Here is your chance to hear the best of the best from the Health Law Institute 2018. These six one-hour topics on a variety of health law issues give you the "must know" information in this ever-changing world of health law. With an outstanding roster of faculty who represent the healthcare industry here in our own backyard, you will gain first-hand access to the thought leaders and expertise of professionals from the area's healthcare industries.
False Claims Act Update
Mr. David, Mr. Hogan, Mr. LaigaieThe number of False Claims Act cases filed and settled continues to rise. Join our distinguished panel as they examine the most notable False Claims Act cases from the past year. The panel will also discuss major issues that have arisen—or that loom on the horizon—involving the FCA. Always a lively discussion!
Lessons Learned from Physician Leasing
Attend to discover: • issues in the Professional Services Agreement • whether there is a separate Management Services Agreement • whether restrictive covenants are necessary • how to handle the introduction of new physicians • dispute resolution • fair market value issues • clinical integration • who owns the records • how is the second negotiation different.
Community HealthChoices and the New Federal Medicaid Managed Care Rules
Mr. Cherry, Mr. Hancock, Ms. Leisch
Community Health Choices (CHC) is Pennsylvania’s new managed care program for health care and long-term services and supports rendered to older persons and persons with physical disabilities. We will address the new federal Medicaid managed care regulations issued in 2016; DHS’s experience navigating those requirements; and the unique components of CHC, including the complaints and grievances process.
Beyond the Financial Terms: Understanding Key Legal Issues in Payer-Provider Contracts in 2018
Attend to become aware of the key non-financial terms of payer-provider contracts. Topics include: • limited networks • audits and data requests • assignment • tiered networks • takebacks and offsets • after-acquired providers • utilization review • regulatory requirements • eligibility determinations • all products clauses • leases and rental network • dispute resolution • issues presented by self-insured plans • value based programs • contract amendments.
Codes of Conduct: Do They Really Prevent Unethical/Illegal Conduct? (ETHICS)
The health care industry has a long history of implementing corporate compliance programs to prevent and detect potential illegal conduct. Often overlooked is the requirement that an “ethics” program must play an important role in order for a compliance program to be effective. This session will discuss recent unethical and illegal conduct in a variety of industries and will focus attention on the value and effectiveness of Codes of Conduct in accomplishing the mandates of corporate compliance.
Successful Integration and Use of Advanced Practice Professionals (APPs)
Ms. Nagele, Ms. Sher
The use of APPs in the hospital and ambulatory setting is expanding rapidly, driven by quality, efficiency and economic factors. We will address a host of challenges: • licensing and clinical oversight of APPs • credentialing and privileging challenges • establishing scope of practice • engaging the supervising/collaborating physicians in effective oversight of APPs • integrating APPs into medical staff governance.
Recorded in October 2018.