled facility settings
  • Special problems impacting post-acute providers including staffing issues, vaccination exemptions, and new federal staffing requirements
  • Government audits of post-acute providers
 

12. Health Care Privacy for Health Lawyers
(repeat)

Kirk J. Nahra

Privacy is becoming one of the core areas for understanding in virtually all areas of health law. Privacy affects most health care policy issues, corporate transactions, business contracts, litigation, business strategy and a wide range of overall compliance issues. This session will provide a baseline for all health lawyers on key areas where health privacy law impacts the business of health care and the use of health information across our health care system.

 
5:45-6:30 pm

Networking Reception
This event is included in the program registration. Attendees, faculty, and registered spouses and guests welcome.

 
6:30 pm

Networking Dinners
Interested in going to dinner with your colleagues?  Sign up on the registration form to express your interest. Information will be sent out to participants closer to the program. 

 


Friday, November 11, 2022

7:00 am-3:15 pm

Registration and Check-In

 
7:00-8:00 am

Continental Breakfast
This event is included in the program registration. Attendees, faculty, and registered spouses and guests welcome.

 
8:00-11:30 am GENERAL SESSION

8:00-9:00 am
18. Fundamentals, Current Circuit Splits and Trends, and Being an Asset to In-House Counsel
Sara Brinkman

Fundamentals of a False Claims Act case
Current circuit splits
Evolving trends in False Claims Act cases
Being an asset to in-house counsel in False Claims Act investigations and cases

9:00-10:00 am
19. It’s a Managed Care World (We’re Just Living In It)
A. Joel Richlin

This presentation will provide an overview of commercial insurance and managed care contracting:

Key concepts in commercial insurance (e.g., HMOs vs. PPOs, Exchange plans, and ERISA plans)
Key concepts in out-of-network reimbursement including the new Federal No Surprises Act (effective 1/1/21)
Key concepts in managed care contracting (e.g., reimbursement methodologies, steerage, billing requirements, appeal requirements, provider manual obligations, and alternative dispute resolution clauses)

10:15-11:30 am
20. The Lifecycle of a Deal: Applying Knowledge to a Hypothetical Transaction
Jamie McCarty
Julia C. Reiland

Using a hypothetical health care client situation, apply fundamental learnings from other conference sessions by:

Walking through the lifecycle of a deal from initial stages of interest through post-closing integration
Practical guidance for addressing critical path items common in negotiations
Best practices for addressing Stark Law and other regulatory issues identified in due diligence
How business and regulatory issues that unfolded during the transaction process are resolved through definitive agreements and post-closing actions

 
11:30 am-12:30 pm
Lunch on your own
 
12:45-2:00 pm Extended Sessions

21. Employees, Providers, and Medical Staffs, Oh My!
(not repeated)
Alexis L. Angell
Rachel Freyman

  • Applicable statutory and regulatory frameworks for employers and medical staffs
  • Navigating common employment law issues, including
    • Tips for avoiding the most common employment law claims
    • Key considerations from recent employment law trends
  • Emerging issues for medical staffs, including:
    • Integrating non-physician Advanced Practice Professionals
    • Trends in Medical Staff governance and oversight
    • Drafting tips and sample language for medical staff bylaws
  • Unique considerations regarding employed providers
    • Information sharing
    • Investigating, disciplining, and settling potential or pending claims
 

8. Innovative Arrangements for Physician Alignment
(repeat)

Annapoorani Bhat
Jeanna P. Gunville

This session will cover the alphabet soup of arrangements that are available to physicians and physician groups to work hand in hand with health systems and other participants across the health care spectrum, including private equity firms. The speakers will elaborate upon such agreements that are designed to create alignment among providers to achieve common goals and provide incentives to facilitate high quality patient care. We will review potential physician alignment transaction structures and discuss the legal and valuation considerations that apply, specifically:

  • A primer on types of arrangements between physicians and participants in the health care continuum
  • Timely, innovative operating structures including value-based care arrangements, as well as tried and tested structures such as integrated networks, Accountable Care Organizations, Management Services Organizations, and Independent Practice Associations
  • Essential transaction documents to create alignment, including professional services agreements, administrative services agreements, management services agreements, and network participation agreements
  • How to address key legal and business considerations
  • Lawyer 101 regarding valuation methodologies, understanding the valuation report, and drafting to accommodate anticipated changes to operations and re-valuation timelines
  • Case studies that highlight best practices
 

9. Compliance Programs - Design, Effectiveness and Governance
(repeat)

Abigail Wong Grisby
Leia C. Olsen

  • The 7 elements of an effective Compliance Program
  • Compliance Program effectiveness from the eyes of government enforcement agencies
  • The Board's role in compliance
  • Risks of failing to have an effective Compliance Program
  • Provide key takeaways
 
2:15-3:15 pm

11. Fundamentals of Effective Health Care Contract Negotiations
(repeat)

Jennifer C. Hutchens
Thomas Spellman

  • The importance of negotiations in health care contracts
  • A framework for approaching health care contract negotiations, including negotiation techniques
  • Strategies for understanding the client and the counterparty, and discuss how to approach deal leverage
  • Impart health care legal, regulatory, and operational considerations that may inform negotiations
  • Apply the learnings to a case study (physician-private equity integration) to explain how real-life contract “deal points” can be effectively negotiated
 

15. Telehealth Fundamentals
(repeat)

Jacob J. Harper

  • Telehealth. Telemedicine. Virtual care. Whatever the name, technology-enhanced remote care services are a critical component of the future of health care
  • Nearly all health care stakeholders are engaged in or considering some type of telehealth care delivery
  • Telehealth involves a constantly evolving framework of federal and state laws that present a unique set of legal and regulatory challenges
  • The fundamental legal issues related to telehealth, including defining telehealth and related care modalities
  • The relevant areas of law and the governmental players regulating virtual care services
  • Dissect some of the recent federal enforcement actions related to “telefraud”
 

In-Person Program Format

How It Works

  • We will offer in-depth breakout sessions where speakers and attendees can interact and collaborate with each other in-person.
  • We consider the health and safety of all those onsite at in-person programs our top priority. AHLA will follow guidance and requirements issued by the CDC as well as by state and local government.. 
  • All attendees, who register for the in-person program, will be required to commit to our Duty of Care agreeing to follow the protocols we establish and monitor their own health for the health and safety of all. 
  • We have adopted a new onsite registration system by providing seamless check-in, onsite badge printing, and safety supplies to all attendees to use while in attendance.
  • Built-in extended time between sessions for moving from room to room, networking with colleagues, and personal break time.  
  • Socially distanced seating arrangements in breakout rooms, regular cleaning in and around meeting spaces, and appropriate signage/floor decals to reinforce spatial distancing and other safety reminders.
  • All program sessions will be recorded. Video of the presentations, along with the materials will be available to all attendees who register to apply for additional On Demand Continuing Education Credits. Those that cannot attend in-person can purchase the eProgram and apply for Continuing Education Credits. More information on our ePrograms.

Benefits of the In-Person Program

  • Step out from behind your computer and network face-to-face with other health law professionals.
  • Interact with colleagues at in-depth breakout sessions.

 

Have a Question?

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Program Accessibility and Special Needs

AHLA is committed to ensuring equitable access to our educational content. We are continually improving the user experience for everyone and offering accessibility accommodations for our in-person programs.

Learn More

Thank You to Our Fundamentals of Health Law Sponsors

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If your organization is interested in sponsoring AHLA's Fundamentals of Health Law program, please contact Valerie Eshleman.