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Physicians and Hospitals Law Institute 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 Physicians and Hospitals Law Institute will open with the Year in Review at 3:30 pm on February 2. AHLA Registration and Check-In will be open beginning at 7:00 am. The program will end at approximately 1:30 pm on February 4. We encourage attendees to add on the Academic Medical Centers and Teaching Hospitals Institute, being held February 2-3, to their registration for additional content. Step 3 in the registration process, will give you the option to add on the program.

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 and wearing masks, 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.

Wednesday, February 2, 2022

7:00 am-5:30 pm

Registration and Check-In

3:30-5:30 pm General Session

3:30-3:45 pm
Welcome and Introductions
Cindy Reisz, AHLA President
Julie Kass, Program Committee Co-Chair
Kristen Woodrum, Program Committee Co-Chair

3:45-5:30 pm
1. Year in Review
S. Craig Holden
Robert G. Homchick
Kristen B. Rosati

While health care lawyers are used to constant change, this last year was a real head-spinner. Our speakers will thus take you on a “spin” through these developments to highlight significant changes we should all know about, including:

  • Health care reform: Biden Administration efforts to enforce and expand the Affordable Care Act, and significant decisions by the Supremes
  • COVID-related legislation, claims and other developments (because no, it’s not over yet)
  • Sprinting to value-based care and continuing challenges with (fraud &) abuse
  • Telemedicine’s new spot at the adult table
  • “HIT”-ing the deck: information blocking and interoperability, OCR enforcement, data breaches and new state laws
  • But wait… there’s more!
5:30-6:30 pm

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

 

Thursday, February 3, 2022

7:00 am-5:30 pm

Registration and Check-In

7:00-8:00 am

Continental Breakfast
(This event is included in the program registration fee. Attendees, faculty, and registered guests are welcome)

8:00-9:00 am

2. Language Access Rights in Health Care: Improve Equity and Avoid Complaints and Litigation​
(not repeated)

Toby K.L. Morgan
Drew Stevens

  • Section 1557 of the Affordable Care Act requires health systems to take proactive steps to provide meaningful access for individuals with Limited English Proficiency and to provide equal access to individuals with disabilities, including individuals who speak American Sign Language
  • Federal law thus requires health systems to provide language assistance services to these patient populations free of charge, which may include oral interpretation services by phone, written translation services, Video Remote Interpreting, in-person interpreters, and other auxiliary aids and services for individuals with disabilities
  • The statutory and regulatory landscape underlying these obligations and review recent litigation in which plaintiffs have alleged a failure to provide appropriate language assistance services or auxiliary aids
  • The legal standards applicable to such claims, the potential remedies, and the potential enforcement mechanisms (such as class actions, federal investigations, and private enforcement)
  • Concrete steps that health systems, including academic medical centers, should take to operationalize compliance, minimize risk, and effectuate communication-equity for all patients and/or research participants
 

3. Look on the Bright Side: The Expansion of Telehealth During (and after) COVID-19
Adam M. Walters

 

4. Difficult Transactions in Health Care and How to Overcome Them
James Bowden
Ethan E. Rii

  • Reasons for increasingly difficult health care transactions and key touch-points to consider
  • How implementing a workable process and framework can preemptively address a host of structuring, regulatory, and drafting hurdles
  • Key approaches in spotting and resolving emerging underlying legal, regulatory, and business issues before they overwhelm a transaction
  • Examples of relevant negotiating areas and best practices (case studies)
 

5. Stark, Kickback and Value-Based Care: Lessons Learned After a Year of Reform
Kristin C. Carter
Christopher Sellers
Joseph N. Wolfe

In this session, panelists will discuss the Stark, Kickback and value-based regulatory changes. Topics covered will include:

  • The current state of the regulatory changes
  • Highlights and lessons learned from trenches, including the "Big 3”
  • Compliance and implementation considerations and value-based care
  • The "special rules" on directed referrals
  • The new bright- line volume/value rule and examples of arrangements that will pass (or fail) these new rules based on guidance in the final regulations
9:30-10:30 am

6. The Growing Threat: Kickback Enforcement in the Private Payor World
(not repeated)

Allan Medina
Alexander F. Porter

  • Increased efforts by the US Department of Justice to bring kickback prosecutions in cases that do not involve Federal health care programs. The panelists will review the types of cases that have been brought against physicians and hospitals involving private health insurance plans
  • The charging theories the DOJ has used when pursuing kickback cases involving private health insurance plans, including honest services mail/wire fraud charges, Travel Act charges, and charges brought pursuant to the Eliminating Kickbacks in Recovery Act (“EKRA”)
  • The similarities and differences between these cases and  more traditional kickback cases charged involving Federal programs under the Anti-Kickback Statute
  • Practical tips to physicians and compliance/legal professionals about how to guard against the risk of prosecution under these evolving DOJ charging theories
 

7. Emerging Trends in Physician Employment/Independent Contractor Contracting and Compensation Arrangements with Hospitals
(not repeated)

Martin D. Brown
Robert A. Wade

  • Physician compensation approval, implementation, and monitoring best practices
  • Emerging compensation arrangements including Value-Based Arrangements, quality, patient access, and bundled payments
  • How are emerging contracting compensation arrangements complying with legal/regulatory requirements?
  • How do emerging contracting compensation arrangements further integration for AMCs/hospitals/physicians?
 

8. Legal Ethics: When Boards are not Boring - What to Do When a Client Puts the Attorney in the Middle
David A. DeSimone
Sarah E. Swank

  • The ethical rules and responsibilities for attorneys related to their response to management and the board of hospitals and physician organization, including potential pitfalls when the lawyer becomes part of the conflict
  • What can go wrong with real life examples, including lessons learned from recent cases 
  • How does it work in practice, hypotheticals of board and other conflict of interest scenarios, including when attorneys are asked to serve on Boards, conflict arises at a meeting and when management is not acting in the best interest of the client
  • The ethics of moving forward or withdrawing from the representation and what that means for the in house and outside counsel
  • Prevention and resources including practical recommendations including policy consideration, governance best practices, and board training
 

9. Ensuring Physician-Hospital Transactions Will Survive Future Compliance Scrutiny
Albert D. "Chip" Hutzler 
Julia K. Tamulis

  • Top 10 physician contracting compliance risk areas, including False Claims Act, Stark Law, Anti-Kickback Statute, and other compliance concerns
  • What happens when there are compliance and documentation problems–review of the consequences of noncompliance or poor documentation
  • How to avoid compliance concerns in transaction terms
  • How to ensure documentation is compliant and litigation ready, should any need arise to defend the transaction later
  • How have the risk areas been affected by new regulations, the COVID pandemic, and the associated waivers
10:30-11:00 am
Coffee Break
Exhibits Open–Meet the Exhibitors
11:00 am-12:15 pm Extended Sessions

10. Health Care Antitrust Enforcement in the Biden Administration: A New Frontier?
(not repeated)
John D. Carroll
Jared P. Nagley
Subramaniam (Subbu) Ramanarayanan
Jane E. Willis

  • The health care industry has been a target of federal and state enforcement for years but may now be at a high water mark in the Biden administration
  • Our panel, which includes two former FTC enforcers, will discuss the key antitrust issues facing hospitals and physicians as they navigate a challenging enforcement landscape
  • Analyze how recent developments at the FTC and DOJ are impacting the health care industry
  • Antitrust issues associated with transactions and clinically and financially integrated multi-provider networks, as well managed care contracting and exclusive contracts between hospitals and physician groups
 

11. Virtual Care, a Pandemic, and the Future
Priya J. Bathija
Melissa Myers
Kimberly E. Peery

During the COVID-19 pandemic, virtual care–including mobile health apps, patient portals, remote monitoring, and telemedicine–became a critical way for health care providers to reach patients. This session will provide an overview of this shift in care delivery at a national level. Speakers will share real examples of virtual solutions implemented by hospitals and health systems and how those hospitals navigated the legal and regulatory flexibilities offered throughout the public health emergency. Speakers will also offer insights from their different vantage points–strategy, policy, and legal–into how services will be redesigned in the future and how virtual care can serve as the basis for other care delivery models, such as hospital at home. This will include perspectives on the benefits and challenges of this transition to virtual care, key decisions that must be made and the legal, payment, and policymaking considerations that are at play.

  • From real-life examples, understand how care delivery shifted throughout the pandemic
  • What decisions were made to accommodate this shift, including an overview of the legal and regulatory flexibilities that became available
  • Key decision points that must be evaluated as hospitals and health systems move into the future, including the legal, payment and policymaking considerations at play
  • The ongoing benefits and challenges associated with virtual care
 

12. Fair Market Value in Health Care–Year in Review: A New Stark-ly Different Post- COVID World, One Year Later
Kelly R. Anderson
Andrea M. Ferrari

This session provides a review of the previous year’s major developments related to or implicating fair market value and commercial reasonableness as regulatory requirements, and uses the recap as the basis for a “Top Ten” list of issues for counsel, compliance officers and valuation analysts to be aware of for the coming year. This year’s session will address the ongoing and residual impacts of COVID-19 and related and potentially transformative temporary and permanent regulatory and payment changes, how things have changed under the Stark Law and Antikickback final rules, the impact of the significant changes in the 2021 and 2022 Physician Fee Schedule rules and the “hot topics” of the year, including data, coordinated care incentives, and provider recruitment and retention. The basic outline for the program is as follows:

  • Our opinion of the “Top Ten” FMV issues of the year
  • A recap of the previous year’s regulatory actions, court cases, settlements and other developments  that focus on and/or otherwise relate to fair market value and commercial reasonableness in hospital-physician transactions, including major court decisions and settlements, trends and developments under the new Stark Law and Antikickback Final Rules (including the new Stark Law definitions of the “Big Three” and new provisions for value based arrangements), telemedicine, new and changing developments and trends in criminal prosecutions rooted in compensation relationships, and the continuing  effects of the COVID-19 public health emergency on compensation trends, survey data and fair market value
  • How these developments might reflect, challenge and/or affect prevailing legal perspectives and operational processes regarding hospital-physician arrangements, including of what to look for and how to analyze relationships, and, in particular, how parties do or should approach questions of fair market value and commercial reasonableness
  • Practical takeaways for counsel, compliance officers, healthcare executives and valuation analysts in the current/eventual post-COVID era
 

13. Hospital Charges under the Microscope: Impact of the Price Transparency Rule and No Surprises Act​
Christi J. Braun
Liz Goodman (invited)
Amanda Hayes-Kibreab
Andrew D. Ruskin

  • Regulatory underpinnings of acceptable hospital charge structures
  • Fundamentals of the Price Transparency Rule and open items
  • Fundamentals of the No Surprises Act including new patient disclosures, notices, and consent requirements to waive patient balance billing protections and the independent dispute resolution process
  • Impact of the rules on payer practices
  • Impact on provider relations with payers, patients, and other hospitals in the same market
12:15-1:15 pm

Lunch on your own

1:30-2:30 pm

14. The Past, the Present, the Future regarding Medical and Recreational Cannabis and the Myriad of Issues that Attorneys Should be Aware of from a Legal and Practical Perspective Affecting Physicians and Hospitals
(not repeated)

Richard Y. Cheng
Lisa M. Gora

  • National overview of medical marijuana: How it started and where we are today
  • The highly diverse state-level legal frameworks versus the tension with federal law; California’s recent amendment regarding administration of medical cannabis at health care facilities
  • Counseling clients, physicians, and organizations such as hospitals and other licensed health care facility settings on the legal implications of medical marijuana–the intrastate versus interstate issue, the issue re storing/administering/consumption on premises at hospitals and other licensed health care facilities; federal and state regulatory concerns
  • Policies and procedures of hospitals, private practices, and other licensed facilities regarding the storing/administering/consumption on premises
  • Barriers for Clients (physicians/hospital and other licensed facilities) getting involved in the marijuana industry: Banking, research, stigma
 

15. From the Front Lines: Implementing and Defending a Mandatory Vaccination Policy
(not repeated)

Brian D. Abramson
W. Mark Easterly
Denise M. Hill

  • Hear from counsel for the first health system in the nation to implement a mandatory Covid-19 vaccination policy for employees and medical staff
  • The EEOC guidance on vaccination policies, including recent updates for determining requests for exemptions
  • The litigation challenging the vaccination policy, with a discussion of the first lawsuit challenging a hospital system Covid vaccine mandate
  • The lessons learned and best practices from the first in the nation mandatory vaccination policy
  • Strategies for navigating federal vaccine mandate rules and conflicting state laws/executive orders
 

16. Getting the Data Out: Compliance with the Information Blocking Rule and Interoperability Requirements
Marti Arvin
Gerard M. Nussbaum
Melissa Soliz

  • Background
    • Regulatory requirements, including the ONC 21st Century Cures Act Final Rule (the “Cures Act Final Rule”) and provider requirements under the CMS Interoperability and Patient Access Final Rule
    • Data Liquidity, Data Asset Management, and Monetization
    • Technical issues (including APIs)
  • Assessing organization readiness and compliance  
    • Defining and upgrading data management capabilities, including preparing for upcoming compliance deadlines under the Cures Act Final Rule
    • Processes and stakeholders
    • Technical capabilities
    • Potential information blocking bottlenecks
    • Contractual posture (vendors and developers, external healthcare providers)
    • Privacy and security compliance, including sensitive data laws (such as 42 CFR Part 2)
    • Addressing patient/representative issues
    • Developing and executing a multidisciplinary plan to enhance capabilities
  • Ongoing monitoring and auditing
    • Evolving regulatory requirements
    • Compliance
    • Corrective actions
    • Integration with enterprise data asset management approach
 

4. Difficult Transactions in Health Care and How to Overcome Them
(repeat)

James Bowden
Ethan E. Rii

  • Reasons for increasingly difficult health care transactions and key touch-points to consider
  • How implementing a workable process and framework can preemptively address a host of structuring, regulatory, and drafting hurdles
  • Key approaches in spotting and resolving emerging underlying legal, regulatory, and business issues before they overwhelm a transaction
  • Examples of relevant negotiating areas and best practices (case studies)
3:00-4:00 pm

17. Culturally Competent Legal Representation of Health Care Systems
(not repeated)
Aimee Greeter
Ashley L. Keith-Phillips

  • Preemptive research of current topics and understand the potential impact on a population's ability to receive medically necessary health care
  • Information gathering processes from front-line clinicians of various levels and backgrounds to gauge experienced or witnessed behaviors/practices that have been exclusionary
  • Evaluate clinician to patient facing policies and superior to subordinate facing policies to determine whether the existing framework supports culturally competent patient care and workplace experiences
  • Address biases and successfully connect with marginalized groups with appreciation for historical knowledge of patient populations serviced/targeted
 

18. Rational Rationing: Navigating Scarce Resource Allocation during COVID and Beyond
(not repeated)

Aletheia Lawry
Janet Malek
Allison Petersen

A panel discussion regarding health care rationing in which we explore legal and ethical issues impacting hospitals that have arisen throughout the COVID-19 pandemic under three levels of scarcity:

  • Conventional Standards of Care: Routine conditions under which standard ethical and legal guidelines apply, including only limited instances of scarcity (e.g. blood shortages, organ transplantation)
  • Crisis Standards of Care: Extreme conditions under which dramatically different legal and ethical frameworks must be used to manage significant scarcity (e.g. triage of ventilators or dialysis machines)
  • Contingency Standards of Care: Moderate conditions under which there is ambiguity about which ethical and legal guidelines should be implemented and how an enduring problem of general scarcity should be managed (e.g. staffing shortages, limited ECMO capacity, medication scarcity)

For each level of rationing, presenters will provide:

  • Brief acknowledgement of ethical principles that guide the approach.
  • Exemplar cases in which practical rationing decisions need to be made in the hospital environment, including:
    • What are the challenges faced by decision makers?
    • What are the legal and ethical requirements that shape those decisions?
  • Review of resources to assist attorneys and ethicists to support best practices in decision-making in these challenging situations
 

19. Advising Physicians About Owner Agreements in a Physician Organization:  A Mardi Gras Parade of Issues
Kim Harvey Looney
Michael F. Schaff

When physicians form or join a physician organization is a critical time for issue spotting. Identifying these issues is critical to the success of those negotiations, drafting documents, and advising physician clients. This session will include practical tips and real life examples for counseling clients. Best practices will be shared by the panelists.

  • How to advise physicians about forming or joining a group practice
  • What documents do you need and how to avoid pitfalls
  • Who gets to make decisions?
  • Who is responsible for what in the practice?
  • What employment terms will there be? Non-compete?
  • How to divide the money including complying with the group practice exception and new value-base options
  • What happens when they are no longer friends? (Buy-out events and terms?)
 

5. Stark, Kickback and Value-Based Care: Lessons Learned After a Year of Reform
(repeat)

Kristin C. Carter
Christopher Sellers
Joseph N. Wolfe

In this session, panelists will discuss the Stark, Kickback and value-based regulatory changes. Topics covered will include:

  • The current state of the regulatory changes
  • Highlights and lessons learned from trenches, including the "Big 3”
  • Compliance and implementation considerations and value-based care
  • The "special rules" on directed referrals
  • The new bright- line volume/value rule and examples of arrangements that will pass (or fail) these new rules based on guidance in the final regulations
4:30-5:30 pm

20. The Patient Engagement and Support Safe Harbor:  A New Opportunity to Address Social Determinants of Health
(not repeated)

Timothy P. Blanchard
Susan A. Edwards

  • The Patient Engagement and Support Safe Harbor: What it is and what it isn’t
  • The prerequisite value-based framework: Not as onerous as you might think
  • Safe Harbor requirements and limitations
    • Limitations on protected remuneration
    • Requirements for protected tools/supports
  • Considering the Safe Harbor in several scenarios
 

21. Behavioral Health in Focus: Integrating Behavioral Health Care Using Telemental Health Services and Other Collaborative Care Models​
(not repeated)

Jeanna P. Gunville
Sarah Jean Kilker

The goal of this session is to create awareness of key strategic, regulatory, and contractual considerations in evaluating potential models to integrate behavioral health into primary care. The session will discuss:

  • An understanding of the history behind fragmented behavioral health services
  • Models for integration of behavioral health into primary care settings
  • Key legal issues in implementing these strategies, including licensure and regulatory flexibilities
  • Key contractual provisions and payment methodology considerations
  • The role of legal counsel working together with business stakeholders to expand access to behavioral health services
 

22. False Claims Act Enforcement from The Frontlines – Investigations and Litigation in 2021 and the Outlook for 2022
George B. Breen
Thomas F. Corcoran
Jeffrey W. Dickstein

The program–featuring experienced government, defense, and relator’s counsel–will spotlight select False Claims Act investigations, litigations, and settlements pertinent to hospitals and physicians from 2021. The panel will also discuss expectations for enforcement priorities and risk areas for 2022. Topics include:

  • Focus areas of enforcement specific to physicians and hospitals
  • Recent settlements, judicial decisions, and regulatory changes that may impact False Claims Act enforcement
  • Impact of proposed HHS rule, and new DOJ policy, on use of guidance documents 
  • Insights, practical tips, and “real world” examples for handling both investigations and FCA litigation
  • Risk and compliance areas for 2022
 

9. Ensuring Physician-Hospital Transactions Will Survive Future Compliance Scrutiny
(repeat)

Albert D. "Chip" Hutzler 
Julia K. Tamulis

  • Top 10 physician contracting compliance risk areas, including False Claims Act, Stark Law, Anti-Kickback Statute, and other compliance concerns
  • What happens when there are compliance and documentation problems–review of the consequences of noncompliance or poor documentation
  • How to avoid compliance concerns in transaction terms
  • How to ensure documentation is compliant and litigation ready, should any need arise to defend the transaction later
  • How have the risk areas been affected by new regulations, the COVID pandemic, and the associated waivers
5:30-6:30 pm
Networking Reception
(This event is included in the program registration. Attendees, faculty, and registered guests are welcome.)

 


Friday, February 4, 2022

7:00 am-3:15 pm
Registration and Information
7:00-8:00 am
Continental Breakfast
(This event is included in the program registration. Attendees, faculty, and guests are welcome.)
8:00-9:15 am Extended Sessions 

11. Virtual Care, a Pandemic, and the Future
(repeat)

Priya J. Bathija
Melissa Myers
Kimberly E. Peery

During the COVID-19 pandemic, virtual care–including mobile health apps, patient portals, remote monitoring, and telemedicine–became a critical way for health care providers to reach patients. This session will provide an overview of this shift in care delivery at a national level. Speakers will share real examples of virtual solutions implemented by hospitals and health systems and how those hospitals navigated the legal and regulatory flexibilities offered throughout the public health emergency. Speakers will also offer insights from their different vantage points–strategy, policy, and legal–into how services will be redesigned in the future and how virtual care can serve as the basis for other care delivery models, such as hospital at home. This will include perspectives on the benefits and challenges of this transition to virtual care, key decisions that must be made and the legal, payment, and policymaking considerations that are at play.

  • From real-life examples, understand how care delivery shifted throughout the pandemic
  • What decisions were made to accommodate this shift, including an overview of the legal and regulatory flexibilities that became available
  • Key decision points that must be evaluated as hospitals and health systems move into the future, including the legal, payment and policymaking considerations at play
  • The ongoing benefits and challenges associated with virtual care
 

12. Fair Market Value in Health Care–Year in Review: A New Stark-ly Different Post- COVID World, One Year Later
(repeat)

Kelly R. Anderson
Andrea M. Ferrari

This session provides a review of the previous year’s major developments related to or implicating fair market value and commercial reasonableness as regulatory requirements, and uses the recap as the basis for a “Top Ten” list of issues for counsel, compliance officers and valuation analysts to be aware of for the coming year. This year’s session will address the ongoing and residual impacts of COVID-19 and related and potentially transformative temporary and permanent regulatory and payment changes, how things have changed under the Stark Law and Antikickback final rules, the impact of the significant changes in the 2021 and 2022 Physician Fee Schedule rules and the “hot topics” of the year, including data, coordinated care incentives, and provider recruitment and retention. The basic outline for the program is as follows:

  • Our opinion of the “Top Ten” FMV issues of the year
  • A recap of the previous year’s regulatory actions, court cases, settlements and other developments  that focus on and/or otherwise relate to fair market value and commercial reasonableness in hospital-physician transactions, including major court decisions and settlements, trends and developments under the new Stark Law and Antikickback Final Rules (including the new Stark Law definitions of the “Big Three” and new provisions for value based arrangements), telemedicine, new and changing developments and trends in criminal prosecutions rooted in compensation relationships, and the continuing  effects of the COVID-19 public health emergency on compensation trends, survey data and fair market value
  • How these developments might reflect, challenge and/or affect prevailing legal perspectives and operational processes regarding hospital-physician arrangements, including of what to look for and how to analyze relationships, and, in particular, how parties do or should approach questions of fair market value and commercial reasonableness
  • Practical takeaways for counsel, compliance officers, healthcare executives and valuation analysts in the current/eventual post-COVID era
 

13. Hospital Charges under the Microscope: Impact of the Price Transparency Rule and No Surprises Act​
Christi J. Braun
Liz Goodman (invited)
Amanda Hayes-Kibreab
Andrew D. Ruskin

  • Regulatory underpinnings of acceptable hospital charge structures
  • Fundamentals of the Price Transparency Rule and open items
  • Fundamentals of the No Surprises Act including new patient disclosures, notices, and consent requirements to waive patient balance billing protections and the independent dispute resolution process
  • Impact of the rules on payer practices
  • Impact on provider relations with payers, patients, and other hospitals in the same market
9:45-10:45 am

23. Legal Issues in Physician Compensation​
(not repeated)

Alice G. Gosfield

  • The real status of the shift to value-based physician payment models
  • The burdens of the existing models including physician burnout and why
  • Understanding P4P, bundled payment and changes in FFS in the current context
  • Debunking Stark myths: Productivity, incident to, and profit sharing
  • When things go wrong: Preparing for voluntary repayments
  • Change that is realistic and permitted
 

24. Why You Should be Re-Examining Health Privacy Law
(not repeated)

Kirk J. Nahra

  • Privacy law is changing dramatically, in the US and around the world
  • In the US, the health care privacy landscape is becoming increasingly complicated, and is presenting major challenges for health care businesses of all kinds
  • These changes–from HIPAA, state law, and an evolving health care landscape–impact your research, your normal activities, your partnerships, your vendors, and your future activities
  • Planning for these complications and changes is critical to the future of the health care industry
 

19. Advising Physicians About Owner Agreements in a Physician Organization:  A Mardi Gras Parade of Issues
(repeat)

Kim Harvey Looney
Michael F. Schaff

When physicians form or join a physician organization is a critical time for issue spotting. Identifying these issues is critical to the success of those negotiations, drafting documents, and advising physician clients. This session will include practical tips and real life examples for counseling clients. Best practices will be shared by the panelists.

  • How to advise physicians about forming or joining a group practice
  • What documents do you need and how to avoid pitfalls
  • Who gets to make decisions?
  • Who is responsible for what in the practice?
  • What employment terms will there be? Non-compete?
  • How to divide the money including complying with the group practice exception and new value-base options
  • What happens when they are no longer friends? (Buy-out events and terms?)
11:00 am-12:00 pm

25. Health IT in a Post-COVID World: Navigating Day-to-Day and Transactional Issues Related to Health Care Technology
(not repeated)
Alisa Chestler
Sean T. Sullivan

Information technology issues proliferate all aspects of health care operations and are critical to the strategic advancement of provider organizations of every size, and especially those that have experienced growth as the pandemic has evolved.  We will cover the complex regulatory and practical aspects of health care technology issues: 

  • Joint Venture and M&A Practicalities: Integration, contractual concerns, and transactional due diligence considerations
  • Health Data Compliance, including Interoperability & Information Blocking, HIPAA, and FTC Health Breach Notification Rule operational and transactional issues
  • Next generation telehealth and remote care compliance
  • Balancing risk management against new opportunities in HIT, including contractual, policy, and practical considerations
 

16. Getting the Data Out: Compliance with the Information Blocking Rule and Interoperability Requirements
Marti Arvin
Gerard M. Nussbaum
Melissa Soliz

  • Background
    • Regulatory requirements, including the ONC 21st Century Cures Act Final Rule (the “Cures Act Final Rule”) and provider requirements under the CMS Interoperability and Patient Access Final Rule
    • Data Liquidity, Data Asset Management, and Monetization
    • Technical issues (including APIs)
  • Assessing organization readiness and compliance  
    • Defining and upgrading data management capabilities, including preparing for upcoming compliance deadlines under the Cures Act Final Rule
    • Processes and stakeholders
    • Technical capabilities
    • Potential information blocking bottlenecks
    • Contractual posture (vendors and developers, external healthcare providers)
    • Privacy and security compliance, including sensitive data laws (such as 42 CFR Part 2)
    • Addressing patient/representative issues
    • Developing and executing a multidisciplinary plan to enhance capabilities
  • Ongoing monitoring and auditing
    • Evolving regulatory requirements
    • Compliance
    • Corrective actions
    • Integration with enterprise data asset management approach
 

22. False Claims Act Enforcement from The Frontlines – Investigations and Litigation in 2021 and the Outlook for 2022
(repeat)

George B. Breen
Thomas F. Corcoran
Jeffrey W. Dickstein

The program–featuring experienced government, defense, and relator’s counsel–will spotlight select False Claims Act investigations, litigations, and settlements pertinent to hospitals and physicians from 2021. The panel will also discuss expectations for enforcement priorities and risk areas for 2022. Topics include:

  • Focus areas of enforcement specific to physicians and hospitals
  • Recent settlements, judicial decisions, and regulatory changes that may impact False Claims Act enforcement
  • Impact of proposed HHS rule, and new DOJ policy, on use of guidance documents 
  • Insights, practical tips, and “real world” examples for handling both investigations and FCA litigation
  • Risk and compliance areas for 2022
12:15-1:15 pm

26. Private Equity Transactions in Physician Owned Organizations
(not repeated)

Clinton Flume
Anna M. Timmerman

  • Key legal and valuation concepts in physician to private  equity (“PE”) transactions
  • The key legal considerations for various transaction  structures, employment agreements, non-compete agreements, equity secession, physician rollover equity, and the inter-workings of complex equity structures
  • A sampling of the players in the space along with a description of current valuation trends
 

3. Look on the Bright Side: The Expansion of Telehealth During (and after) COVID-19
(repeat)

Adam M. Walters

 

8. Legal Ethics: When Boards are not Boring - What to Do When a Client Puts the Attorney in the Middle
(repeat)

David A. DeSimone
Sarah E. Swank

  • The ethical rules and responsibilities for attorneys related to their response to management and the board of hospitals and physician organization, including potential pitfalls when the lawyer becomes part of the conflict
  • What can go wrong with real life examples, including lessons learned from recent cases 
  • How does it work in practice, hypotheticals of board and other conflict of interest scenarios, including when attorneys are asked to serve on Boards, conflict arises at a meeting and when management is not acting in the best interest of the client
  • The ethics of moving forward or withdrawing from the representation and what that means for the in house and outside counsel
  • Prevention and resources including practical recommendations including policy consideration, governance best practices, and board training

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 and are working with the hotel to ensure your health and safety as we transition back to in-person programming. 
  • 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, touchless 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 breaktime.  
  • 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.
  • The program sessions will be recorded. Audio of the presentations, along with the materials will be available for purchase after the program. More information on our ePrograms.

Benefits of the In-Person Program

  • After a year of virtual programming, you will finally be able to step out from behind your computer and network face-to-face with other health law professionals.
  • Interact with colleagues at in-depth breakout sessions.
Program Accessibility and Special Needs

Click here for more information regarding accessiblitiy accommodations for our in-person programs.

Thank You to Our Physicians and Hospitals Law Institute Sponsors

If your organization is interested in sponsoring AHLA's Tax Issues for Health Care Organizations program, please contact Valerie Eshleman.