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Health Law Institute 2022

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TypeTitleStartEndCLEPrice
Day One - Philadelphia
Cancelled
The CLE Conference Center
Wanamaker Building, 10th Floor, Suite 1010, Philadelphia PA, 19107
STARTTue., Mar. 15, 2022
9:00 AM
ENDTue., Mar. 15, 2022
5:00 PM
CLE PRICE
Day One - Webcast

STARTTue., Mar. 15, 2022
9:00 AM
ENDTue., Mar. 15, 2022
4:00 PM
CLE 5 sub/1 eth PRICE Regular: $299.00
New Attorney: $150.00
Day Two - Webcast

STARTWed., Mar. 16, 2022
9:00 AM
ENDWed., Mar. 16, 2022
4:10 PM
CLE 5 sub/1 eth PRICE Regular: $299.00
New Attorney: $150.00

About

The event of the year for every health law professional is back!

The first day of the Institute will consist of one-track of the most important topics presented by dynamic and talented faculty. The second day of the Institute offers the session choices that you have come to love about the Institute. We will offer a "build your own" Institute in a virtual format that you can take from the comfort of your home or office. Join us this year as the Health Law Institute continues to provide you with the practical teaching with realistic solutions to everyday and unexpected problems in health law.

The Institute is the Go-To Event of the Year

The Institute is the premier event of the year for everyone practicing in the health law field. You'll be updated on all the newest developments, including price transparency, private equity in healthcare and overcoming health disparities. With 26 sessions, you can create a learning event best suited to your practice.


Schedule for Tuesday, March 15, 2022

9:00 - 11:00 am

The Health Law Year in Review

Charlie Artz and Robin Locke Nagele

Take this opportunity to stay on top of all of the significant developments in health law in our opening session. In this energetic discussion, you will be taken on a journey through all of the new and important case law and regulatory changes by Charles Artz and Robin Locke Nagele. It's the perfect way to explore what is happening across a broad spectrum of health law issues. You'll also get a glimpse at what is on the horizon in health law.

 

11:00 - 11:10 am

Break

 

11:10 am - 12:10 pm

Legal Issues in Physician Compensation: Stark, P4P, Bundled Payment, E&M and More

Alice Gosfield

To arrive at a truly value driven healthcare system, how physicians are compensated for their work is more critical than ever. Despite predictions of the demise of fee for servicer reimbursement, new approaches to physician payment for their services remain in play along side FFS payment.  While how to construct meaningful incentives to behavior is the purview of others, for lawyers there are significant legal issues to confront in physician compensation within practices, by employers or in any of the newly emerging contexts (e.g., private equity investment). New Stark interpretations within group practices are a major challenge, but other issues need to be addressed as well.  How to allocate dollars received in bundled payment, the varieties of pay for performance programs that have emerged, and even the shift in payment for evaluation and management codes must be taken into account. Finding evidence on what has worked and what is unclear is not very easy. 

 

12:10 - 12:40 pm

Lunch

 

12:40 - 1:40 pm

Community Benefit and Charity Care for Hospitals: Reporting, Charities, Consumer Protection and Tax Exemption Issues (ETHICS)

James Sheehan

State and federal agencies, the Affordable Care Act,  the media, and public interest lawyers  have recently focused the duty and role of charitable hospitals in providing care to moderate income persons,  and  responsibilities for forgiving debt for those unable to pay.  This presentation will address major state initiatives (including Consent Orders in Washington State, the new Oregon “charity floor”  statute,  the New Jersey mandated 100% discount for persons below 200% of federal poverty levels,  and charity care public reporting and  funding in Pennsylvania and New York) review the charity care disclosures required by Schedule H of the IRS 990, and the unique rules governing real estate tax exemptions for Pennsylvania hospitals.

 

1:40 - 1:50 pm

Break

 

1:50 - 2:50 pm

Hospital Price Transparency - Compliance and Business Implications

John Harris and Chris Raphaely

Shifting the $1 trillion dollar hospital industry from confidential payer contracts to publicly published pricing is a massive transformation. New CMS hospital price transparency requirement implicate public relations and business strategy issues, yielding a wide range of hospital and health system approaches to reporting the required data. As compliance increases, we are entering a world of publicly visible payer contracts which affect everything from negotiation strategies to value-based care. We will review: the specific regulatory requirements to report hospital pricing data, the risk of partial compliance, CMS penalties and the implication of pricing transparency on confidentiality clauses in payer contracts; a sample of Philadelphia area pricing data; and what this change means for payer negotiations, value based care, pricing strategy and other business issues.

 

2:50 - 3:00 pm

Break

 

3:00 - 4:00 pm

Keynote Address: COVID-19: Where Do We Stand?

Dr. Paul Offit

Dr. Offit is the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the Perelman School of Medicine at the Univeristy of Pennsylvania.

 


Schedule for Wednesday, March 16, 2022

9:00 - 10:00 am 

Concurrent Sessions (choose one)

False Claims Act Update

Pam Brecht and Greg David

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!

PA Department of Health Update

Yvette Kostelac

Join us to explore the issues that were addressed by the Pennsylvania Department of Health during the past year and that are expected to remain of prime importance in 2022. Find out about implementation of any recently enacted legislation and any forthcoming promulgation of new and revised regulations.

"I Want a Divorce" The Dis-Integration of Healthcare Mergers and Acquisitions: How to Avoid and Anticipate

Heather Alleva and John Washlick

In the wake of the M&A wave, many acquisitions fail to take the necessary steps to integrate their combined operations leading to unwinding the parties. These failures and politically disastrous consequences can be avoided through careful planning during the M&A process, rather than putting them off until after the closing of the transaction. We will explore: reasons for failed consolidations, how to plan in advance to avoid such failures, legal recourse when faced with unwinding an acquisition, event unwind triggers to consider when negotiating the M&A transaction and contract exit strategy provisions for consideration, and fiduciary responsibilities and duties of the repective boards.

Artificial Intelligence and Privacy

Ryan Brown and Erin Duffy

Artificial intelligence (“AI”) promises to profoundly alter the delivery of healthcare. As lawyers, we are often asked to help our clients mitigate the legal risk that can arise when antiquated laws are applied to emerging technologies. One significant area of friction is the application of existing privacy laws, such as Health Insurance Portability and Accountability Act (“HIPAA”) to AI technologies. This presentation will explore several ways AI upends existing approaches to privacy and how to navigate those challenges in a compliant manner.

 

10:00 - 10:10 am

Break

 

10:10 - 11:10 am

Concurrent sessions (choose one)

New Developments in Laborary Testing

Doug Moak

The laboratory industry has undergone significant changes in the last few years as a result of coronavirus, the opioid epidemic, expansion of at-home testing and genetic testing, and other recent developments. This presentation will review recent regulatory changes and legal issues in this new environment, including fraud and abuse, licensing and regulatory oversight, and benefit coverage.

Health Care Grant Fund - Prosecutorial Trends and Compliance Pitfalls - 2022

Paul Kaufman

Every year, the Department of Health and Human Services alone disburses nearly $15 billion in research and scientific grants. These dollars join those from the National Science Foundation, the Department of Defense, and other federal agencies in a pool of tens of billions of federal grant dollars spent on health care research.  Increasingly, though, fraud on these programs is being prosecuted. This fraud is diverse, ranging from improperly substituted personnel to undisclosed connections to private industry or foreign governments to misappropriation for use on personal expenses. The civil and criminal consequences of this fraud are significant, and fraud by individuals can have serious administrative consequences for their institutions, including loss of federal funding. This session aims to explicate the frauds, look briefly at the different statutes being deployed to investigate and prosecute them, and examine what compliance personnel and outside counsel need to know to assure that their clients remain on the right side of the law.

To Compete or Not to Compete: The Future of Competition in Clinical Medicine

Andrea Kirshenbaum and Mandy Rosenblum

The landscape for competition is changing. Non-competition agreements are increasingly disfavored while action to limit anti-competitive activity is increasing. For physicians and other clinical health care providers used to restricting competition, these changes are particularly significant. In this session, we will discuss past and current law governing the use of non-competition agreements in clinical medicine, and antitrust law enforcement in health care. We will explore trends that may illuminate the future of competition restrictions, how they might impact the employment market for physicians and other clinical health care providers, and what individual and institutional providers might do about it.

Section 1557 of the ACA and the Non-Discrimination Rule(s): Compliance for Health Care Providers

Elizabeth Hein

Section 1557 of the Affordable Care Act prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in covered health programs or activities.  Under the Obama Administration, HHS issued a Final Rule that, in key part, defined “discrimination on the basis of sex” to include sex stereotyping and gender identity, providing new protections for LGBTQ patients.  In 2020, under the Trump Administration, HHS issued a new Final Rule removing these protections.  Days later, the U.S. Supreme Court issued its decision in Bostock v. Clayton County, Georgia, ruling that sex discrimination under Title VII includes discrimination on the basis of gender identity and sexual orientation.  Further rulemaking from HHS is anticipated in 2021. This presentation will provide an overview of the current state of affairs with respect to the scope of the discrimination prohibition, and provide practical compliance tips for health care providers.

 

11:10 - 11:20 am

Break

 

11:20 am - 12:20 pm

Concurrent sessions (choose one)

The Public Readiness and Emergency Preparedness Act (PREP) Act

Bob Charrow

Join us for a discussion of the PREP Act declarations from the Secretary of the Department of Health and Human Services and their affect on health care providers.

Coverage in a Crisis: How the Health Insurance Landscape Has Changed During the Pandemic

Richard Hendrickson and Sandra Ykema

Learn about what is happening in health care coverage  law from the perspective of the regulator.  Topics are expected to include federal legislation such as the No Surprises Act, the American Rescue Plan Act, and Build Back Better; and other legislative, executive, and judicial developments at both the federal and state levels that impact health insurance coverage for Pennsylvanians. 

CMS/OIG Regulatory Sprint to Coordinated Care Trips Over Gainsharing and Other Non-Risk Bearing Arrangements

Henry Casale

CMS and OIG ” Regulatory Sprint to Coordinated Care” resulted in each agency’s publication of Value-Based Regulations on December 2, 2020, with a January 19,  2021, effective date.  OIG and CMS were pretty consistent when developing Value Based definitions and Value Based Rules where the physician-value based participants are placed at full financial risk, or at meaningful downside financial risk.   However most hospitals were hoping for clarification and consistency when they enter into gainsharing and various other value-based arrangements where the physicians were not at financial risk.  Unfortunately, here CMS and OIG issued very different rules. For example,  OIG limits its value-based safe harbors where physicians are not placed at financial to in-kind remuneration while the Stark Value Based rules apply to both cash and in-kind remuneration.  OIG did however amend the personal services and management contracts safe harbor to include outcomes-based payment arrangements, which permits cash remuneration, but only under certain circumstances.  This lecture will discuss the similarities and differences in CMS and OIG’s approach to non-risk arrangements and discuss how to how proceed.

Evolving Tax Regimes in an Evolving World: A 2021-22 Tax Update for Healthcare Lawyers

Daniel Hennessey

This session will provide an updated overview of various tax issues and developments affecting the healthcare industry, and, specifically, tax--exempt healthcare providers. The topics will be based on the most recent developments over 2021 and early 2022 including the following: impact of pandemic and associated relief bills on taxes and tax-exempt healthcare providers, actions and proposals of the Biden administration regarding federal tax reform, recent federal income tax cases, rulings and other developments, IRS form and procedural updates, update on IRS compliance/audits, Pennsylvania state/local tax developments.

 

12:20 - 12:50 pm

Lunch

 

12:50 - 1:50 pm

The Ethics and Social  Implications of Genomic Testing (ETHICS)

Professor Amy Campbell

 

1:50 - 2:00 pm

Break

 

2:00 - 3:00 pm

Concurrent Sessions (choose one)

Anti-Trust Update

Mark Mattioli

 

Advanced Practice Professionals Update

Charles Chulack

 

HIPAA Privacy and Security Enforcement

Charles Artz and John Mayernick

Join us for a discussion on a variety of OCR settlements; at least two criminal convictions against individuals in health care facilities for improperly accessing PHI and ePHI; a physician’s litigation based upon his former spouse’s improper access of PHI in violation of the Computer Fraud and Abuse Act; and report on any case law developments with respect to the class action lawsuit pending in the Middle District of Pennsylvania against the Department of Health and one of its contractors who inadvertently disclosed thousands of patients’ PHI.  We continue to monitor enforcement developments and would include those as well.

More Than Just Fuel: Social Determinants of Health and Efforts to Improve Diet and Nutritionn

Daniel Shay

This presentation will examine recent efforts by government and private entities to affect social determinants of health, with a focus on food insecurity, diet, and nutrition. Towards this end, the presentation will address: what social determinants of health actually are, and their impact on health care and related expenses; the specific impact of food insecurity, diet, and nutrition on health care; Federal and private efforts and programs to address food insecurity, diet, and nutrition; and legal risks and complications associated with participation in such programs.

 

3:00 - 3:10 pm

Break

 

3:10 - 4:10 pm

Concurrent Sessions (choose one)

Federal Telehealth Enforcement: Policy Through Prosecution

Mike Cassidy and Jerry Russo

This discussion will cover the Federal policy update, including OIG work plan, summary of OIG/AUSA enforcement initiatives and 2021 and 2022 Medicare telehealth reimbursement changes. We will also examine a case study on telehealth takedown, including government announcement, telehealth scan structure, Federal criminal and civil prosecution and Proffer process.

PA Department of Human Services Update

Ed Cherry and Matt McLees

Attend to hear a brief update on recent matters of interest involving the Pennsylvania Department of Human Services.

The Dangers of Corporatization in Health Care: From Mega-Providers to Private Equity

Professor Barry Furrow

Health care is evolving into new forms that threaten core values in health care.  First, mega-providers – larger and larger systems of health care delivery – threaten to dominate. The consequences of such systems will be explored to gauge whether their costs outweigh the benefits. Second, the financing of health care through private equity introduces new negative forces that may reduce quality of care in both hospitals and nursing homes, as private equity drives toward cost-cutting efficiencies and high charge models that destabilize and disrupt older system models. Third, regulators of health care cost and quality are falling behind. The favored regulatory models—information flow to consumers, transparency of care decisions—are limited in their effectiveness. The consequences of these forces will be considered, including disruption of the hospital-physician relationship; the escalating costs to Medicare and private insurance of mega-providers and private insurance; the weakening of physician and nurse power; and increasing levels of patient adverse events.     

Hot Reimbursement Issues from the Perspective of Providers and Health Plans

Robert Chu and Greg Fliszar

This topic will address the current landscape of the hottest and newest legal issues in health care reimbursement in terms of reimbursement controversies, disputes and how to avoid them.   The presentation will be given from the unique perspective of lawyers representing both the provider and health plan sides of the issues.  

 

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 $80. 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. Please allow up to two weeks after the program for the printed version of the course book to be shipped.

ProPass - Online does not apply to institute programs delivered by webcast.

 

 

Practice Areas

Faculty

NameFirm/Company
Heather R. Alleva Esq. Baker Donelson (MD)
Charles I. Artz Esq. Artz McCarrie Health Law
Pamela Coyle Brecht Esq. Pietragallo Gordon Alfano Bosick & Raspanti, LLP (Phila)
Ryan W. Brown Esq. Duane Morris LLP (Phila)
Amy Tannery Campbell Esq.
Henry M. Casale Esq. Horty Springer & Mattern PC
Michael Allen Cassidy Esq. Tucker Arensberg (Pgh)
Robert P. Charrow Esq. Greenberg Traurig, LLP (DC)
Edward Gerard Cherry Esq. PA Department of Human Services (Main Office)
Robert A. Chu Esq. AmeriHealth Caritas
Charles J. Chulack III, Esq. Horty Springer & Mattern PC
Gregory B. David Esq. Ofc of the US Attorney
Erin M. Duffy Esq.
Gregory M. Fliszar J.D., Ph.D. Cozen O'Connor (Phila)
Barry R. Furrow Drexel University Kline School of Law
Alice G. Gosfield Esq. Alice Gosfield & Associates
John M. Harris Veralon Partners
Elizabeth M. Hein Esq. Post & Schell, PC (Phila)
Richard L. Hendrickson Esq. Pennsylvania Insurance Department
Daniel J. Hennessey Esq. Stevens & Lee (King of Prussia)
Mr. Paul W. Kaufman Esq. United States Attorney’s Office
Andrea M. Kirshenbaum Esq. Post & Schell, PC (Phila)
Yvette M. Kostelac Esq. PA Dept of Health
Mark L. Mattioli Esq. Greenberg Traurig, LLP (Phila)
John Mayernick IV, Esq. Artz McCarrie Health Law
Matthew J. McLees Esq. PA Department of Human Services (Office of General Counsel Hbg)
Douglas L. Moak Esq. Independence Blue Cross
Robin Locke Nagele Esq. Post & Schell, PC (Phila)
Paul A. Offit MD Children's Hospital of Philadelphia
Russell C. Raphaely Esq. Cozen O'Connor (Phila)
Mandy C. Rosenblum Esq. The Law Office of Mandy Rosenblum LLC
Jerry J. Russo Esq. Tucker Arensberg (Lemoyne)
Daniel F. Shay Esq. Alice Gosfield & Associates
James G. Sheehan Esq. Office of the Attorney General, Charities Bureau
John R. Washlick Esq. Buchanan Ingersoll & Rooney PC (Phila)
Sandra L. Ykema Esq. PA Insurance Dept
Faculty may vary by location.
PBI reserves the right to substitute speakers at all programs.
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