ABA Health eSource March 2013 Volume 9 Number 7
ABA Health eSource - Your link to the ABA's Health Law Section
March 2013 Volume 9 Number 7
Health Law Section NewsMarch 27, 2013
March 28, 2013
Fundamentals of Medicare/Medicaid
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Cutting Through the HIPAA Hype: What You Need to Know About the HITECH Act Rules
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Emerging Issues in Healthcare Law Materials
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Chair's Column: Professional Enrichment

Attendees at last month's Emerging Issues Conference enjoyed stimulating and insightful discussions and analysis of new health law challenges, obligations and opportunities. The conference covered ACOs, enforcement trends, evolving compliance obligations, the challenges presented by provider integration and many other topics. Panels on FDA regulation of our food and our DNA gave us a lot to chew on (bada boom).

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This edition of eSource is brought to you by the Medical Research, Biotechnology & Clinical Ethical Issues Interest Group.

CMS Acquiesces to Hospital Pressure, Allows Part B Billing of Hospital Services Following Part A Denial of Inpatient Hospital Claims for Medical Necessity: Is It Enough?

By Jessica L. Gustafson and Abby Pendleton, The Health Law Partners, P.C., Southfield, MI

On March 13, 2013, the Centers for Medicare & Medicaid Services (“CMS”) concurrently issued Ruling CMS-1455-R (the “Ruling”) and a proposed rule (the “Proposed Rule”) to revise Medicare Part B billing policies in the event of Part A inpatient claim denials based on medical necessity. While the Ruling and Proposed Rule purport to provide hospitals with a mechanism to receive reimbursement for services rendered in the event of a Medicare Part A inpatient claim denial, both the Ruling and Proposed Rule are limited, offering no viable long term solution for hospitals.

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Ethical and Legal Issues Arising from the Informed Consent Process in Fertility Treatments

By Catherine Tucker, Concord, NH

As with any medical procedure, patients must provide informed consent to fertility treatments such as artificial insemination and in vitro fertilization (“IVF”). Informed consent occurs when a patient understands the nature of the proposed treatment as well as the potential benefits and risks of the treatment and potential alternatives, and voluntarily chooses to proceed with the treatment.

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HIPAA Omnibus Final Rule Modifies Notice of Privacy Practices Requirements for Covered Entities

By Kimberly J. Kannensohn, Nathan Kottkamp and Allison Harms, McGuireWoods, LLP, Richmond, VA

On Jan. 17, 2013, the Department of Health and Human Services (“HHS”) released the Omnibus Final Rule pursuant to the Health Information Technology for Economic and Clinical Health Act of 2009 (“HITECH Act”) and the Genetic Information Nondiscrimination Act of 2008 (“GINA”).

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Five Common Sense Strategies For Structuring Co-Management Agreements After Advisory Opinion 12-22

By Catherine Greaves, Cox Smith, Austin, TX

As healthcare reform and other factors have increased the pressure to provide quality patient care in a cost effective manner, hospital-physician integration has been seen as one way to accomplish this goal.  Co-management agreements are an increasingly popular method to achieve this desired hospital-physician integration.  As the name implies, these are generally arrangements through which a physician group assists in the management of a single service line or department of a hospital.

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The Importance of Advance Health Planning For Your Clients and Yourself
By Nathan Kottkamp, McGuireWoods, LLP, Richmond, VA

Ben Franklin wisely quipped: “In this world nothing can be said to be certain, except death and taxes.” Unfortunately, without a specific deadline on the death issue, most of us put off planning for it. Most of us also put off planning for healthcare crises. In fact, it is estimated that 75 percent of Americans have never taken the time to discuss their wishes or provided any written guidance to loved ones or healthcare providers in the event they are unable to speak for themselves.

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Medical Research, Biotechnology & Clinical Ethical Issues Interest Group

The Medical Research, Biotechnology & Clinical Ethical Issues Interest Group provides a forum in which members of the Health Law Section can consider and seek guidance about the legal and ethical implications of the difficult conundrums that arise in the clinical arena.

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 Carol A. Poindexter, Shook Hardy & Bacon LLP, Kansas City, MO and Vice Chairs La Vonda R. De Witt, Atlanta, GA; Philip S.  Brewster, Brewster Law Firm LLC, Winnetka, IL; Rebecca Fe De Montreve-McMinn, Shavano Park, TX and Stephen C. Pappas, The Woodlands, TX.


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; Robert T. Rhoad, Crowell & Moring LLP, Washington, DC; Jennifer Tsao, Hernandez Schaedel & Associates LLP, Pasadena, CA and Jose Vela Jr, Assistant United States Attorney, Southern District of Texas, Houston, TX.


Do you want to communicate your ideas to thousands of other members? To contribute a newsletter article on a health law topic, send us your ideas to simeon.carson@americanbar.org.
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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