ABA Health eSource - Your link to the ABA's Health Law Section
November 2010 Volume 7 Number 3
Health Law Section News  November 4, 2010
November 9, 2010
Qualified Plan Amendments: What To Do Before Year End
(CLE Teleconference)

November 11, 2010
Elements of Successful Physician Compliance Programs
(CLE Teleconference)

November 16, 2010
To Disclose or not to Disclose: An Analysis of the New CMS Voluntary Self-Disclosure Protocol
(CLE Teleconference)
November 17, 2010
Health Plans: Compliance with PPACA's Health Claim and Appleals Process
(CLE Teleconference)
November 18, 2010
Fundamentals of Medicare/Medicaid
(CLE Teleconference)

Health Law Highlights

Latest Resources & News

PPACA Resources

HHS Office of Inspector General (OIG)

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CDC Public Health Law News

CDC Newsletter is a free electronic newsletter published monthly by the Centers for Disease Control and Prevention, Public Health Law Program


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

By now you should have received the brochure with the agenda for the Washington Healthcare Summit (“the Summit”); one of the Health Law Section’s primary in-person conferences. The Summit will be held Dec. 6-7, 2010 at the Ritz-Carlton, Pentagon City in Arlington, VA. You can access the brochure with the agenda and registration information here. This is the eighth annual Summit and believe it or not, a number of people signed up before the program was even announced. This is a tribute both to the consistent high quality of the speakers and participants as well as the Summit Planning Committee that works so hard each year to pull everything together.

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Without a Roadmap: What Direction will ACOs Travel?
By Sandra E. Quilty, Baudino Law Group, PLC, Des Moines, IA

Federal officials representing the Federal Trade Commission (FTC), the Centers for Medicare and Medicaid Services (CMS), and the Health and Human Services (HHS) Office of the Inspector General convened a public workshop to discuss how to form an accountable care organization (ACO) without violating fraud and abuse laws. The workshop, attended by more than 300 health industry representatives, was kicked off by opening remarks from the CMS Administrator, the FTC Chairman, and the HHS Inspector General. The federal officials discussed creation and development of ACOs section 3022 waiver authority, and the creation of new safe harbors and exceptions with regard to fraud and abuse laws.

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Impact of the Newly Issued Premium Refund Regulations on Federal Healthcare Reform
By Hilary Rowen, Sedgwick, Detert, Moran & Arnold, San Francisco, CA

On October 21, 2010 the National Association of Insurance Commissioners (“NAIC”) adopted regulations on retroactive refunds of health care premiums for 2011, 2012 and 2013. The regulations put meat on the rather bare bones of the “medical loss ratio” provisions enacted by Congress last March in the Patient Protection and Affordable Care Act (“PPACA”). Insurance is almost exclusively regulated at the state level. Currently, no federal agency has any significant experience in regulating the private health insurance market. In PPACA, Congress mandated that the NAIC – whose membership is the insurance regulators of the states and U.S. territories – develop premium refund regulations, subject to “certification” by the Secretary of the Department of Health and Human Services (“HHS”) by December 31, 2010.

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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.

Managed Care & Insurance Interest Group

The Managed Care & Insurance Interest Group serves as a resource to attorneys who represent or regulate entities and/or individuals doing business in the managed care industry. An emphasis is placed on tracking federal and state laws and regulations as well as market trends. Specific areas of focus include managed care liability; proposed statutory and regulatory reforms; HIPAA and other mandates governing disclosure of confidential patient information; antitrust enforcement actions; any willing provider and patient bill of rights legislation; insolvency issues affecting the organized delivery of care; contracting strategies and innovations; balance billing and out-of-network issues; state and federal managed care programs; restructuring of risk-sharing arrangements; and new products offered by payors and employers, such as network tiering..

The IG is led by Chair Denise Glass, Fulbright & Jaworski LLP, Dallas, TX and Vice-Chairs Jeffrey S. Gold, Healthcare Association of NYS, Rensselaer, NY; Leigh Anne Hodge, Balch & Bingham LLP, Birmingham , AL; Alice King, ESI Healthcare Business Solutions, LLC, Dallas, TX and Fred A. Smith III, Sedgwick, Detert, Moran & Arnold, Chicago, IL.

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.

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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