Government officials and health law experts will address a variety of emerging health industry topics during the American Bar Association Washington Health Law Summit on Dec. 12-13 in Washington, D.C.
On Tuesday, Dec. 13, representatives of the Office of Inspector General at the Department of Health and Human Services, including Robert DeConti, assistant inspector general for legal affairs; Susan Edwards, chief of the industry guidance branch; Susan Gillin, chief of the administrative and civil remedies branch; and Lisa Re, assistant inspector general for legal affairs will speak on federal enforcement and regulatory activities.
Program highlights include:
• “The Supreme Court and Health Care: A Momentous Term” — A panel of experts will review the significant decisions of the Supreme Court’s 2021-22 term, including decisions on eligibility for disability benefits, discrimination in health plan coverage, recovery of personal injury settlements, calculation of disproportionate share hospital payments and the 340B program. They will also assess the implications for health care providers of Dobbs v. Jackson Health and the future of judicial deference to administrative decisions.
Monday, 8:15-9:15 a.m. ET
• “Dobbs: Where Are We Now?” — Panelists will discuss current litigation and legislation resulting from the Dobbs opinion and address relevant constitutional issues.
Monday, 9:15 a.m.-10:15 p.m. ET
• “Addressing Health Equity and Implicit Bias in Payment Reform Models” — The Biden Administration has elevated equity as a top priority throughout numerous health policies and programs. Dr. Dora Hughes, chief medical officer at the Centers for Medicare & Medicaid Services (CMS) Innovation Center, will provide an overview of the center’s Health Equity Initiative, as well as examples of equity-focused payment and care delivery models and efforts to address implicit bias. Nalini Pande, managing director of Sappho Health Strategies, LLC, will describe the policy and legal implications of CMS’ equity strategy, including a detailed analysis of the ACO REACH model requirements and other relevant administration equity initiatives.
Monday, 10:15-11 a.m. ET
• “The Year in Managed Care – A Washington Update” — A panel of experts will focus specifically on CMS policies relating to Medicare Advantage, Medicaid managed care and qualified health plans. They will look at Biden administration priorities and what to anticipate in the year ahead and examine the direction of CMMI and updated/new models to advance value-based reimbursement.
Tuesday, 10:30-11:15 a.m. ET
• “The Medical Debt Crisis, COVID-19 and Potential Legal Solutions” — Medical debt is the most common type of collection reported on consumer credit records, and during the pandemic, even more people have incurred pandemic-related medical debt. Yet, there is a limited legal framework through which to address this crisis. This panel of experts, including Diane Johnston of the Legal Action Center in New York and Sudarsana Srinivasan of the New York State Office of the Attorney General, will discuss the existing legal framework (including the ACA requirements for hospital financial aid, and laws regulating debt collection agencies), and provide insights into how to enforce and improve these laws.
Monday, 1:45-2:45 p.m. ET
• “Let’s Make a Deal – Insurer-Provider Bargaining and Evolving Antitrust Analysis of Provider Mergers” — In healthcare markets, prices are negotiated not between providers and patients, but between healthcare systems and insurers. Commercial health insurers negotiate with providers to build viable networks at prices employers will accept. As healthcare systems become more complex, so too do these negotiations. Continuing consolidation and evolving models of provider-insurer bargaining could affect the analysis of horizontal and vertical health care mergers in ways that the courts have not yet grappled with. A panel of experts will discuss recent trends and signaled direction for healthcare merger enforcement, the effect of provider-insurer negotiations on relevant provider markets (including “cross-market” mergers) and theories of harm that may arise from vertical mergers.
Monday, 4:30-5:30 p.m. ET
• “No Surprises Act – Has it Had the Impact We Expected?” — In December 2020, Congress passed the No Surprises Act (NSA). National and state provider groups have recently filed lawsuits against federal regulators challenging the NSA’s arbitration process. They allege that the process will lead to below-market rates for their services, and they also allege that patients’ access to in-network providers will decrease. This panel will review the state of these challenges, the arguments on both sides and economic evidence related to these challenges.
Tuesday, 11:15 a.m.-Noon ET
• “Healthcare Provider Non-Compete Restrictive Covenants: Recent Developments for Employment and Transactions” — A panel of experts, including Rahul Rao, deputy director of the Bureau of Competition at the Federal Trade Commission, will discuss general requirements and considerations for restrictive covenants for healthcare providers in the context of both employment and transactions. They will cover recent federal and state developments, including discussions of recently enacted state statutes and other rule making. Alternatives to traditional employment-based non-compete restrictive covenants will be discussed for jurisdictions in which such restrictive covenants have become more difficult to implement and enforce for healthcare providers.
Tuesday, 1-1:45 p.m. ET
A complete agenda can be found online at www.americanbar.org.
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