Chair's Column
By Linda A. Baumann, Arent Fox LLP, Washington, DC

As those of you who were there can attest, our Emerging Issues Conference (“EMI”), held in New Orleans from Feb. 23-25, 2011, was a tremendous success. Over 300 people attended a wide range of outstanding, informative and enjoyable programs in the wonderful ambiance of pre-Mardi Gras New Orleans. There were parades (complete with bead-catching opportunities) and street bands right outside the hotel, in the Garden District and other venues, fantastic food and fellowship.

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Accountable Care Organizations Proposed Regulations Reveal Significant Financial Opportunities and Structural Requirements
By Alan S. Gassman and Martha Sosa, Gassman, Bates & Associates, P.A., Clearwater, FL

The proposed regulations with commentary on Accountable Care Organizations (“ACOs”) were released by the Department of Health and Human Services (“HHS”) on Thursday, March 31, 2011 and provide significant specificity on what Medicare is intending to require and provide for ACOs. The proposed regulations are 59 pages long; the preamble is 370 pages long. This article provides a bird’s eye view of the proposed regulations and the preamble. ACOs may be up and running by January 1, 2012.

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Stark Law Update: Determining Whether Compensation is Fair Market Value or Takes Into Account the Volume or Value of Referrals
By David L. Haron, Suzanne D. Nolan & Mercedes Varasteh Dordeski, Frank Haron Weiner, PLC, Troy, MI

Healthcare arrangements within the purview of federal Stark laws require a careful analysis of the manner in which physicians are compensated. Over the past year, three significant court decisions have emerged which add another layer of complexity to the “compensation” issue. Therefore, any attorney reviewing an arrangement for compliance with Stark should be familiar with these decisions.

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CMS Issues Proposed Rule Requiring States to Implement Policies for Payment Adjustments for Provider Preventable Conditions
By Conrad Meyer, Chaffe McCall, L.L.P., New Orleans, LA

On February 17, 2011, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would implement Section 2702 of the Patient Protection and Affordable Care Act (PPACA) requiring states to implement policies under their Medicaid programs prohibiting federal payments to states for providing medical assistance for healthcare-acquired conditions. The proposed rule would require the states Medicaid programs to implement these policies by July 1, 2011.

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Bruesewitz v. Wyeth's Impact on the Vaccine Safety Debate
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Childhood vaccines are extolled for effective prevention of dangerous diseases. However, a persistent anti-vaccine movement resists vaccination due to real and perceived links between vaccines and adverse health effects, including autism. Closely related to the vaccine safety debate is the policy concern about balancing the need to compensate individuals who are harmed by vaccines and to prevent vaccine manufacturers from exiting the market due to the prospect of unmanageable tort liability. The recent Supreme Court decision in Bruesewitz v. Wyeth strikes a balance in favor of shielding vaccine manufacturers from design-defect liability and thus limits the options for claimants of certain vaccine-related injuries to recover compensation.

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The Patient Protection and Affordable Care Act of 2010 ("PPACA") Includes Mandatory Compliance and Ethics Program Requirements for Nursing Home Providers

By Beth Rosenbaum, Benesch Friedlander Coplan & Aronoff LLP, Cleveland, OH and Ari J. Markenson, Benesch Friedlander Coplan & Aronoff LLP, White Plains, NY

In March 2000, the Office of the Inspector General of the U.S. Department of Health and Human Services (the “OIG”) published compliance program guidance for nursing facilities setting forth seven elements of an effective compliance program and discussing risk areas that providers should focus on. In September 2008, the OIG published supplemental compliance program guidance for nursing facilities setting forth additional risk areas for nursing home providers. Each of these OIG guidance documents were published to assist providers with voluntary compliance program development.

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HIPAA Enforcement Escalates -- What Does This Mean for the Healthcare Industry?

By Shannon Hartsfield Salimone, Holland & Knight LLP, Tallahassee, Florida

For many years, HIPAA enforcement activities were minimal, or did not result in significant penalties, giving many covered entities a false impression that HIPAA compliance need not be a priority. All of that changed, however, in February of 2011 when the Department of Health and Human Services (HHS) announced HIPAA settlements and penalties totaling $5.3 million, involving two different covered entities.

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Did you know membership in an interest group is FREE with your Health Law Section membership?

Did you know your membership in the ABA Health Law Section qualifies you for free membership in up to three interest groups of your choice? Interest groups, which are comprised of twelve practices areas within health law, make significant contributions to the Section's programming, publications and legislative initiatives. The interest groups also provide an excellent opportunity for you to interact with and have access to some of the most outstanding lawyers in the legal community. You can enroll on our webpage by clicking here. If you have any questions or need more information, please contact Simeon Carson at simeon.carson@americanbar.org

Healthcare Fraud and Compliance Interest Group

The Healthcare Fraud & Compliance Interest Group addresses topical, cutting edge issues which are the focus of fraud and abuse prevention, investigations and prosecutions.

The IG is led by Chair Donald H Romano, Arent Fox LLP, Washington, DC and Vice-Chairs Gwen Kathleen Chapman, Arthocare, Inc., Austin, TX; James G. Sheehan, Office of the New York State Medicaid Inspector General, Albany, NY; Martha J. Talley, Office of Health & Human Services, Chevy Chase, MD and Joel G. Wakefield, Coppersmith Schermer & Brockelman PLC.

If you would like to join the Interest Group, continue by clicking the following link: Health Law Section IG Sign-up Form.

ABA eSource Editorial Board

The ABA Health eSource Editorial Board is led by Chair Lisa Genecov, Locke Lord Bissell and Liddell LLP, Dallas, TX and editorial board members Michael E. Clark, Duane Morris LLP, Houston, TX; Adrienne Dresevic, The Health Law Partners, PC, Southfield, MI; Marla Durben Hirsch, Potomac, MD; Conrad Meyer, Chaffe McCall, LLP, New Orleans, LA and Jennifer Tsao, Hernandez Schaedel & Associates LLP, Pasadena, CA.