Section Chair's Column: Afterglow
By David L. Douglass, Sheppard Mullin, Washington, DC
I write my final Chair’s Column still basking in the afterglow of our first Section-wide leadership training meeting, in Denver. It was energizing to watch experienced health lawyers and our associated professionals come together to contribute their expertise, energy and talents to growing the Section and enhancing our ability to serve our members. The meeting epitomized the qualities that characterize the Section.
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Health Benefit Exchange Contracting – Providers could be Left Holding the Bag for Two Months of Claims on Subsidized Exchange Patients
By Brett Johnson, JD, MPH, MS, Center for Medical and Regulatory Policy, California Medical Association, Sacramento, CA
In 2014, many providers of healthcare services may not only discover that they are now contracted for health benefit exchange products under existing contracts, but that they may also be holding risk under one or more of those contracts. This is because federal law will allow exchange plan (officially known as “qualified health plan” (“QHP”)) issuers to pend claims submitted by providers in the last two months of a federally subsidized patient’s three-month grace period for premium payment delinquency.
Implementation of PPACA’s Cuts to Disproportionate Care Hospital Payments Foreshadows Negative Consequences for Many Hospital Systems
By Esther R. Scherb, Latham & Watkins LLP, Washington, DC
More than three years after the passage of the Patient Protection and Affordable Care Act (“PPACA”), and only a handful of months before its effective date, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule on how it intends to implement the legislation’s dramatic changes to the Medicare Disproportionate Share Hospital (“DSH”) program.
One More Time with Feeling: PPACA Cases Post 2012
By Bruce F. Howell, Schwabe, Williamson & Wyatt, Portland, OR
After the United States Supreme Court decision in 2012 upholding the constitutionality of the Patient Protection and Affordable Care Act (“PPACA” or the “Act”), new challenges to the provision of the Act have arisen.
Louisiana Supreme Court Denies HCQIA and State Law Immunity for Peer Review Action Against Physician
By Gilbert F. Ganucheau, Jr., Kathleen L. DeBruhl & Associates, L.L.C., New Orleans, LA
The Louisiana Supreme Court, in an opinion issued on June 28, 2013, interpreted both federal and state law to find that a hospital was not immune from liability for failure of the hospital to provide due process and to follow its Medical Staff Bylaws (“Bylaws”).
Managed Care Litigation, Second Edition --
By David M. Humiston Editor-in-Chief, Sedgwick LLP, Los Angeles, CA; ABA Health Law Section
“An important, authoritative ‘must have’ resource for practitioners to help them rapidly focus on key issues and expertly advise their clients.” —David M. Humiston, from the Preface
Managed Care Litigation, Second Edition is a practical reference written by litigation experts for practitioners who handle managed care disputes and need to be aware of all statutory, regulatory, and case law developments that impact businesses, health care providers, and insurance companies in the managed care arena. The treatise offers in-depth analysis of all the important issues in managed care litigation, providing both a basic overview and a comprehensive examination of legal matters.
- Regular Price: $455.00
- Special ABA Section Member Price: $341.25 with Priority Code HLBOOK
- 2013/Approx 1,500 pp. Hardcover/ISBN 978-1-61746-286-3/ABAWEB2286
Payment & Reimbursement Interest Group
The Payment & Reimbursement Interest Group follows trends, changes and practices in reimbursement, billing and collection under Medicare, Medicaid and other federal and state health care programs. The group also tracks major development relating to reimbursement and payment policies of other third party payors including commercial insurers and self-insured entities.
If you would like to join the Interest Group, click the following link: Health Law Section IG Sign-up Form.
The IG is led by Chair Joseph V. Geraci, Husch Blackwell LLP, Austin, TX and Vice Chairs Jessica Lamanna, UHS Inc, King Of Prussia, PA;Preeya M. Noronha, King & Spaulding LLP, Washington, DC; Lesley C. Reynolds, Fulbright & Jaworski LLP, Washington, DCand Melissa (Lisa) Thompson, Adelman, Sheff & Smith, Annapolis, Maryland.
ABA eSource Editorial Board
The ABA Health eSource Editorial Board is led by Editor, Marla Durben Hirsch, Potomac, MD; Chair Conrad Meyer, Chehardy Sherman, LLP, New Orleans, LA and editorial board members Claire Castles, Jones Day, Los Angeles, CA; Robyn Diaz, St. Jude Children's Research Hospital, Memphis, TN; Amy K. Fehn, Wachler & Associates, P.C., Royal Oak, MI; Steven Postal, National Association for Home Care and Hospice, Washington, DC; Robert T. Rhoad, Crowell & Moring LLP, Washington, DC and Jose Vela Jr, Assistant United States Attorney, Southern District of Texas, Houston, TX.
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|The opinions expressed are those of the authors and shall not be construed to represent the policies or positions of the ABA or the ABA Health Law Section.|
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