Physicians, lawyers to discuss latest health care developments at Chicago conference

Physicians and their counsel will explore the role of doctors in today’s changing health care environment during the American Bar Association’s Physicians Legal Issues Conference, June 7-9 in Chicago. Conference attendees will learn practical advice on healthcare dispute trends, the False Claims Act, how fair market value is determined in a health care merger and other legal issues.
On Thursday at 8:15 a.m., Bertha K. Madras, a member of the Presidential Commission on Combating Drug Addiction and the Opioid Crisis and professor of psychiatry at Harvard Medical School, will speak on addiction in America and the opioid crisis. 

On Friday at 8:15 a.m., Alec Alexander, deputy administrator and director for the Center for Program Integrity at the Centers for Medicare and Medicaid Services, will discuss CMS program integrity issues.

Conference highlights include:

• “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. A panel of experts, including Melinda Reid Hatton, general counsel, American Hospital Association, and Michelle Skipper, vice president, American Arbitration Association, will provide guidelines for Alternative Dispute Resolution (ADR), including differences between mediation and arbitration; review national healthcare ADR trends; and 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.

• “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 it 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 an FMV opinion; how “legal” terms (e.g., non-competes, representations and warranties) affect FMV and purchase price; and overview of the underlying variables that impact valuation multiples.

• “Will Medicare Revoke Your Billing Privileges? Don’t Answer “No” Too Quickly” — The Centers for Medicare & Medicaid Services (CMS) wields broad authority to revoke providers’ and suppliers’ Medicare billing privileges. This authority, one of CMS’s most potent program integrity tools, has been applied in seemingly draconian ways. This session addresses key issues for providers and suppliers facing revocation of billing privileges, including an overview of CMS’s revocation authority, how CMS is using this authority against provider and suppliers and strategies for appealing revocation.

• “Halifax False Claims Act Case: The Relator’s Perspective with the Taxpayers Against Fraud Education Fund” — Healthcare fraud is a persistent industry problem and costs taxpayers hundreds of millions of dollars a year. False Claims Act and qui tam whistleblowers can be one of the government’s strongest tools for combating this fraud, recouping taxpayer dollars and protecting patients. This panel provides an inside look at a whistleblower’s experience though a discussion with a former whistleblower in the health care industry.

• “HIPAA in a Digital World: Taking the Paper Out of Healthcare” — Since passage of HIPAA, pocket-size supercomputers are now common. Outside healthcare, almost any transaction can occur digitally, but healthcare clings to paper and ink. A panel of experts will discuss HIPAA myths in a digital age, including how technology can advance privacy and security, why apps and application program interfaces are the future, how HIPAA encourages data sharing and how attorneys can break down barriers to digital solutions.