2018 MCC & PLI Conference Thursday classes

Thursday June 7, 2018

8:00 - 8:15 am
Opening Remarks

Chair, Health Law Section
Hilary H. Young, JD, Joy & Young LLP, Austin, TX

8:15 - 9:00 am
Addiction in America: The Opioid Crisis & Beyond

SPEAKER: Dr. Bertha K. Madras, PhD, The Presidential Commission on Combating Drug Addiction and the Opioid Crisis & Professor, Dept. of Psychiatry, Harvard Medical School will be speaking on addiction in America and the opioid crisis.

9:00 - 10:00 am
Navigating the Minefields of a Successful Physician Hospital Collaboration

Physicians and hospitals are pursuing different forms of collaborative arrangements, including affiliations, joint ventures, PHOs, ACOs, and other networks. These collaborations may help providers expand into new service areas or new payment models focused on quality and efficiency goals. The panelists will discuss:

•           Strategic considerations for hospitals and physicians;

•           Evolving physician hospital collab models beyond employment or clinical co-management;

•           Overlap of strategic business objectives and legal issues;

•           Checklists to address legal and business issues during informational and operational phases

SPEAKERS: Violet Anderson, JD, Vice President, Regional General Counsel, Christus Health, Irving, TX
Clay Countryman, JD, Breazeale, Sachse & Wilson, Baton Rouge, LA

10:00 - 10:15 am
Break

10:15 - 11:15 am
Will the FTC Block Your Physician Practice Merger? Here’s How to Tell

Physician practice mergers are now a major focus of FTC enforcement efforts, but how do you tell whether a transaction could be challenged? When might you need specialized antitrust guidance? What are the danger signs? What types of evidence might you face? Two experienced healthcare antitrust attorneys will discuss these questions and others. After providing a short background, they will explain how physician practice mergers, whether resulting from a hospital acquisition or a merger of independent practices, whether horizontal, vertical, or both, are analyzed, focusing on the major variables and types of evidence agencies consider, and a number of practical considerations that inform an analysis.

SPEAKERS: Christi J. Braun, JD, Managing Counsel, Vanderbilt University Medical Center, Nashville, TN
Jeff Miles, JD, Senior Counsel, Baker Donelson, Washington, DC

11:15 am - 12:15 pm
The Dollars and Sense of Out-of-Network Reimbursement

Out-of-network (OON) providers face many challenges, such as payments from payers that fall short of billed charges and difficulties with balancing billing patients. To help providers navigate this landscape, the speakers will offer insights on:

•           Key types of OON payment methodologies

•           OON laws in CA, TX and IL, including aims, differences and effectiveness of such laws

•           Emerging trends in federal and state legislation

•           Practical solutions and approaches to resolve disputes with payers

SPEAKERS: Christian Puff, JD, Hall Render, Dallas, TX
David M. Rosenberg-Wohl, PhD, JD, President, Hershenson, Rosenberg, Wohl APC, San Francisco, CA

12:15 - 1:15 pm
Lunch on your own

1:15 - 2:15 pm
Healthcare Dispute Trends and Innovative Conflict Resolution

Physicians, hospitals and health plans have disputes.

The forum and process for addressing case disputes can significantly impact the resolution of a dispute and how to salvage the relationships of those involved. The panel will:

•           Provide guidelines for Alternative Dispute Resolution (ADR); including differences between mediation and arbitration

•           Review national healthcare ADR trends

•           Explore the pioneering approach of a Mediation and Conflict Resolution Officer within a healthcare system to resolve conflicts among and between providers, care teams, hospital departments, and relevant third parties

SPEAKERS: Melinda Reid Hatton, JD, General Counsel, American Hospital Association, Washington, DC
Michelle Skipper, Vice President, American Arbitration Association, Charlotte, NC
Martin Stillman, MD, JD, Mediation and Conflict Resolution Officer, Hennepin County Medical Center, Minneapolis, MN

2:15 - 3:15 pm
False Claims Act – An Open Relator and Defense Counsel Conversation

Relator and defense counsel have different perspectives and priorities in alleged fraud cases. This session brings these varying, often conflicting, viewpoints together for a lively discussion of:

•           Recent False Claims Act case updates

•           Practical real-world ideas for physicians to address and prevent relators and the government from asserting False Claims Act violations

•           The government’s use of data analytics to scrutinize physician billing

•           Future enforcement and case trends

SPEAKERS: Lisa M. Noller, JD, Foley & Lardner, Chicago, IL
Matthew K. Organ, JD, Partner, Goldberg Kohn, Chicago, IL
MODERATOR: Philip Brewster, JD, Brewster Law Firm LLC, Winnetka, IL

3:15 – 3:30 pm
Break

3:30 - 4:30 pm
Physician Investment Opportunities – What Are the Regulatory Pitfalls?

Physician investment in healthcare businesses, such as ancillary or management services organizations, must be carefully scrutinized to ensure compliance with various state and federal healthcare laws. This presentation will provide an overview of investment opportunities and explain why they are offered. In particular, this presentation will discuss:

•           Why investment opportunities convey regulatory risks with potential civil and criminal sanctions

•           Structuring investments to meet Stark Law exceptions and Anti-Kickback Statute safe harbors

•           Compensation structures that may be problematic, & fair market value and appraisal issues

•           State corporate practice of medicine and fee-splitting implications when investing with non-physician entities or individuals

SPEAKERS: Richard Y. Cheng, JD, CHC, Dykema Cox Smith, PLLC, Dallas, TX
Nicholas A. Newsad, Healthcare Transaction Advisors, Littleton, CO

4:30 – 5:30 pm
Myth of the Multiple – How to Agree on a Price

Healthcare M&A is fraught with misperceptions on how fair market value (FMV) is determined and how it relates to the final purchase price. This session aims to educate on how FMV is determined, how FMV relates to and informs purchase price negotiations, key compliance issues that may impact FMV, and how non-financial deal terms can impact purchase price. Specific topics include:

•           Legal reasons for obtaining a FMV opinion

•           How “legal” terms (e.g., non-competes, representations and warranties) affect FMV and purchase price

•           Overview of the underlying variables that impact valuation multiples

SPEAKERS: Jason Ruchaber, CFA, ASA, Managing Director, VMG Health, Denver, CO
Emily Tremmel, JD, Associate General Counsel, Advocate Health Care, Downers Grove, IL

6:00 – 7:00 pm
Networking Reception

Enjoy a chance to relax and network with colleagues over drinks and hors d’oeuvres. You will have the opportunity to meet our speakers, as well as members of the American Bar Association Health Law Section and the Chicago Medical Society