The American Health Law Association (AHLA) is the largest nonprofit, nonpartisan educational organization devoted to legal issues in the health care field with nearly 14,000 members. As part of its educational mission, AHLA's Speaking of Health Law podcasts offer thoughtful analysis and insightful commentary on the legal and policy issues affecting the health care system. AHLA is committed to ensuring equitable access to our educational content. We are continually improving the user experien ...
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Texas’ attorney general recently filed a civil lawsuit against a New York physician for prescribing medication abortion pills via telehealth to a woman in Texas. Natalie Birnbaum, State Legal and Policy Director, RHITES, and Krusheeta Patel, Associate, Manatt Phelps & Phillips LLP, discuss this first open challenge to abortion shield laws and the i…
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Glenn Prives, Partner, Epstein Becker & Green PC, and Elizabeth Kastner, Senior Transactional and Corporate Counsel, TriHealth, Inc., discuss the current climate around hospital/physician affiliation models in the age of private equity, and they cover six different models they are currently seeing in the health care industry. Glenn and Elizabeth sp…
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Lisl Dunlop, Partner, Axinn Veltrop & Harkrider LLP, speaks with Mark Seidman, Partner, Weil Gotshal & Manges LLP, about some of the potential health care antitrust priorities of a second Trump Administration. They discuss how antitrust enforcement has changed over recent administrations; and the incoming administration’s potential approaches to th…
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Michael Peregrine, Partner, McDermott Will & Emery, about the governance trends that health care boards should anticipate in 2025. These trends fall into three categories: those that arise from the change of administrations in Washington, DC, those that are relat…
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David Cade, Executive Vice President and CEO, American Health Law Association, speaks with Eric Zimmerman, Partner, McDermott Will & Emery, about the potential health care priorities of a second Trump Administration. They discuss possible health care considerations in any upcoming tax bill, drug pricing and Pharmacy Benefit Manager reform, the Affo…
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Gerald Griffith, Partner, Jones Day, and Stephanie N. Switzer, Senior Counsel, Cleveland Clinic, discuss, in top ten style, common audit risks for nonprofit health care organizations and strategies for minimizing potential tax exposure. Gerald and Stephanie spoke about this topic at the 2024 Annual Meeting in Washington, DC. Learn more about the 20…
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On September 20, a jury ruled in favor of St. Charles Surgical Hospital and the Center for Restorative Breast Surgery in their case against Blue Cross Blue Shield of Louisiana for failure to fully pay for services rendered, awarding the plaintiffs over $421 million. Joe Aguilar, Managing Partner, HMS Valuation Partners, speaks with Matthew Sherman,…
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Dan Levin, Director, Stout, speaks with Danielle Tangorre, Partner, Robinson & Cole, and Parker Eastin, Partner, Nicholson & Eastin, about the legal and regulatory landscape surrounding marketing arrangements in health care and how they are working with their clients to structure these arrangements. They discuss the types of arrangements they are s…
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Michelle Johnson Tidjani, CommonSpirit Health, and Florence L. Di Benedetto, Di Benedetto Solutions, Inc., discuss the mental health challenges that health lawyers face and how to tackle the stigma that the legal profession attaches to mental health. They share their personal experiences with mental health and strategies to build resilience and cop…
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Danielle Bangs, Director, Veralon, and Kelley Taylor Hearne, Partner, Faegre Drinker Biddle & Reath LLP, discuss the growing trend of health systems entering into joint ventures and other forms of partnership with specialty operators. They cover the trends they are seeing in this area, legal and financial issues that need to be worked through as th…
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Kevin Malone, Epstein Becker Green, speaks with Dr. Henry Harbin, a leader in the behavioral health space, about the September 2024 final rule implementing amendments to the Mental Health Parity and Addiction Equity Act. They discuss what the new regulations do to advance mental health parity, what this means in the context of managed care and ment…
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Michael Peregrine, Partner, McDermott Will & Emery, about the proper role of health care organization boards in relationship to technology, including artificial intelligence. They discuss the National Association of Corporate Directors’ (NACD’s) 2024 Blue Ribbon …
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Valerie Cohen, Partner, Venable LLP, speaks with Randy Sergent, Executive Vice President & General Counsel, CareFirst BlueCross BlueShield, and Shane Hunt, a government health care attorney, about the wide-ranging impacts of Loper Bright, Corner Post, and Jarkesy on the health care industry. They discuss the effect of Loper Bright on day-to-day com…
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Joe Wolfe, Attorney, Hall Render Killian Heath & Lyman PC, speaks with Robert S. Salcido, Partner, Akin Gump Strauss Hauer & Feld LLP, about the current landscape of the False Claims Act (FCA) in the health care industry. They discuss the recent district court opinion declaring the FCA’s qui tam provisions unconstitutional (Zafirov v. Florida Medic…
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Alé Dalton, Partner, Bradley Arant Boult Cummings LLP, speaks with Ari Markenson, Partner, Venable LLP, about how early career professionals can use the complexities of the health care industry to their advantage. They discuss why the average health care lawyer is like a “Swiss Army Knife,” how to navigate the sea of acronyms that exist in the heal…
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David Crapo and Bethany Corbin discuss enterprise risk management for health care organizations, with a particular focus on cybersecurity. They cover the sources of cyberattacks on health care organizations, risks involving third-party vendors, strategies for minimizing cybersecurity risks, legal requirements, different stakeholder responsibilities…
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Jenna Brofsky, Partner, Husch Blackwell LLP, and Thomas Spellman, Associate General Counsel and Vice President, Fresenius Medical Care North America, discuss approaches for drafting health care contracts, focusing on negotiation techniques and strategies and non-compete provisions. Jenna and Thomas are co-authors of AHLA’s Health Care Contracts: A …
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Jiayan Chen, Partner, McDermott Will & Emery, and Lauren Willens, Senior Counsel, Henry Ford Health, discuss how health care organizations can safely and responsibly implement artificial intelligence (AI). They cover the opportunities and risks of AI in health care, the current state of AI regulation, the role that patient safety organizations can …
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Texas recently filed a lawsuit against the U.S. Department of Health and Human Services challenging both the HIPAA Final Rule to Support Reproductive Health Care Privacy and the HIPAA Privacy Rule, with potential implications for the balance of power between federal health privacy regulations and states’ authority to investigate potential legal vio…
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Jennifer Hatchett, Of Counsel, Hall Render Killian Heath & Lyman PC, and Jennifer McGowen, Senior Counsel, Health Plans and Networks, CHRISTUS Health, discuss considerations related to the provider’s role in Medicare Advantage marketing. They cover ways that providers can help their patients select a Medicare Advantage plan, CMS' guidance on “commu…
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Health Care Corporate Governance: Board Oversight of Compliance in Light of DOJ’s New Guidance
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Michael Peregrine, Partner, McDermott Will & Emery, about the Department of Justice’s (DOJ’s) updated compliance program guidance and its implications for Board oversight of compliance. They discuss the DOJ’s updated Evaluation of Corporate Compliance Programs gu…
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Nathaniel Mendell, Partner, Morrison Foerster, Kristopher Hult, Principal, Charles River Associates, and Jonathan Porter, Partner, Husch Blackwell, discuss some hot topics related to artificial intelligence in health care and accompanying case law trends. They cover issues related to antitrust, patient facing applications, claims processing and cla…
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with two health IT leaders, Daniel Clark and Supantha Banerjee, about the current landscape of health IT and some of the biggest challenges they are seeing. They discuss how to drive efficiency and value in health IT systems, how to engage providers in the use of data…
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David E. Kopans, Partner, DLA Piper LLP (US), and Larry Pliskin, Senior Vice President, General Counsel & Chief Compliance Officer, Home Care Delivered, Inc., discuss current trends and developments surrounding the delivery of health insurance coverage in the United States. They cover artificial intelligence in health insurance, marketing health in…
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Leslie C. Overton, Partner, Axinn Veltrop & Harkrider LLP, speaks with Rebekah Goshorn Jurata, General Counsel, American Investment Council, and Dr. Isabel Tecu, Principal, Charles River Associates, about antitrust agencies' increased scrutiny of private equity in health care. They discuss certain aspects associated with the private equity model, w…
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Brad M. Thompson, Partner, Epstein Becker & Green PC, Chris Provan, Managing Director & Senior Principal Data Scientist, Mosaic Data Science, and Sam Tyner-Monroe, Ph.D., Managing Director of Responsible AI, DLA Piper LLP (US), discuss how to analyze and mitigate the risk of bias in artificial intelligence through the lens of data science. They cov…
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Jordan Zoeller, Senior Vice President, Stout, speaks with Julie Sullivan, Shareholder, Greenberg Traurig LLP, about recent trends in the regulation of transactions related to behavioral health providers. They discuss current federal and state oversight trends, state laws impacting behavioral health providers both at the hospital and outpatient leve…
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Andrew London, Partner, Foley Hoag LLP, and Peter Fjelstad, Assistant Vice President, State Regulatory and Legal Affairs, Pharmaceutical Care Management Association, discuss the evolution of federal preemption of state health care laws, mainly pertaining to ERISA and Medicare, and the corresponding increase in state efforts to regulate the structur…
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Michael Peregrine, Partner, McDermott Will & Emery, about the nature, role, and purpose of corporate officerships. They discuss general principles related to the roles and fiduciary duties of officers and the specific duties of the Chairman of the Board, CEO, sec…
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Caroline Reignley, Partner, McDermott Will & Emery LLP, and Travis Lloyd, Member, Bass Berry & Sims PLC, discuss site-neutral payment policy, an issue that is top of mind for many hospitals and health systems given the shifting legal landscape and congressional interest. They cover the history of site-neutral payments; issues related to relocation,…
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Joe Wolfe, Attorney, Hall Render Killian Heath & Lyman PC, speaks with Marissel Descalzo, Partner, Tache Bronis and Descalzo PA, about the current landscape of health care fraud settlements and enforcement activity. They discuss what triggers a false claim and accompanying investigation, what drives whistleblowers, patterns with respect to false cl…
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Nicholas Kump, Senior Associate, King & Spalding LLP, speaks with Kim Baltz, Director of Tax, Bon Secours Mercy Health, and Zack Fortsch, RSM US LLP (retired), about how health care organizations can navigate the Form 990. They discuss why the Form 990 is important, logistics for completing and submitting the Form 990, key parts and schedules in th…
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Tara Sklar, Faculty Director, Health Law & Policy Program, University of Arizona James E. Rogers College of Law, and Kathryn Huber, MD, Kaiser Permanente, discuss the prevalence of cognitive impairments as the U.S. population ages and the implications this has for the future of digital health care. They cover the legal and regulatory landscape and …
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Ritu Cooper, Shareholder, Hall Render Killian Heath & Lyman PC, Greg Demske, Partner, Goodwin Procter LLP, and Melissa Wong, Partner, Holland & Knight, discuss strategies that health care organizations can employ when dealing with fraud and abuse investigations. They cover the full life cycle of an investigation, sharing their own insights and expe…
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Alé Dalton, Partner, Bradley Arant Boult Cummings LLP, speaks with Mara Smith-Kouba, Counsel, Bristol Myers Squibb, and Avery Schumacher, Associate, Epstein Becker & Green PC, about the experiences and challenges of Millennial and Gen Z health law professionals. They discuss the takeaways from a survey of early career professionals by Major, Lindse…
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Jon Moore, Head of Consulting Services and Client Success and Chief Risk Officer, Clearwater, speaks with Leah Voigt, Chief Compliance Officer, Corewell Health, and Dr. Mark Sendak, Population Health and Data Science Lead, Duke Institute for Health Innovation, about the policies, procedures, and structures that guide the application of artificial i…
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Hope Levy-Biehl, Partner, Davis Wright Tremaine LLP, and Ryan Thurber, Shareholder, Polsinelli PC, discuss the growing trend of shifting patient care for acute illnesses into the home. They cover the federal hospital at-home waiver, state-level developments, special considerations related to the at-home care model, factors driving the growth of the…
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Ashlee Gray, General Counsel, Transforming Age, and Aleah Schutze, Of Counsel, Steptoe & Johnson PLLC, discuss how long term care providers can navigate the legal and practical considerations of medical marijuana. They cover the current legal and regulatory landscape, legal and compliance risks for providers, and best practices for providers regard…
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James L. Burke, Hall Render Killian Heath & Lyman PC, and Carmen Johnson discuss how to use value-based enterprise (VBE) within the Stark and Anti-Kickback safe harbors to advance health systems’ needs. They cover the four components of VBE, the Stark and Anti-Kickback VBE rules, and how creating a VBE can be a good strategy and significantly reduc…
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Measuring the Effectiveness of Your Compliance and Ethics Program, Using CMS's Requirements of Participation
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Joseph Zielinski, Compliance and Privacy Officer, CarDon & Associates, and Michelle R. Adams, Associate General Counsel, Ensign Services, discuss how to measure a long-term care facility’s compliance and ethics program. They cover why compliance is so important in the context of long-term care facilities, existing compliance and ethics frameworks, …
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Eric Setterlund, Partner, Bradley Arant Boult Cummings LLP, speaks with Melissa Soliz, Partner, Coppersmith Brockelman PLC, Annie Harrington, Chief Legal Officer, Pyx Health, and Sarah Raybin, Counsel, Vanderbilt University Medical Center, about how to launch a successful social determinant of health (SDOH) platform for sharing data among a patient…
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Health Care Corporate Governance: Implications of Current Antitrust and Competition Enforcement
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Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Michael Peregrine, Partner, McDermott Will & Emery, about how the Biden Administration’s antitrust and competition enforcement initiatives are impacting health care board duties. They discuss how health care antitrust risk and enforcement have changed and how hea…
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The health care industry is still parsing the effects of the Supreme Court’s recent decisions in Loper Bright Enterprises v. Raimondo, which ends Chevron deference, and SEC v. Jarkesy, which entitles defendants to a jury trial when the government seeks civil penalties. Chip Hutzler, Partner, HMS Valuation Partners, speaks with Greg Demske, Partner,…
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On June 20, a federal judge in Texas sided with the American Hospital Association in its lawsuit against the Department of Health and Human Services’ (HHS’) updated guidance on the use of tracking technologies. Andrew Mahler, Vice President, Consulting Services, Privacy & Compliance, Clearwater, speaks with Carolyn V. Metnick, Partner, Sheppard Mul…
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For more than six years and nearly 80 episodes, Norm Tabler has entertained AHLA with his unique take on recent health law and other legal developments. Now, Norm bids farewell to the Lighter Side of Health Law. New Health Law Daily Podcast Coming in January 2025 Coming in January 2025, AHLA’s popular Health Law Daily email newsletter will also be …
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Delphine O’Rourke, CEO, 8Fold Inc., speaks with Ramona Thomas, General Counsel & Vice President of Risk and Compliance, Planned Parenthood of Orange and San Bernardino Counties, about the recent Supreme Court decisions that impact women’s health. They discuss FDA v. AHM and the use of mifepristone in medication abortions, Moyle v. United States and…
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Edo Banach, Partner, Manatt Phelps & Phillips LLP, and Keith Lagnese, Chief Medical Officer, Sutter Care at Home, discuss the structure and delivery of palliative care. They cover issues related to regulation, oversight, and reimbursement. Edo and Keith spoke about this topic at AHLA’s 2024 Long Term and Post-Acute Care Law and Compliance in San Di…
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Dan Grauman, Managing Director and CEO, Veralon, speaks with Cristina Cavalieri, SVP and University Counsel, Thomas Jefferson University Hospital, and Jeannie C. Frey, SVP, Chief Legal Officer and General Counsel, CHRISTUS Health, about health care system governance structures. They discuss the drivers of health care governance structure changes, h…
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Valerie G. Rock, Principal, PYA, and Kristin M. Bohl, Member, Bass Berry & Sims PLC, discuss the 2024 Medicare Physician Fee Schedule (MPFS) Final Rule, specifically changes related to Evaluation and Management (E/M) visits. They cover CMS’ Framework for Health Equity and requirements related to clinical integration, community-based organizations, …
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Delphine O’Rourke, CEO, 8Fold Inc., speaks with Naseem Sayani, General Partner, Emmeline Ventures, about how the current legal and regulatory landscape is impacting innovation and investment in women’s health. They discuss the connection between investment and innovation and access to health care, where investment and innovation are taking place, h…
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