Program Information

Thursday, June 17, 2021

1. Hot Topics for In-House Counsel and Compliance Officers–A Panel Discussion
Carrie Dunn-Lucco
Abigail Wong Grigsby
Melissa A. Mora
Meaghan Moriarty

• 2020 brought about a lot of uncertainty and change for health care entities. 2021 will be no different. We are a group of female in house counsel and compliance professionals from various parts of the country and in various sized organizations. We are joining together for a conversation that discusses the similarities, and differences, we face in our highly regulated industry. We will conduct a panel discussion on various hot topics that affect the health care industry and how we personally, and our organizations, are handling those changes. We will discuss:
• The new Stark Law and Anti-Kickback statute final rules; if our entities are taking advantage of the new flexibility afforded by the new rules, or adjusting to limitations imposed, and how our physician arrangements will change as a result
• The price transparency and surprise billing rules and how our entities are complying
• HIPAA privacy rule provisions expected in 2021 and our views on the proposed changes. We will discuss whether if, as written, the proposed revisions will be problematic for our entities Fourth, we will discuss the various COVID-19 waivers, including telehealth and its rapid expansion, as it applies to our organizations. We will discuss changes in Medicare coverage, state licensing issues and challenges, and likely government audits

2. Legal Operations: Keys to Change Management and Working Smarter
Dawn R. Crumel
Harold Jordan
Anne Post

• Why Legal Operations is the future of legal practice
• What is it–Key Components of Legal Operations: Legal service requests, matter management, ebilling, use of artificial intelligence, document management, and retention
• What is the problem: Issues that lawyers experience in accepting change
• How to make it work: Best practices and keys to success in change management

3. Three Defenses and an Antitrust Immunity … Saving Your Transaction from an Antitrust Challenge
Alexis J. Gilman
Christine L. White
Emily C. Bowne

Federal and state antitrust enforcers continue to actively scrutinize health care mergers and acquisitions, and that scrutiny is likely to be as rigorous or more so under the Biden Administration. As parties go through merger-review process, what are the defenses and mitigating factors that antitrust enforcers consider when evaluating mergers? This panel will cover:

• Entry and expansion
• Efficiencies
• Failing-firm and flailing-firm defenses
• Certificates of public advantage (COPAs)

4. Next Level Security Incident Response: Do You Speak IT?
Iliana Peters
William Tippie

One of the most resource-intensive and legally-risky activities for in-house counsel is assisting in and/or directing the response to data privacy and security incidents. In this session, we will teach you how to "speak IT", and improve your understanding of the data security issues involved in these types of incidents, which can have a breach impact on your organization, both with regard to regulatory investigations and data breach litigation.  Specifically, we will discuss:

• Important details to understand in current cyber threats
• What your forensic vendor wishes you knew
• Significant developments in privilege for forensic investigations
• Biggest risks in regulatory investigations

5. Health Care Fraud Enforcement Trends: New or Different Challenges Ahead?
Patrick S. Coffey
Ahmed Elganzouri
Matthew D. Krueger

• DOJ enforcement priorities in health care under the Biden administration
• The effect of COVID-19 on health care enforcement: Provider relief funds and other potential risk areas
• Recent False Claims Act and related fraud enforcement initiatives impacting health care organizations
• DOJ's FCA dismissal authority (Granston) and other authorities in connection with whistleblower actions
• The future of Stark Law and Anti-Kickback based FCA enforcement after the new Stark/AKS rules
• Recent guidance on effective compliance and insights on the key issues for healthcare provider organizations, including the use of data analytics

6. Effective Recruitment and Retention Strategies that Champion Diversity and Inclusion
Aimee Greeter
Antonia A. Peck

• Actionable strategies to champion diversity and inclusion in employee selection and retention
• First-hand examples of how workforce development (with a specific focus on diversity and inclusion) impacts organizational effectiveness
• Contrast diversity initiatives that have tried and failed with tried and true best practices
• Compliance with applicable employment laws while recruiting employees from a diverse background

7. Key Learnings from Summary Suspension Proceedings
Heather L. Fields
Jeffrey Frost
Robin Locke Nagele

• Insights from experienced counsel on representing physicians and hospitals through the summary suspension process
• Navigating between the non-punitive culture of safety versus practitioner accountability for disregard of protocols and safety procedures
• Balancing patient safety and fairness in the peer review and corrective action process
• Maintaining the distinction between employment/contractual rights and medical staff due process
• Training medical leadership in evaluating, acting on, and documenting FPPE and peer review to create a strong, contemporaneous record and avoid post-hoc justification for actions taken
• Moving beyond emotion to clear-eyed analysis of events and standards prior to initiating summary suspension

On-Demand Offerings

I. Risk Sharing with Physicians
James M. Daniel

• New models that account for both health system/hospital and physician needs
• Legal differences between Professional Services Agreement (PSA) model and employment
• Various joint venture strategies
• Ability for providers to share risk

John Barnes
Lona Fowdur
Wilson P. Rotenberry

• What is surprising and what is not about the No Surprises Act
  • Summary of the Act and requirements for payors and providers
• How do payors and providers approach the contractual rate-setting process and what are the implications for out-of-network rates?
• How do we anticipate the No Surprises Act will affect managed care negotiations?
• What does the Act mandate, and how should payors and providers prepare for compliance?
• What are some additional economic considerations for providers, payors, and arbitrators?

III. Narrowing the Gap After COVID: What Hospitals Need to Know About Disparities in Women's and Maternal Health Care and New Regulatory Standards and Options for Improving Care Delivery
Priya J. Bathija
Lisa Diehl Vandecaveye
Delphine P. O'Rourke

As health care transitions to value-driven models and the global pandemic highlights the importance of a strong public health system that addresses the needs of vulnerable populations, issues in women’s health, including pregnancy and care for babies and children, are pressing concerns for hospitals, health systems, physicians, and those they serve. Causes of morbidity and mortality for women, expectant mothers, and babies are complex and include lack of consistent access to comprehensive care and persistent racial and economic disparities in health and health care. This session will provide an overview of recent legislative and regulatory actions and proposals, how they may develop and what they may mean for providers and patients in this time of pandemic.

• Background: Where we are with women’s health, including past and current regulatory and legislative proposals
• Looking Ahead: AHA and Joint Commission activity
• New Developments: New January 2021 Joint Commission Standards for perinatal care and the new HHS initiative announced December 2020

IV. Legal Ethics: Conflicts of Interest Policies - What to Do When A Client Conflict Turn into An Attorney Headache
David A. DeSimone
Sarah Swank

• A conflict of interest for the Board and senior management
• Lessons learned from recent University of Maryland, Sloan Kettering, and other recent cases regarding avoiding, identifying, and resolving conflicts of interest
• Ethical rules and responsibilities for attorneys related to conflict of interests including potential pitfalls when the lawyer becomes part of the conflict
• Hypotheticals of board and other conflict of interest scenarios
• Practical recommendations including policy consideration, governance best practices, and board training