Here is your chance to hear the best of the best from the Health Law Institute 2019. 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
Ms. Brecht, Mr. David, Mr. Hogan
The 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!
Damned if You Do, Damned if You Don't: Hazard for Out of Network Providers From Fee Waivers to Surprise Billings
Explore the changes in the healthcare reimbursement landscape arising out of the proliferation of narrow network and tiered insurance plans, and the corresponding increases in the numbers of providers choosing to "go out of network." Non-contracted providers frequently offer fee discounts and other waivers of patient financial responsibility as a means of gaining or retaining (after a contract termination) market share. In the first portion of our discussion we will explore the successes and failures of various legal theories that plans are increasingly advancing to deter referrals to out-of-network providers. In the second portion we will examine recent federal and state efforts to limit patient exposure to "surprise billings" and other forms of balance billing (including ACA reforms for out-of-network coverage of emergency medical services).
Increased Scrutiny of "No-Poach" Agreements and the Impact on Health Care Practices
Ms. Datte, Ms. Levine, Mr. Young
In recent years, private plaintiffs, the federal antitrust agencies, state attorneys general and Congress have all turned their focus to "no-poach" agreements, which prohibit companies from hiring or soliciting each other's workers. Private class action plaintiffs have increasingly targeted no-poach and wage-setting agreements with success in fields including health care. We will examine the current governmental and private plaintiff scrutiny of no-poach agreements, particularly as to how they may affect the health care industry in terms on "non-solicitation" and "no-hire" agreements between health care entities.
The European Union's General Data Protection Regulation: Its Impact on US Healthcare and What You Need to Know
The European Union's General Data Protection Regulation ("GDPR") took effect this year, drastically impacting the collection, processing, storage, and use of data related to European Union data subjects. Any entity that processes data related to an EU data subject will be required to comply with the granular technological, administrative and legal requirements laid out in the GDPR. We will discuss the global impact of the GDPR on the collection, processing and storage of health-related data, including a comparison of the requirements for security and privacy under HIPAA and the HITECH Act, with a comparison to the requirements of the GDPR.
Working With Hospital Leadership: Who Is the Client? (ETHICS)
Ms. Nagele, Ms. Sher
A hospital is a complex organization with multiple leadership constituencies - board, administration and medical staff. What is particularly unique is that the hospital medical staff is an organizationally distinct entity within the hospital structure, acting as an agent of the hospital in carrying out professional oversight activities. For legal counsel working with hospital leadership, this can give rise to ethical dilemmas and potential conflicts of interest. We will address: ● Navigating legal representation with multiple leadership constituencies ● Managing the conflicting agendas that can arise in the academic medical centers, community hospitals and multi-entity health systems ● Identifying potential conflicts of interest and when to engage separate counsel ● Special challenges that arise in a jurisdiction (e.g., New Jersey, California) that recognizes the medical staff as an independent entity capable of suing the hospital.
What's Good for GM...? Self-Funded Health Plans
Ms. Gifford, Mr. Leeds
In the fall of 2018, General Motors announced that it had entered into an arrangement with the Henry Ford Health System to provide health benefits to 24,000 salaried employees in Southeast Michigan. Recent years have seen other employers with self-funded health plans contract directly with providers for services at discounted rates. We will: ● Address the emergence and motivating forces behind these employer-provider relationships ● Explore legal and practical issues in these relationships ● Consider relevant contracting strategies ● Take into account employer, provider and third party administrator perspectives.
All attendees will receive the course materials as a digital book. A printed copy of the course book is available, at a discount to attendees, for $40. Additional copies are available at full price. If you wish to purchase the printed version of the course book, please call PBI Customer Service at 800-932-4637. Printed versions of the course book will not be distributed at the course; please allow up to two weeks after the program for the printed versions of the course book to be shipped.
Recorded live in October 2019.