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Health Law Institute 2023

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TypeTitleStartEndCLEPrice
In-Person - Both Days - Philadelphia
Pennsylvania Convention Center
12th & Arch Streets, Philadelphia PA, 19107
STARTTue., Mar. 14, 2023
9:00 AM
ENDWed., Mar. 15, 2023
4:35 PM
CLE 12 sub/2 eth PRICE Regular: $649.00
New Attorney: $325.00
In-Person - Day One - Philadelphia
Pennsylvania Convention Center
12th & Arch Streets, Philadelphia PA, 19107
STARTTue., Mar. 14, 2023
9:00 AM
ENDTue., Mar. 14, 2023
4:35 PM
CLE 6 sub/1 eth PRICE Regular: $399.00
New Attorney: $200.00
In-Person - Day Two - Philadelphia
Pennsylvania Convention Center
12th & Arch Streets, Philadelphia PA, 19107
STARTWed., Mar. 15, 2023
8:30 AM
ENDWed., Mar. 15, 2023
4:35 PM
CLE 6 sub/1 eth PRICE Regular: $399.00
New Attorney: $200.00

About

PBI’s annual Health Law Institute is the premier event for health law professionals. We are thrilled to be back LIVE at the Pennsylvania Convention Center in Philadelphia. Join us for two full days of “create your own” content, as you select from four different tracks of breakout sessions. Back by popular demand, the Health Law Basics Bootcamp will take place on Day 2 of the Institute. You don’t want to miss the health law event of the year!

The Institute Kicks Off with the “Year in Review”
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. 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.

Day 1: Keynote Address - How AI is Transforming Healthcare
Join Dr. Nina Kottler as she provides an overview of AI’s role in healthcare through the lens of radiology. Dr. Kottler will discuss the maturity of AI in healthcare,  the need to continue to improve AI related care, and hurdles to successful deployment. Dr. Kottler will review lessons learned, discuss a unique perspective on AI and human biases, and provide a glimpse into the future of AI in healthcare.

Safe Harbor Reception
Held immediately following Dr. Kottler’s keynote presentation, the annual Safe Harbor Reception is a time to relax, unwind, and network with your colleagues. 

Day 2: Keynote Address - Private Equity in Healthcare
Private equity firms now own roughly 11% of U.S. nursing homes and 4% of hospitals. According to a KPMG Advisory Services analysis, there were 1,145 private equity deals involving health systems, physician practices, nursing homes and disability care in 2021. Professor David Hoffman and Jim Sheehan return to discuss these private equity deals, and your increasing responsibilities as a health law professional. Jim will take a look at the regulatory oversight and compliance concerns when nonprofit health care organizations sell their assets or ongoing operations to private equity firms, or when they enter into agreements with private equity firms and provide such firms with control over the revenue from nonprofit units or functions. Professor Hoffman will review the evidence and recent research about the scope of private equity in health care, and the impact of private equity on quality of patient outcomes in institutional care settings - primarily nursing homes, assisted living organizations, and hospitals. 

Returning This Year: Basics Bootcamp
Day 2 of the Institute features a Basics Bootcamp track.
Build a solid foundation for your clients and your practice with sessions about:
- Health professional licensure in PA
- Health care facility licensure in PA
- Medical staff issues
- Third party payments
- Medicare/Medicaid fraud and abuse
- HIPAA privacy and security

Program Schedule
*The program schedule is still subject to change based on speaker availability.* 


Day 1:

Health Law Year in Review – Charlie Artz, Rick Robinson, Ian Donaldson
Charlie Artz returns to present the Physician Year in Review.  The Physician Year in Review will address the U.S. Supreme Court’s landmark decision in Ruan v. United States establishing an objective intent standard applicable to federal controlled substance prescription criminal prosecutions, and U.S. Court of Appeals decisions subsequent to Ruan.  Several favorable U.S. Court of Appeals and federal court decisions will be addressed in the context of the Anti-Kickback statute and False Claims Act as they relate to physician compensation arrangements and remuneration. Stark enforcement, medical and orthopedic practice compliance, stem cell therapy and surgery center AKS cases will be analyzed.  ICD-10 upcoding, diagnostic testing fraud, incident to, LCD noncompliance, clinical lab false claims, provider misidentification and other important physician developments will be addressed.

False Claims Act Update – Charlene Fullmer
Join our panelists as they examine the recent decisions. You’ll hear each panelist’s point of view on these cases.

Health Care Antitrust Update: The Year in Review – Charles Honart
This past year has been one of the most active in many years in the health care antitrust world. Among much more, the FTC successfully challenged hospital mergers in New Jersey and Utah, post-merger litigation was underway involving allegations of illegal tying and steering and the use of “gag” clauses, the FTC requested comments with respect to possible revisions to its horizontal and vertical merger guidelines, the FTC issued a policy paper concerning certificates of public advantage, a case was argued to the U.S. Supreme Court involving the scope of the FTC’s authority when it considers merger cases and issues involving cross-market mergers were again in the spotlight. This year’s course will review these and other notable developments.

Biometric Privacy and Healthcare – Jeffrey Rosenthal
Biometric technology allows for the identification of an individual based on their unique physical characteristics (i.e., fingerprint, face, voice, etc.).  This presentation will address the current legal landscape surrounding biometric privacy, legal pitfalls, and pending legislation (including in Pennsylvania).  It will also address how the healthcare industry has applied biometric technology across a wide-range of services in hospital settings, out-patient care, and virtual medicine for, among other things, patient identification, medical record access, and pharmaceutical authorizations.

Department of Health – Legal Developments and Updates– Kevin Hoffman and Doug Snyder
This will be an update from the Department surrounding the development and implementation of the Medical Marijuana and Long Term Care regulations. We will also address the drafting of the hospital regulations and the new law concerning staffing support agencies.

Quality Fraud: What’s That? – Alice Gosfield
The predominant basis for fraud and abuse enforcement under federal law is the False Claims Act. While most of those enforcements and settlements turn on things like failing to perform services or under documentation of the service billed, and the like, there are a host of requirements pertaining to quality that can lead to false claims and other forms of fraud and abuse enforcement like sanctions and exclusions. This is an especially thorny issue post -Escobar which turned on whether the claim impliedly stated something false if it did not meet such issues as conditions of participation for payment, or medical necessity. In addition to those types of problems which sound in clinical judgments and not financial behaviors, there are an increasing number of quality reporting mandates which provide separate bases for fraud enforcement for failure to comply with requirements or making false statements pertaining to quality. There are quality relevant civil money penalties addressing actions leading to premature discharge, incentives to physicians to reduce services to patients and using incentive plans that put physicians at financial risk motivating under-delivery of services. This sub-category of fraud problems is an increasing but under-appreciated challenge for physicians as well as facilities. I propose to elucidate these issues with some practical guidance.

No More Surprise Medical Bills…For the Most Part: Provider Considerations for the No Surprises Act in 2023 and Beyond – Nicole Aiken-Shaban and Salvatore Rotella
This session will provide an overview of the basics of the No Surprises Act and its implementing regulations.  We will also highlight current issues as to the government’s enforcement of the NSA, and offer practical guidance to health care providers seeking to ensure compliance with the Act now and in the future.

Private Equity Deals: Risks and Rewards for Physicians – Michael Cassidy and Danielle Bangs
Private equity investment in the physician space has proliferated in the past few years and physician groups are increasingly considering competing offers from private equity and strategic buyers. Understanding what a private equity path would look like - and the risks and rewards it presents relative to other options – is crucial. This session will provide an overview of PE investment in the physician practice space, how PE-backed physician practice transactions are commonly structured and valued, and explore the tradeoffs, risks and rewards that physicians considering this path should consider.

Advising the Organization (Ethics)– Heather Alleva and John Washlick
This presentation will provide a roadmap for Board members of healthcare entities that are undergoing a M&A or other significant transaction. It will serve as a guide for Board members (and their General Counsels) in understanding the Board’s fiduciary duties, how to appropriately evaluate and approve a transaction, and governance approval processes, among other things. We plan to discuss Board members’ obligations and responsibilities at various phases throughout the transaction, including pre-transaction (where the entity is positioning itself to be acquired or evaluating targets), during the diligence, negotiation, and closing phases of the deal, and post-closing. This presentation will be particularly useful to new Board members and General Counsels navigating M&A healthcare transactions for the first time.

2022 Privacy and Cybersecurity Litigation, Legislative and Enforcement Overview– Angelo Stio III, Barry Boise & Sadia Mirza
The panel will outline the material litigation, legislative and enforcement matters that occurred in 2022 and address how these matters may impact how health care organization collect, process or store personal information and/or protected health information.  The panel will not only identify the material developments in 2022 in each area, but they will discuss the latest best practices and options for risk mitigation in dealing with these developments.

Expanding Protections in Coverage, Costs, and Claims: A Regulator’s Perspective– Richard Hendrickson and Sandy Ykema
Join Department Counsel Richard Hendrickson and Sandra Ykema from the Pennsylvania Insurance Department as they share the health insurance regulator’s perspective on recent developments. Topics include health equity, nondiscrimination, post-Dobbs and preventative services coverage, network adequacy, price transparency, the No Surprises Act, prior authorization, and external review (Act 146).


Day 2:

Virtual Isolation: Is Hyperconnectivity Helping or Harming the Legal Profession? – Brian Quinn
If we stop to think about what we look at most during the day, the answer would probably not be our family or friends, nor our clients or colleagues. The most feasible option would be our mobile phone. Smartphones are now our companions for work, social, leisure and even family life. However, excessive use can lead to problems of dependence, addiction and fear. We find ourselves simultaneously connected and alone. Workers today are ‘never turned off.” Like our mobile phones, we only go on standby at the end of the day as we crawl into bed, exhausted. Gradual, incremental increases in responsibilities, duties, pressures and demands upon lawyers, at home and at work, combined with long work-days and weeks has placed our profession at risk. At some point work may dominate our lives and keep us at a chronically high level of distress; yet we are often unaware that we have lost balance in our lives. Since it doesn’t appear that the “always-on” culture will be switching off any time soon, we need to develop key strategies that can help safeguard our personal life. Recent studies have shown that there has been a dramatic increase in impairment due to alcoholism, addiction and mental health disorders among members of the legal profession. The statistics are compelling and clearly indicate that 1 out of 3 attorneys will likely have a need for substance use or mental health services at some point in their careers. And Technology ? What role does it play in perpetuating this public health crisis ? Attorney Brian S. Quinn is the Education and Outreach Coordinator for Lawyers Concerned for Lawyers of Pennsylvania. He will discuss:
1. The early warning signs of impairment, with special emphasis on stress, anxiety and trauma, including the mental health impact of technology in the post- COVID-19 world.
2. The free services that Lawyers Assistance Programs provide to lawyers, judges, their family members and law students. 
3.  A close look at what barriers exist that prevent lawyers and judges from seeking the help they need and the role that education plays in breaking the stigma and fear associated with addiction and mental illness in the legal profession.
4. Wellness strategies that can be used by legal professionals and their families.
5. The ethical challenges created by the imposed isolation of the pandemic, including the role technology plays, and it’s possible long- lasting effect on the legal profession.

Lessons Learned from HIPAA Enforcement – Daniel Shay
This program will explore real-life examples of what happens when the HIPAA regulations are violated. It will examine common HIPAA compliance mistakes, and how the HHS Office for Civil Rights (OCR) has chosen to enforce HIPAA in such circumstances. The presentation will draw examples from Resolution Agreements and the personal stories of health care practitioners, and compare similarities and differences between violations that lead the OCR to take punitive or remedial measures, or both. The presentation will tie the violations back to specific provisions within the HIPAA regulations, with a goal of providing context to the cases.

Protecting the Reputation of Licensed Professionals – Dave Dearden
This program will focus on issues that attorneys representing licensed professionals should consider to help their clients take proactive steps to protect their public profile and reputation.

Health Professional and Health Care Facility Licensure in PA – Victoria Johnson
Session description coming soon.

Employment Challenges in the Post-Pandemic Age of Substance Abuse – Andrea Kirshenbaum and Mandy Rosenblum
Prior to the COVID-19 pandemic, rates of substance abuse were climbing. These rates increased dramatically after the start of the pandemic. Studies show that one-third of Americans reported increased alcohol consumption since the start of the COVID-19 pandemic, and 29% of drug users reported increase in drug use during the same period. Healthcare providers, who have disproportionately been impacted by the pandemic, have been and remain at high risk for substance abuse. The opioid crisis also has created significant challenges for healthcare providers since the start of the pandemic. This interactive presentation will address these challenges including how to handle suspected diversion and impairment and when and under what circumstances must hospitals and other licensed providers report individuals to State and Federal authorities. The presentation also will provide practical advice on mitigating the risk of disability discrimination claims and managing FMLA leave.

Use and Disclosure of Patient Behavioral Health Information after Pennsylvania Acts 32 and 33 of 2022– Douglas Moak
Pennsylvania law has historically been one of the most restrictive in the nation with regard to use and disclosure of patient mental health and substance use disorder treatment information. Concerned that these restrictions were hindering coordination of patient care and leading to avoidable negative outcomes, the Pennsylvania legislature enacted the bipartisan bills Act 32 and Act 33 of 2022, with the intent of bringing Pennsylvania law into closer alignment with federal privacy standards. The changes were effective July 7, 2022. This presentation will cover the history of Act 32 and Act 33, what has changed under Pennsylvania law and what has not, and what this all means for patients and other health care community stakeholders.

The ONC Information Blocking Rule: A Primer and Operationalizing Compliance – Cate David

Session description coming soon.

Medical Staff Issues – Robin Nagele

Session description coming soon.

Complaints About the Quality of Care in Your Hospital by Members of the Medical Staff: Is It a Matter of “Free Speech”? – Charles Chulack and Hala Mouzaffar
“Free speech” has been a hot topic in the press recently. Suspensions and revocations of Twitter accounts have been met with claims of “that violates my freedom of speech!” The ill-fated attempt by Elon Musk to buy Twitter was grounded in his belief “in its potential to be the platform for free speech around the globe.” But, the First Amendment only protects speech from government censorship. Moreover, the right to free speech under the First Amendment is not absolute. Everyone is familiar with the prohibition on shouting “fire” in a crowded theater, but what about speech that involves allegations about the quality of care in the hospital lodged by members of the Medical Staff?  What restrictions, if any, can you place on such speech? A well-functioning performance improvement process relies on the submission of concerns about quality in the hospital. Accordingly, hospitals often encourage the raising of these concerns so they can be addressed.  However, hospitals are generally permitted to require the registering of quality complaints through appropriate channels.

A 2022-23 Tax Update for Healthcare Lawyers – Daniel Hennessey
This session will provide an update in survey format on a broad range of federal (as well as PA/local) tax issues and developments specifically impacting the healthcare industry, including tax-exempt healthcare providers. The specific topics will be based on the most recent developments over 2022 and early 2023 and might include, among others, the Impact of pandemic and associated relief bills on taxes and tax-exempt healthcare providers, actions taken and proposals under consideration by the Biden administration and Congress, recent federal income tax cases, rulings and other developments, IRS form and procedural updates, developments with respect to IRS compliance/audits, and Pennsylvania state/local tax developments.

Health Care Price Transparency Made Plain – Chris Raphaely
This session will address the efforts of providers and payors to comply with new federal price transparency mandates and the broader implications of same.

Third Party Payments – James Billings-Kang
Session description coming soon.

APP/NPP Evolution: Positives and Negatives for Physician Practices– Robin Nagele
Recent years have seen a vast expansion in services provided by Advanced Practice Professionals, spurred in part by COVID.  In the private practice setting, APPs/NPPs extend the reach of physician services, and are often able to so economically and profitably.  However, changes to the Medicare Fee Schedule relating to split/shared visits in the inpatient setting could have a significant impact on overall compensation for physician practices.   This session will explore (i) the causes and benefits of the expansion in APP/NPP services, (ii) APP/NPP billing requirements, (iii) impact of changes in the Medicare Fee Schedule, and (iv) fraud and abuse risks in the inpatient and outpatient settings.

Hot Reimbursement Issues: How to Get Paid for the Services You Have Provided – Gregory 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 and prepare to challenge them
Tough Issues in Practice and Other Acquisitions: Fraud and Abuse and Post-Closing Liabilities – Mark Mattioli
This session will explore some of the challenging issues encountered in the acquisition of physician and other healthcare practices.  Topics to be discussed include:
  Asset vs. Equity Purchase: When does it avoid liability
                Compensation Structures including Earn-Outs and Deferred Compensation
                Corporate Practice and the role of the Management Agreement
                Handling Problematic issues in Diligence

Medicare/Medicaid Fraud and Abuse – David Sokolow
Session description coming soon.

Ethical Considerations with the Dobbs Decision – Delphine O’Rourke
Session description coming soon.

Telehealth and Benefits for Underserved Populations: Mirage or Oasis? – Barry Furrow
This presentation will examine the rapid proliferation of telehealth and telementalhealth tools in the health care marketplace.  It will examine the nature of telehealth, the benefits it offers in improving access for underserved populations (rural patients, patients in need of behavioral health therapies, and the possible limitations of telehealth as an access-promoting tool. It will also look at some of the legal issues that must be faced -- these include the risks of fraud in billing for telehealth by providers, the risks presenting by private equity as it moves into telebehavioral health, and the limits on provider practice across state lines.  

Research Year in Review – Lisa Murtha
This session will outline all new laws, regulations and industry guidance from the relevant research agencies including the FDA, NIH, OHRP, ORI, OMB, as well as the enforcers including the OIG and DOJ. There have been a number of recent cases on clinical trial fraud that will be very interesting to the audience.

HIPAA Privacy and Security – Daniel Shay
This presentation will cover the basics of the HIPAA Privacy and Security Rules, as well as the Breach Notification Rule.  It will provide understanding of certain key terms, address regulatory requirements, and offer practical guidance for ensuring compliance.  The presentation will also examine Security Rule case studies to help illustrate the ways that health care providers break the rules.



Create your own program - outstanding selection of topics
The Institute offers more than 30 different sessions to choose from, addressing significant health law topics from numerous angles - all designed to provide you with information and practice tips to make you better at what you do. Tailor your experience to your specific needs by selecting the sessions that matter most to you and your practice. This is just one of the many features that make this Institute an outstanding investment of time in your professional development.

 

We'd like to thank our sponsors for their generous contributions to this year's Institute:

Gold

Jefferson Health
Post & Schell


Silver

Buchanan Ingersoll & Rooney PC
Fox Rothschild LLP
HealthCare Appraisers
Horty, Springer & Mattern
Reed Smith LLP
Stevens & Lee

 


Each day of this Institute has been approved by the Pennsylvania Continuing Legal Education Board for 6 hours of CLE credit. Workshop choices will determine whether credits are substantive or ethics.

 

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. 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.

 

Practice Areas

Faculty

NameFirm/Company
Nicole Aiken-Shaban Esq. Reed Smith LLP (Phila)
Heather R. Alleva Esq. Baker Donelson (TN)
Charles I. Artz Esq. Artz McCarrie Health Law
Danielle Bangs MHA, Principal Veralon Partners Inc
James R. Billings-Kang Esq. Cozen O'Connor (DC)
Barry H. Boise Esq. Troutman Pepper Hamilton Sanders LLP (Phila)
Michael Allen Cassidy Esq. Tucker Arensberg, P.C. (Pgh)
Edward G. Cherry Esq. PA Department of Human Services (Main Office)
Charles J. Chulack III, Esq. Horty Springer & Mattern PC
Catherine E. David Esq. Reed Smith LLP (Phila)
David R. Dearden Esq. Sansweet Dearden & Burke Ltd
Ian Donaldson Esq. Horty Springer & Mattern PC
Charlene Keller Fullmer Esq. US Attorney's Office
Barry R. Furrow Drexel University Kline School of Law
Alice G. Gosfield Esq. Alice Gosfield & Associates
Richard L. Hendrickson Esq. Pennsylvania Insurance Department
Daniel J. Hennessey Esq. Stevens & Lee (King of Prussia)
David R. Hoffman Esq. David Hoffman & Associates PC
Kevin J. Hoffman Esq. Pennsylvania Department of Health
Mdj Charles M. Honart Esq. Stevens & Lee (King of Prussia)
Victoria H. Johnson Esq. Fox Rothschild LLP (Exton)
Andrea M. Kahn-Kothmann Esq. Thomas Jefferson University
Andrea M. Kirshenbaum Esq. Post & Schell, PC (Phila)
Dr. Nina Kottler Radiology Partners
Mark L. Mattioli Esq. Greenberg Traurig, LLP (Phila)
Matthew J. McLees Esq. PA Department of Human Services (Office of General Counsel Hbg)
Sadia Mirza Esq. Troutman Pepper Hamilton Sanders LLP (CA)
Douglas L. Moak Esq. Independence Blue Cross
Hala Mouzaffar Esq. Horty Springer & Mattern PC
F. Lisa Murtha Esq. Moses & Singer LLP
Robin Locke Nagele Esq. Post & Schell, PC (Phila)
Delphine Park O'Rourke Esq. Goodwin Procter LLP
Sherri G. Patchen Esq. PA Office of General Counsel
R. Christopher Raphaely Esq. Cozen O'Connor (Phila)
Frederick Robinson Esq. Reed Smith LLP (DC)
Mandy C. Rosenblum Esq. The Law Office of Mandy Rosenblum LLC
Jeffrey N. Rosenthal Esq. Blank Rome LLP (Phila)
Salvatore G. Rotella Jr., Esq. Buchanan Ingersoll & Rooney PC (Phila)
Kenneth J. Serafin Esq. PA Department of Human Services (Office of General Counsel Hbg)
Daniel F. Shay Esq. Alice Gosfield & Associates
James G. Sheehan Esq. Office of the Attorney General, Charities Bureau
Ruth M. Siegel Esq.
Douglas A. Snyder Esq. PA Department of Health
David S. Sokolow Esq. Fox Rothschild LLP (Phila)
Angelo A. Stio III, Esq. Troutman Pepper Hamilton Sanders LLP (NY)
John R. Washlick Esq. Buchanan Ingersoll & Rooney PC (Phila)
Sandra L. Ykema Esq. Pennsylvania Insurance Department
Faculty may vary by location.
PBI reserves the right to substitute speakers at all programs.
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